Altering a patient’s genetic makeup to treat a disease

Dear Doc,

Why has modern science placed so much emphasis on genetic engineering? Also, could you shed light on laser surgery. Is it a scientific breakthrough?

 Alnashir D Walji

Dear Alnasir,

Genetic engineering is the laboratory modification of the genetic material/DNA of an organism so as to create changes in the organism that can continue over time. It has been used to genetically modify livestock and plants such as to make disease-resistant or drought-resistant plants. It has also been used to make medical products like hormonal treatments - human insulin and growth hormone, interferon and for making some vaccines.

Gene therapy refers to changing genes so as to cure genetic diseases or to prevent them in people who are already genetically predisposed. The technique allows healthcare providers to treat certain conditions by modifying one’s genetic makeup instead of using traditional treatment methods like medication and surgery.

Gene therapies can work by several mechanisms, according to the Food and Drug Administration:

Replacing a disease-causing gene with a healthy copy of the gene

  Inactivating a disease-causing gene that is not functioning properly

  Introducing a new or modified gene into the body to help treat a disease

There’s a lot of ongoing research on utilising genetic engineering for genetic diseases and cancer prevention and treatment.

There’s also a lot of concern on whether the research processes and the action of modifying DNA is ethical. There are also concerns that genetically modified plants may have negative effects on the persons consuming them and that they may also hurt the environment. It is also a concern that genetically modified plants may not have the properties that they are said to have.

For animal and human genetic engineering, the main concerns are around ethical and social implications. While gene therapy is generally welcome due to the potential for management or cure of serious conditions, there are concerns around the ethics of the research process, the potential risks when delivering the treatment, possible failure of treatments and potential negative effects on children born later to those who receive the gene therapy. Genetic engineering to improve performance or specific traits in humans faces even greater criticism and the research is less advanced.

Laser surgery uses light beams to cut, instead of using surgical instruments. Laser is an acronym that stands for Light Amplification by Stimulated Emission of Radiation. The laser is a device that produces light waves that are “coherent”, meaning that they have similar wave lengths and move in the same direction, and the waves are “in phase”, meaning that the light waves travel together, all this producing very narrow and bright light beams that can be focused on a spot, also concentrating a lot of energy on that one spot.

Lasers are used in many devices and in diverse fields. For surgery, lasers help to improve precision, especially for surgeries conducted on a small area and there is less damage to surrounding tissues, and healing may be faster. In addition, laser has a cauterising effect, meaning that it burns the tissue, which stops bleeding, prevents infection and can remove unwanted or damaged cells. However, laser therapy is costly and sometimes repeat treatments may be required.

Laser surgery may be used for treatment of some conditions affecting the eyes, the skin, the kidney, the prostate and in cancer treatment. Laser therapy may also be used in management of nerve pain. It may also be used in cosmetic procedures such as removing birth marks and tattoos, managing hair loss or removing hair, and tooth whitening.

The technique used to deliver the laser beams and the exact type used depends on the specific procedure such as carbon dioxide lasers for shallow cuts on the skin versus delivery of the laser through an endoscope for internal organs.

While recovery after laser therapy may be shorter than after traditional surgery, the recovery process and possible complications are similar. For some procedures, the laser therapy may need to be repeated later.

Hey doctor,

I currently weigh 75kg. I have a big belly and at times I feel like I am pregnant, yet I am not because I experience a regular monthly period. Then there is this hardness near the breast. What might that mean? Anna

Dear Anna,

Having excess body fat around the waist is called abdominal obesity or visceral/central obesity. For women, this is a waist circumference greater than 35 inches (or 88cm), and for men, it is a waist size greater than 40 inches (102cm). Abdominal obesity carries a higher risk of developing high cholesterol levels, high blood pressure and problems with blood glucose/sugar control. Because of this risk, it is advisable to reduce abdominal obesity through exercise and diet. Ideally, exercise should include daily moderate intensity activity for 30 to 60 minutes and strength training. The diet should consist of complex starches, lean proteins and vegetables. The hardness near the breast may be as a result of irritation from a bra, or from fluid build-up under the skin, or from infection or skin conditions. It may also be due to an abnormal growth. It is advisable for you to be reviewed by a doctor to determine whether there are any underlying conditions. Relevant tests will be conducted, and this may include a pregnancy test. Treatment will be tailored according to the identified causes.  It is also advisable for you to get counselling on the best diet for you from a nutritionist and to also exercise daily, and if possible, with the guidance of a personal trainer.

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