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Biotech Businesses Medicine

Genetic Testing Coming To a Drugstore Near You 110

Hugh Pickens writes "The Chicago Sun-Times reports that Walgreens is slated to begin selling genetic-testing kits priced from $20 to $30 apiece that can tell people whether they're likely to get breast cancer, Alzheimer's disease, become obese, or suffer from a range of other maladies. However, to get the results of various tests, shoppers will have to fork over an additional $79 for drug-response results, $179 for 'pre-pregnancy planning' results, $179 for health condition results, or $249 for a combination of the three. Pathway Genomics and other companies already offer such tests online, but Walgreens will be the first brick-and-mortar retailer to sell them. FDA spokeswoman Karen Riley says Pathway overstepped its bounds when it announced its plans to market the tests directly to the consumer at 6,000 of Walgreen's 7,500 stores and wants Pathway Genomics to submit data showing that its tests give accurate results. 'The claims have limitations based on existing science,' says Riley, 'and consumers should not be making important medical and lifestyle decisions based on these tests without first consulting a health-care professional.' Walgreen responded that FDA clearance is not required to sell the kit in its stores; and anyway, the drugstore chain already sells other diagnostic and testing products such as pregnancy tests, paternity tests, and drug tests."
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Genetic Testing Coming To a Drugstore Near You

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  • by eldavojohn ( 898314 ) * <eldavojohn@gm a i l . com> on Wednesday May 12, 2010 @07:06AM (#32180854) Journal
    Here's some required reading [pathway.com] if you are contemplating this. Most importantly:

    5. Services Limitations. The Services provided by Pathway Genomics are solely for research and educational purposes and uses. Although based on scientific research, the Services, including all information about genetic findings and probabilities, have not been fully validated and shall not be relied upon by you or any other person to diagnose, treat or prevent any disease or health condition. You should consult with a physician or other appropriate health care professional regarding the diagnosis, treatment and prevention of any disease or health condition.

    Emphasis mine. I knew that'd be in there along with point 13 (the indemnity clause). On the plus side they've got this:

    9. Proprietary Rights. You own all Genetic Information derived from your saliva or other biological material. Genetic Information means the As, Ts, Cs, and Gs at particular locations in your genome.

    If you submit or post content on the Pathway Genomics website or otherwise using the Services, (a) you retain any copyright rights that you hold in this content, and (b) you grant Pathway Genomics a nonexclusive, perpetual, irrevocable, royalty-free, worldwide license to copy, modify, translate, publicly display and distribute this content. This license grants Pathway Genomics the right to use this content to provide the Services and to provide this content to other companies and individuals affiliated with Pathway Genomics. You warrant to Pathway Genomics that you have the right, power and authority to grant this license.

    Of course we all would think that would go without saying but you never know these days and in bullet 12 they follow that up with you have permission to send them this sample. I shudder to think that someone might grab some of their significant other's saliva in order to see what their genetic tests reveal and call the whole thing off based on the fact that their offspring would have a 5% higher chance of getting breast cancer according to The Super Deluxe Cancer Finder 3000.

    • I wonder what "other companies and individuals" are affiliated with Pathway Genomics?
    • by ledow ( 319597 ) on Wednesday May 12, 2010 @07:18AM (#32180910) Homepage

      I think the biggest problem with your last comment is that it should be a good thing... if you are with someone "significant" who calls the whole thing off because of things like that, then you're much, much better off without them, surely? More dangerous would be something like you sending off a workmate's saliva to see if they have HIV and then using that information to force them out of a job, etc. That's the sort of casual mis-use that we *don't* need.

      • Could be worse (Score:4, Insightful)

        by Moraelin ( 679338 ) on Wednesday May 12, 2010 @07:37AM (#32181022) Journal

        It could, and probably will, be worse. I can see this kind of thing used by companies when they're supposedly testing for drugs, and it'll just so happen that down the line there'll be some "restructuring" in which everyone who is slightly more probable to need sick days down the line is silently let go. And God have mercy on you if someone does a statistic to the effect of "people with gene XYZ show a 2% higher chance of depression / drug use / paedophilia / having problems with authority / whatever."

        • Re: (Score:3, Informative)

          by AndersOSU ( 873247 )

          There are laws against using genetic information for hiring/firing decisions and health insurance purposes.

          Laws aren't perfect, so it's conceivable and perhaps even probable that a few people will be negatively impacted by insufficiently private genetic testing, but systematic abuse of this kind of information opens you up to law suits that are far more serious than slightly elevated group insurance rates.

          • by maxume ( 22995 )

            Even without laws, the underlying assumption that there is actually a genetic underclass that is worth discriminating against is sort of silly. Companies discriminating on productivity are likely to be far more successful than companies discriminating on statistical likelihood of future sick days.

            Insurance is different, but perhaps genetic testing will force us (as a society) to confront the difference between health coverage and insurance.

            • Margaret Sanger, the founder of Planned Parenthood, was unpopular for her views on eugenics. Too soon after Nazi Germany and their experiments with eugenics. But, to some degree, eugenics might be unavoidable.

              We already have genetic counselors. How is that different from eugenics, I don't know. Perhaps a matter of degree. Many of us already deliberately avoid childbearing to avoid transmission of a wide variety of congenital diseases.

              This genetics testing helps to improve detection of more subtle defe
              • The reason eugenics is a dirty word is that it is implicitly directed. Individuals making independent fitness decisions about their mates is called natural selection. With the availability of genetic testing we've gone from avoiding mates with cleft pallets and clubbed feet to (possibly) avoiding reproducing with someone with DG5G in their genome. It's the same as it always was, only now with more information.

                • by mollog ( 841386 )
                  There is a truth to what you said; Sanger promoted a compulsory birth control for people with genetically caused disease.

                  But, with the availability of low-cost screening of individual genetic makeup, is seems inevitable and advisable that public policy will be created that coerces individuals to avoid parenthood when there is a risk of disease. In a society where health care is becoming an expected socially provided benefit, the impending down-side is that society will act to prevent disease, if only to
          • Re: (Score:3, Insightful)

            by denzacar ( 181829 )

            There are laws against using genetic information for hiring/firing decisions and health insurance purposes.

            You don't fire someone because he/she is likely to get sick, is homosexual or a lower race.
            You find something else to fire them for. See this instructional video. [imdb.com]

      • More dangerous would be something like you sending off a workmate's saliva to see if they have HIV and then using that information to force them out of a job, etc. That's the sort of casual mis-use that we *don't* need.

        Why would you use a genetics test to test for HIV? While you can now test for HIV with saliva, Pathway Genomics [pathway.com] does not check for HIV as it's not a genetically inherited disease. It can be passed from mother to offspring prior to or during birth but it's not inherit to the genetic material. These tests at Walgreens are not to check for HIV or AIDS.

        if you are with someone "significant" who calls the whole thing off because of things like that, then you're much, much better off without them, surely?

        Depends, relationships are all about compromise. You meet the perfect someone but they're a hypochondriac when it comes to cancer. Oh well, you can work past that until they get their hands on this test and demand you take it or, like I said, send in your sample without your consent. No one's perfect. Someone worrying now about their offspring's future is not a bad thing. The bad thing is proceeding without consent. Your fears, however, make absolutely no sense.

        Someone with a genetically inherited disease working next to you does not pose a risk unless you plan on them becoming your father or mother.

        • by tom17 ( 659054 )
          I didn't know genetics can be passed down through adoption!
        • by zarzu ( 1581721 )

          (...) unless you plan on them becoming your father or mother.

          your ideas intrigue me. i'd like to subscribe to your newsletter.

    • I shudder to think that someone might grab some of their significant other's saliva in order to see what their genetic tests reveal and call the whole thing off based on the fact that their offspring would have a 5% higher chance of getting breast cancer according to The Super Deluxe Cancer Finder 3000.

      I wouldn't be *as* concerned with the interpersonal relationship side of things. If someone learns they both carry the recessive Gene for a harmful genetic disorder (*not* trivial stuff like eye color or crow's peak) then it's important to know. And maybe with their values they *want* their own kid with their mate, and not from a sperm/egg donor or adoption agency. If it was anything more trivial than that, then it was probably not a healthy relationship anyway.

      The big thing would be companies using said

      • If someone learns they both carry the recessive Gene for a harmful genetic disorder (*not* trivial stuff like eye color or crow's peak) then it's important to know.

        In our own minds, we feel it's important to know. However, by knowing and avoiding mating with someone with a recessive gene for some condition we consider tragic, we may be preventing the completion of a gene mutation in progress that would strengthen us at some point in the future. No, not all of our offspring live as a result of these inherited diseases but it is likely some will and they may reproduce, potentially passing on a new gene that avoids this condition in the future.

        We learn more from adve

        • Are you trolling or was that a serious statement?

          We learn more from adversity. Having the perfect child doesn't teach us anything. I would posit that many of those parents who have to deal with children with disabilities learn a lot more about parenting and selflessness than those whose children are considered "normal" by society.

          Take a moment to consider life from the disabled child's point of view. Obviously, you didn't think this one through.
          • Take a moment to consider life from the disabled child's point of view. Obviously, you didn't think this one through.

            And you'd be wrong.

            How about those children that go on to overcome their adversities? Are you going to avoid having a child because that child may have dyslexia? Cerebral palsy? Diabetes? You don't want your child to go through breast cancer? Perhaps Crohn's disease? Hemophaelia? How about those children that go on to do great things even though their genetic makeups are not what we may consider normal? Are you going to shun Helen Keller? Ever stopped to consider the difficulties through which s

    • by clemdoc ( 624639 )

      Here's some required reading [pathway.com] if you are contemplating this. Most importantly:

      5. Services Limitations. The Services provided by Pathway Genomics are solely for research and educational purposes and uses. Although based on scientific research, the Services, including all information about genetic findings and probabilities, have not been fully validated and shall not be relied upon by you or any other person to diagnose, treat or prevent any disease or health condition. You should consult with a physician or other appropriate health care professional regarding the diagnosis, treatment and prevention of any disease or health condition.

      Emphasis mine. I knew that'd be in there along with point 13 (the indemnity clause).

      What's the problem? Of course decisions based on genetic testing should be taken only after consulting a doctor. That actually should be written in big letters on the packaging.

    • Well, as long as that someone does any of
      - smoke
      - eat fast food crap
      - use nasty chemicals for cleaning
      - use nasty chemicals on the body
      - use furniture with nasty chemicals
      - live in a city with dirty air
      - live in a house with nasty chemicals built-in
      - gets too much radiadion (e.g. UV)
      - etc...
      he/she is an idiot when acting like that anyway.

      I don’t shudder. since I don’t want to date idiots anyway. ^^

    • I've always thought about: Walk-in MRI clinics. Show up with say, $100 and we'll throw you in a machine and give you a DVD of the ONLY copies of the images - after you sign a waver absolving us of all responsibilities about what the images mean, leaving the analysis to you and your doctor(s).

      Of course I suspect all doctors would refuse to even look at the images, let alone analyise them, as they didn't get their beak wet from the clinic profits or insurance overcharges. Plus the AMA would probably muscl
      • I've been to walk in MRI clinics. Siker Medical MRI in Portland Oregon, my doctor at a hospital with multiple MRI machines recommended I go there because Siker had newer ones and better ones.

        I had my MRIs and was given the images on CD-ROM along with software to view them for Mac/Windows.

        It costs a crapload more than $100 though since the Siemens 3 Tesla machine costs about 3 million dollars and a couple hundred thousand dollars a year to keep running, plus salaries for the staff. I hear the computers and s

    • by orgelspieler ( 865795 ) <w0lfieNO@SPAMmac.com> on Wednesday May 12, 2010 @12:52PM (#32184578) Journal

      Funny that they claim you retain copyright to your genetic information, just so they can claim you've given them permission to distribute it. In order for something to be copyrighted, it has to have creative content. That means you can't keep them from publishing it based on copyright law, but you can't grant permission based on copyright law either. They're trying to use this as an end-run against privacy and non-discrimination laws (HIPAA and GINA).

      The service limitation clause is more of the same. They're pretending they're not providing a medical service, so they won't be held accountable. HIPAA privacy rules only apply to medical service providers. Very sneaky, these guys.

      It's sad to think that people were mocking congress when they passed the genetic discrimination law. Now it appears they didn't go far enough. Maybe they should have made a genetic information protection law. The Supreme Court (or was it a federal court?) recently ruled that they can't patent genes (BRCA). So maybe there's hope.

  • next theyl be hiring surgeons and charging "sale" prices for operations..

  • “The claims have limitations based on existing science, and consumers should not be making important medical and lifestyle decisions based on these tests without first consulting a health-care professional,” Riley said.

    So why don't I just ask the gypsy fortune teller instead. She probably has more experience experience.

    • by fuzzyfuzzyfungus ( 1223518 ) on Wednesday May 12, 2010 @07:27AM (#32180968) Journal
      They gypsy certainly has better applied psych skills; but, for a great many genetic(or suspected but not yet fully elucidated) conditions, there is a way that is cheaper and more effective.

      Family history.

      With the exception of (not-nonexistent; but quite rare) conditions caused by a mutation or mutations that originated with you, not earlier in the line, or a fairly small number of well developed genetic tests, most of which you aren't going to get over the counter at CVS, you'll have a better chance of learning about the likely phenotypic consequences of your genes by looking at mommy and daddy, keeping their environment in mind(daddy's lung cancer probably doesn't count as "family history" if he was a chain-smoking asbestos miner, it probably does if he wasn't).

      DNA sequencing has, certainly, gotten cheap enough that you might actually get a fairly accurate reading of a subset of your genome for a hundred bucks through the mail. However, I'd be quite surprised if, when it comes to predicting the consequences, which are what people actually care about, the method is going to outperform just looking at family history. In a lot of cases, the science simply isn't settled, at any price. Even where it is, you are going to be getting some mail merge algorithm, not a geneticist, or even a genetic counselor, for your hundred bucks.
      • Here's the catch (Score:4, Informative)

        by nbauman ( 624611 ) on Wednesday May 12, 2010 @10:57AM (#32183206) Homepage Journal

        there is a way that is cheaper and more effective.

        Family history.

        With the exception of (not-nonexistent; but quite rare) conditions caused by a mutation or mutations that originated with you, not earlier in the line, or a fairly small number of well developed genetic tests, most of which you aren't going to get over the counter at CVS, you'll have a better chance of learning about the likely phenotypic consequences of your genes by looking at mommy and daddy

        You are correct.

        I just went through a stack of articles on this so let me see if I got it right.

        There are two kinds of genetic diseases.

        First there are the extremely rare diseases which are caused by a single mutation, like Gaucher disease. If it was in your family, you'd almost certainly know it, or you'd at least know that you have a problem in your family, because you would have had relatives who had it. Like most of the rare diseases on that list http://www.pathway.com/more_info/full_list_of_conditions [pathway.com] (all of which you can look up in Wikipedia) it's a pretty dramatic disease.

        One of them in the news lately was Charcot-Marie-Tooth disease, which is worth looking up http://www.nytimes.com/2010/03/11/health/research/11gene.html [nytimes.com] http://en.wikipedia.org/wiki/Charcot-Marie-Tooth_disease [wikipedia.org] just because it's so interesting.

        Second there are the more common diseases like breast cancer, colorectal cancer, coronary artery disease, diabetes, etc., which most of us will die from.

        There are a few single-gene mutations that will usually result in cancer, like the BRCA1 or BRCA2 gene for breast cancer, which occur in about 1 or 2% of the population.

        But most of the other genes that are associated with those diseases only confer an additional 1% (or less) risk of the disease. That's the big frustration in genetic medicine. The doctor tells you, "You've got a genetic variation that, other things being equal, gives you a 1% increased risk of getting diabetes." How is that information going to change your life in any way?

        Scientists think they're doing pretty well if they discover a gene that increases the risk of a common disease by 10%. Now 10% is the *relative* risk. If 5% of the population gets a particular disease, that gene will increase the risk to 5.5%, which is not much greater. So you've found out that you have an increase in the *absolute* risk of 0.5% from that one gene. (But you don't know anything about the dozens of genes affecting that disease that they haven't discovered yet.)

        One of the problems with BRCA1 and BRCA2 is that those genes were patented by Myriad Genetics, which was charging $3,000 or more to test for that one gene. Many of the most important genes were patented, and one of the disadvantages of that was that it made it impossible to put together a cheap screen of all the common disease-associated mutations. Myriad just lost a patent lawsuit, and if that decision is upheld, we will be able to get genetic screens with every important known mutation. http://www.aclu.org/free-speech/brca-genes-and-patents [aclu.org] But I can't tell from Pathway's web site whether they include BRCA1 and BRCA2 screening in their test.

        Another problem is that mutations are caused by a defect in DNA. There are lots of defects. The Pathway test may be testing for one breast cancer mutation, while you have a different mutation somewhere else along the DNA strand that gives a protein with a different but equally damaging defect.

        Now that I look at it again, I see that they don't include Charcot-Marie-Tooth disease in their genetic screen. http://www.pathway.com/more_info/full_list_of_conditions [pathway.com] (Maybe that's

        • Clap. Clap. Nice Summary. You get 2000 Internets and a free Colonoscopy!
        • Family history can give you the clues of what to look for. But family history does not mean that a person has actually inherited a gene with a defect. That's where this sort of DIY genetic screening can come in handy. If your family has a history of a disease, one that you don't want to transmit to your offspring, then this sort of testing can be a godsend. You might discover that you did not get the gene(s) for the disease.
          • by nbauman ( 624611 )

            Depends on the gene and the disease. There are some genes that are closely associated with the disease, and some that are more loosely associated.

            That's what the parent meant by "penetrant"; if a gene has high penetrance, it's more likely to express itself, regardless of the environment. If it has low penetrance, you could die of old age and never know you had it.

            The BRCA1 gene has a very high penetrance for breast cancer. If a woman has it, she will be very likely (I think 60%) to get breast cancer by age

      • by loudmax ( 243935 )

        Not everyone has a very good grasp of their family history. I know my grandparents, but very little about my great-grandparents. Also, I know how my grandparents died, but not what else they were at risk for. Adoptees may not even know their biological parents.

        I'm not disputing your larger point that family history shouldn't be ignored. But genetic testing is available to anyone, regardless of their relationship with their parents. This is also a science that's advancing by leaps and bounds. Imperfect

    • Indeed. The tendency to become obese comes from the western diet, not from the genes. You may have helpful or unhelpful genes, but they play a minor role. The same applies for a number of other diseases.
    • As I understand it the test is 99.9% accurate when detecting the stupidity gene.

      Whilst on the subject, did you know that dysentery is hereditary? It comes through the genes...

  • " and consumers should not be making important medical and lifestyle decisions based on these tests without first consulting a health-care professional. " Really? Don't they know their target demographic? I don't know about you guys, but I can already see a battalion of trashy people walking out of Walgreen's with a genetic testing kit in tow. You know, the kind of people who are going to rage when they find out they have to pay for the results and then base life decisions on it, because hey, "I already su
    • Ofcourse they know people will make important decisions based on it, they just don't want to get sued over it.

    • by zarzu ( 1581721 )
      that comment is from the fda, who has no say in the matter. in an earlier response someone already listed the terms of agreement which tell you not to go crazy because of test results and obviously that you can't blame pathway genomics for anything you do. that their target demographic are people that will base choices on the results (there might be a people who do it for fun, but $100 is quite a bit of money for that) doesn't matter since they are covered by the toa. it's essentially like a psychic, just a
  • can't blame them (Score:4, Insightful)

    by castironpigeon ( 1056188 ) on Wednesday May 12, 2010 @07:25AM (#32180954)
    If they were going to wait for FDA approval before selling these things they'd have to wait... a year? 5 years? 10 years? And how much money would they have to sink into validation testing? I can't blame them for slapping a disclaimer on the thing and selling it as is.
  • This is just a diagnostics test. It won't kill anyone. The FDA should let the market sort this things out and not get in the way of progress.

    They do enough damage already by setting up a huge entry barrier for startups and new drugs. This only benefits the big Pharmaceutical companies, and I think that is probably the point...

    • Re: (Score:2, Flamebait)

      by OzPeter ( 195038 )

      This is just a diagnostics test. It won't kill anyone. The FDA should let the market sort this things out and not get in the way of progress.

      So you have no problem with unregulated and unproven testing being marketed to a public which does not have the smarts to figure out that they are being ripped off by a fear driven marketing campaign?

      Or as another choice - you don't care if the swabs used are black plague laden - because black plague laden swabs are more convenient and cheaper for the testing company to supply?

      • by M8e ( 1008767 )

        "Not FDA regulated" != unregulated

        For example the FTC has things to say about false advertising. (a test should work, otherwise it's not a test.)

        And surely there is law against using black plague laden swabs...

        • by OzPeter ( 195038 )

          And surely there is law against using black plague laden swabs...

          And I'd suggest that the FDA was responsible for that

      • by javilon ( 99157 )

        Well,

        Your answer sounds to me like a fear driven marketing campaign.

    • by vlm ( 69642 ) on Wednesday May 12, 2010 @07:43AM (#32181060)

      This is just a diagnostics test. It won't kill anyone.

      Hopefully you'll never be in the market for a blood sugar test kit.

    • by alen ( 225700 )

      unless they prove that it works there needs to be a disclaimer like on all the infomercial products that you use this for entertainment purposes only and it hasn't been tested.

    • This is just a diagnostics test. It won't kill anyone.

      Depressed person: "This test says that I'm highly likely to die of an extremely painful and debilitating disease in 30 years!" <shoots self in head>

      • Darwinism again in action. So let's just have a nanny state and "protect" everyone from their genetic information.

  • So many things wrong with this, let's count...

    1) False positives causing worry and unnecessary preventive maintenance.

    2) False negatives causing folks to overlook healthy practices that they might have otherwise prescribed to.

    3) A combination of both. Cats and dogs living together, mass hysteria...
    • Re: (Score:3, Insightful)

      "So many things wrong with this" and you could only come up with three?

      I don't know the specifics of this test, but genetic analysis is generally done multiple times, since it's not like DNA is limited in quantity. This lowers the error rate and mitigates both of your points. If the first run of the test indicates you have a marker for a disease, and you don't actually, you'd expect that the next run will disagree with that, and then next one too.

      While chances aren't zero that a false positive would make

  • I read this title as:

    Generic Drug testing coming to a store near you.

    and somehow was intrigued
  • What's interesting about this is that one can use a take-home test to genetically test someone else without their consent.
  • Just wait a couple more years, and get a full genome sequence for the same price. We've already got SNPchips that can do almost 2 million [affymetrix.com] genetic tests for about $500 [harvard.edu]. Admittedly, that's for high-volume (96 individuals at least) research-based analysis, but I'm sure it will enter the general public arena in due time.

  • This is BS Voodoo (Score:5, Informative)

    by quixote9 ( 999874 ) on Wednesday May 12, 2010 @09:16AM (#32182060) Homepage
    Scientists don't know yet which genes in which combinations cause Alzheimers or heart disease or cancer. (Trust me. This type of thing was my job.) All scientists know at this point is a few genes which are associated with chronic diseases.

    You'd have a better chance of a true prediction of your fate using astrology. We don't know enough to make a yes/no test for those diseases. We do know enough to make a yes/no test for pregnancy or drugs. (Actually, not always on the latter. Don't eat any poppy seed buns the day before.)

    The difference between a drugstore test and a doctor's is that there is some chance the doctor will be aware of the complexity, of what the testing cannot do, and of how much it really means for your future.

    The drugstore test is just a way to take your money.
    • This is why any serious test gives you probabilities and not yes/no answers. Of course any scientist is aware that most diseases are not linked to a single gene that acts as an on-off switch and that in most cases a cluster of multiple genes might influence the susceptibility for certain diseases, which, then is further modulated by environmental factors. You are perfectly right in that this has no place in the drugstore - even if it gives results in the form of possibilities, this will only instill unjusti
    • Yes, I agree totally. Having these results floating around uninterpreted by someone who really knows the science is just a recipe for silliness, but also some real harm could come if people jump to conclusions.

      At one point, our obstetrician ordered up a "routine genetic screening" while my kid was in utero. I guess he was looking for Downs or something where the markers are well-known. What came back was a report of a marker - a "backwards" chromosome, and a cryptic one-liner about possible dire stuff and a

  • At least, if it is Walgreens — or nearly any other company, that does not actively fight unionization of workforce — we can have a (semi-)intelligent discussion...

    But if it were Walmart doing this...

  • Nowhere in TFA does it explain what you get for the $20-$30 that will be forked over to Walgreens.. Does that just buy you a tube and an envelope?

  • The 3rd person sequenced James Watson had 20-some deleterious genes, including one for macular degeneration blindness. None had manifested so far. Ditto for Prof Steven Pinker who was about the tenth person sequenced. He carried a gene for baldness. He had a full head of hair at age 55 the last time I saw him.

    I think it would matter more if you had a known manifestation in an immediate ancestor and were shown to be carrying that too.
  • just one more useless thing marketed to hypochondriacs and obsessive compulsives.

  • It's bad enough, the realization that I am mortal, that I'm inevitably going to die. Historically, most succumb to this reality and hope they die with dignity, honor or respect and admiration but technically most have always hoped they simply die in their sleep at an old age. No one wants to think about being horribly maimed in a car accident only to die slow and painfully. No one wants to think about dieing of Alzheimer's, or leprosy or any horrible condition perhaps lung cancer. The truth is, dieing i

    • You absolutely got it - we need more stoicism. Living your life in a constant attempt to micromanage risks kills your spirit.
    • I realized when I was 7 years old that I was mortal. I was diagnosed with advanced Acute Lymphoblastic Leukemia and was told "you won't live to be 8".

      That was in October 1980. I've made it through that, another cancer, a stroke, a tumor, being wounded in a terrorist attack and a car accident.

      I know I'm going to die, I'm finally with a good woman who is also a cancer survivor and we are going to live for every day because we both know tomorrow could be the end. I don't worry about drinking or smoking killing

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