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The Language of Life: DNA and the Revolution in Personalized Medicine

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This book provides both academic and practical information about the latest developments in DNA research. Some of the practical advice could help you reach educated decisions about what medical treatments to pursue. It's likely that even many doctors aren't yet aware of certain kinds of DNA tests that can be crucial indicators about which treatments might be effective and which ones might actually be lethal.

For example, any woman contemplating having a prophylactic mastectomy might want to read this book first to learn about how new BRCA tests could more accurately predict her chances of eventually getting many forms of cancer. DNA tests available now can help a woman who has already been diagnosed with cancer determine whether certain forms of chemotherapy would help her, or whether they would just be needlessly, and perhaps fatally, debilitating.

There is also a DNA test that would alert doctors that certain people might have a special sensitivity to coumadin, a drug widely used as a blood thinner. Many medical centers don't perform this test before coumadin is prescribed, and excessive bleeding and even lethal hemorrhaging can be the result.

A small percentage of people have a toxic reaction to statins, the drugs now commonly prescribed to lower cholesterol. A DNA test now available could identify those people for whom the drugs might pose dangerous problems.

But DNA analysis doesn't have to be limited to the human's normal genome. By analyzing the genome of the cancer cells themselves, doctors can now refine their treatments.

Collins covers a variety of such topics that it would really benefit any urgent consumers of medical care to educate themselves about before proceeding with treatment. However, he also gives advice about how the average person can make use of the latest developments in DNA research.

In the field of crime detection, it might soon be possible, not only to match a perpetrator's DNA with a suspect's DNA, as we commonly see on CSI series. It might also be possible to describe what a perpetrator looks like from their DNA. That is, DNA analysis of crime scene DNA might lead the police to a blue-eyed, red-headed, freckled male who is 5'10" tall. This sort of analysis is controversial though and might be restricted. On the other hand, the DNA research going on now into stem cells might enable doctors to proceed without violating any ethical principles.

Collins goes on to summarize the results you can expect to get from the three leading on-line companies offering personal DNA analyses after you send them a saliva swab. Collins includes checklists in the book, tallying up which disease susceptibilities, which pharmaceutical effects, and which other life trajectory likelihoods, each Company can reasonably predict for you. In addition, he tells the extent to which these DNA analyses can currently help you trace your ancestral roots. (Right now, DNA yields only very general results along these lines.)

However DNA research is proceeding at a gallop, and predictions that can only be made in the form of vague generalizations today, might be much more pinpointing tomorrow. So again, women contemplating prophylactic mastectomies because current BRCA tests can't make very accurate predictions about their probability of developing breast cancer - might want to consider holding off a little after reading this book.

The author of this book was himself on the cutting edge of DNA research, leading one of the teams racing to sequence the entire human genome. He has continued to be in the forefront of DNA investigations, so most of the information here comes across as being authoritative and reliable. However, there are a few paragraphs that might strike the reader as being lapses from this standard.

For example, Collins entertains the idea that some (presumably male) homosexuality might be a matter of choice or will rather than innate orientation. He also rather astonishingly pronounces that 70% of one's adult weight is dictated by one's genes. Well, that would be nice to believe, but I don't think a lot of the research backs him up on that, or at least such an assured percentage would not be applicable to a majority of us.

On the whole though, this book provides very readable insights into what those at the forefront of DNA research are discovering, and how such studies already are and soon will be having major effects on all our lives.

I have just finished reading "the Language of Life". I enjoyed reading it. It was much better than I was expecting. The coverage of genetics was at such a level that it was easy to understand (perhaps too easy?). It's difficult not to catch Francis Collins' optimism and enthusiasm as to the promise of mapping the human genome, and being able to work out which genes are really important in producing malignant tumours, and hence which genes are promising targets for treatment strategies. Previously, because mapping the genome was so difficult and expensive, it was difficult, if not impossible, to distinguish the important genes in tumours, from unimportant mutations resulting from increased cell division or loss of DNA repair genes.

I only have a few quibbles. I don't think it is useful to define mutations as being always harmful, everything else just being variants. Mutations can be harmful, beneficial and neutral (the usual situation).

Secondly, I didn't like the end of each chapter, where he has a "What you can do now to join ... revolution?" Generally, it's a website providing information. The chapter on ageing has a beauty of a web address for [...] ... with a long sequence of letters, numbers and symbols, which navigates to I don't know where. I found the tool easily just navigating from the homepage (the address was much shorter, I wonder if Francis Collins gave the address for his results?).

Thirdly, I think that missing out on the mitochondrial story with regard to ageing, is missing the most important cause of ageing.
Nick Lane's book "Power, Sex, Suicide: Mitochondria and the Meaning of Life" is a good book for the discussion of this.
Basically, most of the genes coding for mitochondria have been moved to the nucleus, except for 13 very important genes, which are still in the mitochondria (mitochondria were originally bacteria which entered into a symbiotic relationship with a species of Archaea to produce the first eukaryotic cell). In the mitochondria, these 13 genes are 20 times more likely to undergo mutation than those in the nucleus, resulting in the mitochondria becoming less and less efficient in producing energy, until the cell dies. Looking at buccal epithelial cells (even if the mitochondria are examined) isn't going to tell what is happening in heart muscle fibres or brain cells.
This is apparently the way calorie restriction increases lifespan in mammals (and presumably also us, although the degree of calorie restriction is enough to make your life miserable enough that it just seems longer), by reducing the rate of mutations in mitochondria.

The Language of Life: DNA and the Revolution in Personalized Medicine
Book Review by Richard L. Weaver II, Ph.D.


Before I was a speech-communication major in college--and since I was in the ninth grade in junior-high-school, I might add--I wanted to be a doctor. Most of my courses in high school and early college were all science courses. My interest in science did not wear off, and when I graduated from the University of Michigan, I had to make general science a minor since I had had so many courses in the area, and my graduation would have been delayed for at least a year if I had to pick up a new minor. All this is explanation for my love of science and, thus, of this book.

Collins has written a science book on DNA for the masses, and I absorbed the information like a sponge in water. It is a terrific read not just for Collins' unbelievable knowledge, the revealing and interesting examples cited, the comfortable, readable, and friendly writing style, or even the specific detail he offers: "The best-understood genes are those that code for protein. This process involves first making an RNA copy of the DNA; that RNA is then transported to the ribosome `protein factories' in the cytoplasm, where the letters of the RNA code are translated into the amino acids used by proteins....This translation is carried out using a triplet code word; for example, AAA in the RNA codes for the amino acid lysine, and AGA codes for arginine" (p. 7). Most of the language is not of this style and not nearly as complex.

But, getting back to my point about why the book is a terrific read. The book is a terrific read because of how it relates to us all. Collins writes: "The consequence of all this progress is that a new science has appeared at the very center of biology and medicine: you could call it DNA cryptography. We've intercepted a highly elaborate message of critical importance for the future of the human species" (p. 13). To drive this point home for every reader, Collins says, "Family health history turns out to be the strongest of all currently measurable risk factors for many common conditions, incorporating as it does information about both heredity and shared environment" (p. 14).

The book is as reader-friendly as a science book can be. At the end of nine of his ten chapters, Collins has included a box entitled, "What you can do now to join the personalized medicine revolution," which offers specific methods for readers to take responsibility for their lives. If you think you may have trouble with some of the language, there is an eight-page glossary to assist you. Also, numerous figures help in explaining concepts.

This is a great book written by the Director of the National Institutes of Health who spent fifteen years as director of the National Human Genome Research Institute at the National Institute of Health. Collins was awarded the Presidential Medal of Freedom in 2007, and the National Medal of Science in 2009. The book is copyrighted 2010.

Great book as an overview of genetics and genomics complete with some basic science background, a thorough discussion of the current state of the art and practical applications thereof, as well as an exciting chapter projecting upcoming developments in the field.

Clearly, the science supporting Dr. Collins' book is rock solid but our understanding of what it means in our day-to-day lives (and in treating patients clinically) is only in its infancy. It boggles my mind to think of the progress we will make in this field over the next 10-20 years. If you care about where you came from (genetically) or wish to know more about your health prospects, you've got to read this book or listen to it on audiotape!

This is an outstanding read for anyone interested in genetics and the future of personalized medicine based on genetic information. It is also packed with useful information at the end of each chapter suggesting actions to take that assist in the near term delivery of health care. The style is easy to read and Dr Collins is able to discuss complex issues in understandable language.

The book was slightly scattered in topics and tended to get preachy about things like patents. Overall the book was enjoyable and the stories drove home the importance of continuing work in this area and how different medical care will be in the next 20 or so years.

This is an excellent book which explains in easy terms the importance of the DNA and the double elix in any living creature, of the genes connected with it and the possibility that they represent for the future of medicine. A future which is already developing and creating a medical revolution.

I read this great book on my Kindle. Not a too good an idea because of the difficulty with studying many diagrams and charts. This book is full of interesting and current information important in this age. It is very readable and full of references to further reading.

I cannot speak for the book contents, as it has not come out yet, but as the former editor of [...], the first editor at [...] (the first direct to consumer genetic testing company) and the editor who launched two channels on genetics on WebMD (one for consumers and one for physicians- alas neither is still available online), the front flap copy was absolutely inaccurate, misleading and sensationalistic in the extreme.

It is not possible to get a simple home genetic test to find out if one has a susceptibility to all genetic diseases. Testing costs hundreds to thousands of dollars per disease. While getting tested is relatively simple - i.e. you need to submit some saliva or blook - the outcomes of results often have complex psychological implications. There is an entire profession that helps people make decision about genetic testing - genetic counselors - and their help and support should be sought before making a testing decision for most (but not all) people.

I also recommend reading Doris T. Zallen's balanced and research-based book, To Test or Not To Test: A Guide to Genetic Screening and Riskt. The book is based on interviews with 100 people who received genetic testing. Half of the people interviewed received genetic testing. Half did not. The differences in their responses is quite interesting. Zallen provides people with four simple questions to answer before getting tested.

Research on the [...] indicates that 1 in 5 genetic tests is already ordered inappr [...] page also states that one in three genetic tests is misinterpreted. I believe this data is quoting professional treatment sources - i.e. not even including home genetic testing.

One wonders if we substitute the word blood for genetic testing - i.e. blood testing - if everyone will feel this is the latest fashion and one simply must have a genetic test to be au courant. Medical testing is a serious matter. Genetic testing in most cases will only tell you if you have a higher than average risk for one of the following diseases: hemochromatosis, blood clotting disorders, breast cancer, colon cancer, Alzheimer's and a few other diseases. There are also tests to determine which drug will work better than others or if at all (examples: Tamoxifen, Warfarin, and others) for your particular genetic type.

We need to be responsible in the ways we communicate about genetic testing - instead of having 23andme fly zeppelins over Nob Hill in SF and appear on Oprah and at NY Fashion Week creating the impression that genetic testing is a socially trendy, faddy and cool thing to do. Nothing could be further from the truth. Families have come apart when they've discovered who the carrier in a family is, on occasion. Opening Pandora's box - even for small number of diseases for which tests exist - is not a simple, breathlessly enthusiastic decision to make. We should stop acting like teenagers about genetic testing when we talk about it in the media.

If a genetic test is indicated, consider the pros and cons of getting a test. Get the help of a genetic counselor to help you - or at the very least, read To Test or Not to Test as a first step.