Radio Review: Exchanges at the Frontier - Genomics

The philosopher AC Grayling introduced the first of this
year's 'Exchanges at the Frontier' BBC World Service broadcasts. He was joined
in the Wellcome Collection hall by sixth-formers from London schools, with more
students from as far afield as Ghana and Brazil linked in.

Genome sequencing was up for debate, reflecting the huge
impact that the Human Genome Project has had on the public imagination. Even
the opening music to the broadcast had apparently been composed using DNA.

AC Grayling started by asking the students: 'Who would like
to have their genome sequenced to know what lies in store in the way of cancer,
Alzheimer's disease, Parkinson's disease?'

The majority of students in the room would not, it
transpires. In response, a student in Brazil argues in favour, because he saw the problems a late Parkinson's diagnosis caused for his uncle.
Others quickly rebut this, saying that most people would not be able to handle
the information.

So, within the first minute, it is already clear that
genomic sequencing is something of a Pandora's Box; or, as AC Grayling calls
it, 'a modern dilemma'. This dilemma has been building since the first human
genome was fully sequenced in 2003.

Professor Nazneen Rahman, welcomed like a rock star with
whoops and applause, explains some of the scientific complexities. She's head of
genetics and epidemiology at the Institute of Cancer Research, and head of the cancer
genetics clinical unit at the Royal Marsden Hospital in London. She's worked
with Professor Mike Stratton, one of the discoverers of the BRCA2 gene.

Mutations in BRCA2 dramatically increase a person's risk of
breast cancer. Accordingly, the BRCA test is one of the best-known gene tests in medicine. Professor Rahman explains this test in some detail, and so the
broadcast is a good source of information for those considering undergoing it.

Professor Rahman is a 'disease detective' who studied
medicine before doing a PhD in genetics. She debunks the myth that science is
not as creative as the arts, presumably aiming to encourage the young
scientists in the audience. However she also admits to becoming an 'accidental
scientist' after deciding to do a spell of research while pregnant and not wanting
to do the long hours that medicine demands.

But fitting the complexity of the genome into a fifty-three
minute broadcast is a tall order, and cracks occasionally show. Professor
Rahman briefly mentions imprinted genes, but then quickly steers away from the
thorny issue of epigenetics.

So, what are we to conclude about genomic sequencing from
the discussion? Professor Rahman stresses that genetic tests don't yet provide
perfect information, and why this is a reason that people are wary of having
them. There are so many genetic and environmental factors involved in
developing most complex conditions (including cancer) that tests can still only
estimate the risk. However she does argue firmly in favour of genetic
sequencing for those already diagnosed with a disease, as it allows for more
personalised medicine.

The discussion is guided in the first part by intelligent
questions from the students. Indeed, some are surprisingly technical, such as
Orla from London who asks about false positives and negatives in screening. The
show is more informative than entertaining although AC Grayling does make a terrible
pun on the word gene, asking Rahman if she's 'hunting for Levis'. Nevertheless
the broadcast is frequently fascinating, and can be recommended to both genetics
experts and beginners.

The latter part of the broadcast moves into more ethical
questions, such as - should we screen babies' genomes as soon as they're born? Professor
Rahman vetoes discussion of 'designer babies', as 'at the moment' nothing can
be done genetically to influence intelligence, or any non-health-related
attributes. Questions of genetic discrimination - which is illegal in the UK - are
raised. Professor Rahman politely sidesteps the idea of government regulation
on genome sequencing itself by saying that scientists are working for the good
of the human race.

Despite her great expertise in genetic testing, Professor Rahman
hasn't had her genome sequenced. Much like the majority of students who were
polled at the start of the broadcast, she wouldn't choose to; saying she prefers
surprises, even unwelcome ones.