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Influence of Genes

Genes aren't destiny, author and oncologist Siddhartha Mukherjee tells NPR's Terry Gross. But they can influence biology, along with some input from the environment and other sources, he adds. Mukherjee has a new book out on genetics.

Genetic research, Gross notes, is affecting how researchers and doctors think about disease. Some diseases — like cystic fibrosis or Huntington's disease — are strongly influenced by genetics, but others like diabetes or heart disease also have a genetic, though less pronounced, component and even infectious diseases can be influenced by a host's genetic susceptibility to infection, Mukherjee tells her.

In cancer, new genetic knowledge is changing how oncologists view disease, Mukherjee says. While he suspects that the anatomical-based descriptors for cancer will remain, he says they'll likely be modified by new genetic information — for instance, "breast cancer, which has these following mutations," he says.

And that information will then influence treatment approaches with therapies potentially targeting those mutations and the pathways in which they reside, he adds.

Mukherjee notes, though, that environment and other factors also affect a person's cancer risk. For instance, he points out that not all women with BRCA1 mutations develop cancer, despite their increased risk of disease.

And that indicates that genes aren't the end-all be-all. The centerpiece of this book is that biology is not destiny," Mukherjee says. "But some aspects of biology and some aspects of destiny are commanded very strongly by genes." The truth, he adds, is in the details.