Ten Years Ago Mike Joyner Was Skeptical of Precision Medicine. What Does He Say Today?

This is a free preview of a paid episode. To hear more, visit www.mendelspod.comA recent New York Times article highlighted a remarkable study showing that exercise can help keep colon cancer in remission. After eight years, 90 percent of patients in a structured exercise program were still alive, compared with 83 percent in the control group. Yet despite these results, such programs are rarely covered by insurance. It’s a striking example of something our guest today, Mayo Clinic physiologist Mike Joyner, has argued for years. Are we overlooking some of the most powerful ways to improve human health in our pursuit of molecular medicine?Over a decade ago, we invited Joyner on as a skeptic of the emerging precision medicine revolution. He questioned whether breaking biology into ever smaller molecular pieces would deliver the improvements in human health being promised. Ten years later, we begin by asking Mike a simple question. Was he right? “I think I was more right than wrong,” he says. Despite important successes in oncology and drug development, he argues that precision medicine has yet to make the broad impact on public health its advocates envisioned.Joyner remains as provocative as ever. He argues that biomedical researchers have become too dependent on engineered animal models and should pay more attention to nature’s own experiments. The discovery of GLP-1 drugs is a case in point. He welcomes their enormous potential for improving public health but worries that people taking them without exercising may lose valuable muscle mass and miss the additional benefits of physical activity.We also venture into the contentious debate over transgender athletes in women’s sports. Drawing on physiological research, Joyner argues that suppressing testosterone does not fully eliminate the athletic advantages associated with male puberty. For him, the evidence supports maintaining biological sex categories to preserve fair competition for women.Throughout the conversation, Joyner challenges us to think beyond the molecular and ask a bigger question. Are we doing the kind of science that will actually make people healthier?