Speaking at a conference in San Francisco Wednesday, geneticist Craig Venter revealed that he had just had surgery for prostate cancer three weeks ago. A health workup at his own high-end clinic, Health Nucleus, pinpointed the cancer.
Famous for leading one of two teams in the 1990s that raced to unlock the human genome, Venter said he had surgery soon after the diagnosis because the cancer was classified as “high grade,” meaning likely to grow and spread quickly, according to the National Cancer Institute.
“It was a surprise for me,” he said. There were no indications, such as elevated levels of the prostate-specific antigen (PSA) protein—a potential warning sign for prostate cancer—that Venter had the malignancy.
Private clients who presume to be healthy can get the same workup for $25,000 at the San Diego clinic, which launched last year. Part of the regimen includes a whole genome analysis. Venter’s DNA had an unusual repeating pattern in the code of the androgen receptor gene, a key part of the hormonal system that regulates hair loss, muscle and bone growth, and other biological fundamentals. A high number of the repeats signals lower risk for prostate cancer, Venter said. But his X chromosome, where the gene resides, had an extremely low number of the repeats.
But as much as he used the Health Nucleus clinic to catch his cancer, he seemed eager Wednesday to use his cancer to tout his clinic, volunteering his health information and cracking jokes with his interviewer from The Economist magazine. “I’ve always been accused of having balls of steel,” Venter said, poking fun at his own in-your-face reputation and penchant for self-promotion. “It’s because I only have six repeats.”
Venter’s own genome was also the first to be published in full, all 6 billion letters, in 2007. He has branched into synthetic biology, founding a company to produce biofuels and other products, and he led a team that reported this year building a bacterium that used the minimum number of genes possible.
More than four hundred people have used the Health Nucleus clinic, according to spokeswoman Heather Kowalski. The clinic is part of Venter’s firm Human Longevity (HLI), founded in 2014 and amply funded since then. The startup’s eventual goal is to sequence 100,000 human genomes a year and supplement them with other layers of health data for a massive database that HLI can charge researchers to access—and that HLI itself could eventually use to discover drugs or create other medical products. “We’re trying to match traits from people in the clinic to what we find in the genome,” Venter said.
Venter said Wednesday that 40 percent of the Health Nucleus clients, who buy the service believing they are healthy, are found to have “serious disease,” and 20 percent have life-threatening disease. He did not elaborate, but spokeswoman Kowalski said the diseases ranged from cancer to metabolic conditions to aneurisms and more. The clients get a whole genome analysis, brain and body scans, sequencing of their microbiome and metabolites—chemicals produced by the body’s processes that are floating around in the blood—and various other tests.
Venter’s comments add to the debate about testing for cancer in otherwise healthy people. For decades, many clinicians, medical societies, and advocacy groups like Susan G. Komen have urged healthy people to get regular testing for various cancers. Screening saves lives, goes the mantra. But many experts have come to question the widespread use of mammograms to detect breast cancer and the PSA test for prostate cancer. The risk is over-diagnosis: unnecessary biopsies, surgeries, and drug regimens for people wrongly diagnosed or whose cancer might never have progressed.
But proponents of new forms of screening, particularly blood tests, want to create reliable diagnoses of DNA and other proteins to catch cancer as early as possible, arguing that cancer before it spreads is much more treatable.
The race is on to collect reams of personal health data and turn them into businesses. Joining HLI are Seattle’s Arivale, the San Francisco Bay Area’s 23andMe and Invitae (NASDAQ: NVTA), and many others. Venter said HLI has accumulated about 20 petabytes of data, putting it “in Amazon [data storage service]’s one-percent club, right up there with video streamers and porn sites.” The firm spends $1 million a month on storage and computing, he said.
The “concierge” Health Nucleus service, which insurance won’t cover, also raises the question of whether such services and products to help healthy people stay healthy will be limited to rich people. An audience member at the conference Wednesday asked Venter and other speakers if insurance would ever pay for “catching things at an early stage.”
Not until there’s a large body of evidence that tests, scans, or medicines actually help, Venter answered. Brian Kennedy, the president and CEO of the Buck Institute for Research on Aging in Novato, CA—which recently spun out a company that’s pursuing drugs to treat “diseases of aging”—noted one precedent. “High cholesterol isn’t a disease,” he said—meaning it can show up in otherwise healthy people. But insurance companies pay for cholesterol-lowering statins, Kennedy said, because of decades of studies to show that lower cholesterol decreases the risk of cardiac disease.