Same Symptoms, same disease, same treatment?

Patients diagnosed with the same disease have generally been thought to have the same root cause. They are often offered the same treatments. However, clinical experience tells us that patients do not all respond in the same way.

In reality, patients diagnosed with the same disease can have very different experiences with their disease. For example, the disease might develop slowly or quickly, it might be more or less severe or it might be chronic (long-term). In addition, different patients may respond very differently to the same treatment:

• some will respond well
• some will respond, but less well
• some will not respond
• some may have serious side effects (adverse reactions)
• some may develop ‘resistance’ to the medicine (they stop responding) - this can happen even if they responded well at first.

When treating a patient, doctors try to take into account various clinical and lifestyle factors for individual patients. However, often the only option is to try a treatment, monitor the patient’s response, and change the dose, schedule or medicine if necessary.

We now know that these patients are probably affected by ‘different’ diseases. In other words, the same symptoms shown by the patients can be caused by different processes happening in their cells (they have a different underlying pathology). These differences can have a great effect on the way a disease progresses, and on the best treatment to choose.

This is an important change in the approach to diagnosing and treating disease.