What would you do if you found out you have an increased risk for cancer? This is certainly a scary question.
Thankfully, most people do not need to worry about the answer, because the majority of cancer is sporadic (random). Sporadic cancer is due to non-hereditary factors such as environmental exposures, lifestyle choices, age or other factors we don’t yet understand. However, 5-10% of all cancer is hereditary. Hereditary cancer is the result of changes in the DNA, called mutations, which are passed down from one generation to the next. These inherited genetic mutations can significantly increase an individual’s risk of developing cancer in their lifetime.
Genetic testing is available to individuals who meet criteria based on their personal and family history of cancer. For example, young age of diagnosis of cancer (usually under 50) is a common indication for genetic testing. Other indications include many family members with the same type of cancer, rare cancer types, or an individual with several different cancers. For those who qualify, genetic testing usually requires a blood or saliva sample. A lab then examines the DNA present in each sample to identify inherited genetic changes that may increase the risk of developing cancer.
An integral part of genetic testing is the genetic counselor. Many different types of medical providers can offer genetic counseling, but genetic counselors are health care professionals who have advanced training in both medical genetics and counseling. Cancer genetic counselors are further specialized to help individuals and families understand how their DNA affects their cancer risks. They also discuss risk management and prevention options, review family considerations, coordinate genetic testing and provide ongoing support for individuals with hereditary cancer risk.
There are many benefits to identifying hereditary cancer risks, including prevention, treatment and public health.
Detecting cancer earlier: Individuals with an increased risk for cancer may have access to more frequent cancer screening and they may start at younger ages than the general population. For example, individuals with an increased risk for breast cancer may undergo additional breast screening in the form of magnetic resonance imaging (MRI) of the breast tissue. The goal of screening is to detect cancer earlier and therefore improve the outcome of treatment.
Preventing cancer: Preventative surgeries, lifestyle modifications and risk-reducing medications all help to mitigate an individual’s risk for cancer. Individuals at increased risk for cancer may consider preventative surgeries before cancer has the chance to develop, such as the proactive removal of both ovaries to prevent ovarian cancer. Risk-reducing medications are also available for individuals with increased risk for breast and colorectal cancer. In addition, many individuals choose to adopt other proactive strategies for cancer risk reduction such as improved diet, exercise, sleep and other lifestyle modifications.
Treating cancer: We are now in an age where personalized cancer treatment is a common occurrence. Hereditary cancer genetic testing may help to guide health care providers and their patients in making surgical and treatment decisions. In addition, individuals with cancer may have access to clinical trials based on the specific hereditary cancer mutation they carry.
Informing family: If an inherited cancer risk is identified then family members may also have an increased risk for cancer. It is important to notify relatives of one’s genetic testing results so that they may also benefit from their own genetic evaluation.
Public health: Although it is not the primary goal of clinical genetic testing, growing knowledge of hereditary cancer risks will contribute to a deeper understanding of the inherited component of cancer. These advancements may guide public health policies, insurance coverage and future research and treatment interventions that will benefit all.
Cancer genetic testing is a complex topic, and guidelines for testing and risk management will certainly evolve over time. It is important to speak with your health care provider or a genetic counselor to determine if hereditary cancer genetic testing is appropriate for you.
The Cancer Genetics Program at Northside offers cancer genetic testing and counseling to help reduce the impact of cancer on you and your family. A team of expert genetic counselors is trained to help you understand your cancer risks and make informed decisions about genetic testing. Learn more.
