Thank you to Dorothy Lewis, Licensed and Certified Genetic Counsel from Capital Health, for explaining how genetics can impact a person’s decisions when coming to grips with a cancer diagnosis. While a majority of cancer is considered sporadic, there is a sizable portion that can be linked to inherited genetic mutations. Testing for these mutated genes, of which a single gene can have thousands of documented mutations, can provide more knowledge about potential cancer, impact screening recommendations, potential familial risks, and treatment options.
There are many different genetic cancer syndromes, but the 2 most common are BRCA-1 & 2 (Hereditary Breast/Ovarian Cancer) and HNPCC or Lynch (Hereditary Non-Polyposis Colon Cancer). The genetic mutations associated with these syndromes can potentially indicate other types of cancer risks, such as prostate or pancreatic cancer for BRCA-1 & 2 or uterine, stomach, or small intestine for Lynch.
Not everyone should undergo genetic cancer screenings; however, the following are triggers that may indicate genetic testing is appropriate:
- Early onset of cancer: under 45 for breast, 50 for colon
- More than 1 primary cancer in the same patient
- Cancer in multiple generations on same side of family
- Constellations of cancer: breast/ovarian cancer, colon/endometrial cancer, pancreatic and melanoma
- Unusual cancers: male breast cancer, ocular melanoma
- Uncommon histology: medullary thyroid cancer
- Geographic/ethnic considerations: Ashkenazi-Jewish heritage
The entire genetic counseling and testing process can take anywhere from 2-4 months and generally involves:
- Family history and risk review
- Patient education
- Selecting the best testing option
- Drawing blood and testing
- Final disclosure
If you have any questions regarding genetic testing, please contact the Cancer Genetics Program at Capital Health at 609-537-7043. If you would like a copy of the presentation, please visit https://www.njstatelib.org/wp-content/uploads/2019/07/Cancer-in-Families.pdf.