HJLR Mar/Apr 2019

52 MAR / APR 2019 I  Healthcare Journal of little rock column ONCOLOGY Genetics Testing: Useful for Cancer Awareness and Prevention Cancer genetics studies hereditary and familial cancer. While only about 10 percent of cancers are hereditary, the goal is to reduce the mortality rate of cancer in Arkansas, which is higher than the nation- al average. Genetic counselors occupy a small, but important slice of this fight by helping to identify individuals at risk for hereditary breast and ovarian cancer, he- reditary colon cancer, and other inherited forms of cancer. Those of us working in clinical settings see patients most commonly in such areas as prenatal, pediatrics, and cancer. I am tasked with identifying the most infor- mative family member to test, assessing the most appropriate genetic test(s) for patients and their families, interpreting the results, and helping patients and their physicians apply the results to medical management decisions. I serve doctors as a genetics brain in their back pocket; I am their genetics search engine. Who Benefits from Cancer Genetic Counseling There are certain markers indicating a patient should consider genetic risk as- sessment and testing. They include: • Common cancers at an uncommon age • Common cancers at uncommon fre- quency • Rare cancers (e.g. ovarian or pancreatic) Especially in regard to breast and ovar- ian cancers, the focus tends to be on the mother’s side of the family. Dad’s family history is just as important, but it is often overlooked or not reported. It is striking to hear that you have breast cancer when you are 35. After a cancer di- agnosis, genetic testing can help answer the question, “Why me?” It also can help inform how treatment should proceed—in- cluding radiation, surgery, and chemother- apy. After looking at the results of genet- ic testing, we can also help other family members understand the benefits of test- ing so that we can promote awareness, early detection, and prevention for even more people. Because of such high-profile figures as Angelina Jolie, most people are familiar with the BRCA1 and BRCA2 genes, which are known to increase the risk of breast cancer. Individuals with a mutation in one of these genes have a 55 to 87 percent risk of breast cancer. They also have an in- creased risk—64 percent—of a second new occurrence of breast cancer. If this gene mutation is detected, the recommendation is to consider increased surveillance. Starting a routine of breast surveillance with mammogram and breast MRI alternating every six months is rec- ommended for women at greatly elevated risk. Individuals with a BRCA gene mutation are at increased risk of not only breast In the most basic terms, cancer is a genetic disease. Cancer is caused by changes to genes that control the way cells grow and di- vide. Some of these cancer-causing genetic changes are inherited fromour parents, and others are acquired during a person’s lifetime.