Genetic Aspects Of Cancer: Is Testing In Your Future?

Under the direction of genetic counselors Beth Crawford and Peggy Conrad, a cancer risk program has been developed at the UCSF/Mt. Zion Cancer Center. Although not all cancers are inherited, some families have high risk for breast, ovarian and colorectal cancers. The Cancer Risk Program identifies these families and helps individuals to understand their risks, creates personalized, individualized prevention and screening options, and makes referrals for additonal genetic evaluation if required. The program provides a complete range of educational classes which detail genetic aspects of inherited cancer, an assessment of lifetime risks of occurrence, and the prevention and early detection interventions which are currently available. A diverse group of medical professionals offers screening, testing and psychological support.

If you have any of the following risk factors, you may want to learn more:

• An early age diagnosis of colon or breast or ovarian cancer in yourself or any relative

• Two or more close relatives (like parent, brother, sister, child) with cancer

• Any relative with multiple or unusual cancers, like male breast cancer or pancreatic cancer

• Several individuals with cancer in more than one generation of your family

• Much has recently been written about genetic testing for certain hereditary forms of cancer which may determine if an individual carries a specific cancer risk gene. BRCA1 and BRCA2, for example, are the principal genes that indicate an inherited susceptibility to breast and ovarian cancers. They account for 80 to 90% of all inherited cases of breast cancer and the majority of inherited ovarian cancers. Because genetic testing is complex, careful thought and consideration must precede its use. Counseling and testing begin only after an informed consent process which includes a thorough discussion of risks and benefits. All testing is voluntary; all information is confidential. There is a fee for these tests which can run as high as $1500. It may be covered at least partially by insurance.

If the results of the risk assessment indicate no increase in cancer risk, the relief can be enormous and well worth the price. If risk assessment does determines that you have increased cancer risk, the Cancer Risk Program team will develop an individualized risk reduction plan that may include the following:

• Systematic monitoring or periodic screening for early detection

• Changes in diet, exercise or other lifestyle factors

• Instruction in early detection breast self-examination techniques

• Information regarding available clinical trials

• Identifying other family members who may be at increased cancer risk and may benefit from heightened screening

• Enroll in on-going studies that will evaluate the effectiveness of screening and lifestyle interventions.