There has been a great deal of discussion in the news lately about genetic testing, following Angelina Jolie’s decision to have a preventive double mastectomy after genetic testing revealed she had a high risk of developing breast and ovarian cancer.
Jolie, whose mother died from ovarian cancer, is prompting many to ask their doctors if genetic testing is right for them.
Eric Fowler, Manager of Genetics Counseling at CTCA outside Chicago, answered some common questions about inherited cancers and genetic testing.
Which cancers are inherited?
About 5 to 10 percent of cancers are inherited. They include: breast, ovarian, prostate and colon cancer. Some cancers, such as lung and cervical cancer, are less likely to occur as the result of an inherited risk.
Who should get tested?
In general, people with personal and/or family histories of cancer at younger ages (before age 50), or families with multiple occurrences of the same or related cancers should be tested. Genetic testing is also an appropriate consideration for people who have some types of cancer, such as ovarian, fallopian tube or primary peritoneal cancer, regardless of their age at diagnosis or family history.
For cancer survivors, genetic testing may reveal the risk of developing a new cancer and may provoke discussion about which screening tests and cancer prevention tactics are most beneficial.
What questions should you ask your doctor?
- Does my personal or family history suggest I have an inherited risk for cancer?
- What are my risks of developing a certain cancer based on my personal and family histories?
- Are there any cancer screening and prevention recommendations that are appropriate for me based on my personal/family history?
- Is a referral to a genetic counselor appropriate?
How does the process work?
If cancer runs in your family, ask your doctor whether genetic testing is right for you. He or she may provide you a referral to see a genetic counselor. The counselor will discuss your personal and/or family histories of cancer, assess your readiness for genetic testing and talk to you about the impact the test results may have on you and your family. The counselor will also determine which genes should be considered for analysis.
For the tests, samples of your blood will be taken and analyzed in a lab. In some cases, cheek cell or other tissue samples may also be needed. After analysis is complete, the genetic counselor will call or meet with you again to discuss the results and next steps.
Will insurance cover the costs of the testing?
Some insurance companies use personal and family history criteria to determine whether genetic testing is covered. Criteria may include: types of cancer in the family, ages when the cancers occurred and which relatives in the family had cancer. Labs that provide genetic testing will typically verify insurance benefits before testing begins, including out-of-pocket costs.
For more information on heredity and cancer, Fowler recommends the following resources: