Genetics Program at Eastern
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Cancer comes with many unanswered questions. You may wonder why you got cancer in the first place or about your risk for recurrence of cancer. You may also worry about the risk of cancer for your family members.
The Department of Genetics at CTCA at Eastern Regional Medical Center (Eastern) offers a cancer genetics education, counseling and testing program. This program strives to help address some of these questions by determining whether or not your cancer was due to an inherited pre-disposition to the disease.
“Many community cancer centers don’t have a genetics program. This may be because they don’t know about its importance or they don’t have appropriate resources Therefore, many patients who come to Eastern are appropriate for genetics counseling but are unaware of that,” says Marty Weinar, MS, RN, CCRC. Weinar heads Eastern’s Department of Genetics as well as the Department of Research.
Overview of Cancer Genetics
All cancer has a genetic basis. Cancer is a condition triggered by mutations (changes) in the genes of a cell that result in uncontrolled, abnormal cell growth.
Cancer most often occurs as a result of a combination of gene mutations influenced by environmental factors and lifestyle. All of us acquire gene mutations as we age. Some mutations are repaired and some are not. Most people who develop cancer are over the age of 50 since it takes many years for enough genetic changes to accumulate that result in this disease.
Some families have gene mutations that are passed down from one generation to the next. Members of these families may inherit a mutation in a very important gene that is present at birth and in every cell in the body. Individuals who inherit one of these mutations don’t inherit cancer, but inherit an increased risk of developing cancer. However, not everyone who is born with a gene mutation will develop cancer.
Individuals who have inherited a mutation in a cancer susceptibility gene have a greater than average risk of developing certain cancers. And, patients whose cancer is due to a mutation in an inherited cancer susceptibility gene have an increased risk of developing a second cancer. The goal of the Cancer Genetics Program at Eastern is to identify these patients and then offer options to reduce the risk of getting another cancer.
The Cancer Genetics Program at Eastern
Eastern’s Cancer Genetics Program may help you determine if your cancer was due to an inherited gene mutation and if you are at an increased risk of developing a second cancer. The program consists of genetics education, counseling and testing services. You will learn about the role of genes and hereditary in the development of cancer and which of your family members may be affected.
The components of the program are:
- An introduction to cancer genetics
- A review of your personal and family history of cancer
- An individualized hereditary cancer risk assessment
- Genetics education, counseling and testing
Hereditary risk assessment
During your initial evaluation period at the hospital, you will learn about Eastern’s Cancer Genetics Program. During this visit, you will receive an overview of the role that genes and heredity play in the development of cancer, and how it may relate to your situation.
You will fill out a family history questionnaire, which includes questions regarding your personal and family history of cancer. This information will help determine if you are a candidate for genetic testing.
The following are some red flags for a hereditary cancer predisposition:
- Family member with a known inherited gene mutation
- Breast, colon or uterine cancer diagnosed under the age of 50
- Ovarian cancer diagnosed at any age
- Two or more close family members who have had the same type of cancer
- The same type of cancer in several generations of the family
If your personal and family history merits an introductory genetics education session, you can then decide whether or not you would like to pursue genetic counseling and testing.
Genetic testing consists of a mouthwash or blood test. Analysis of the sample can determine if you inherited a gene mutation that contributed to your diagnosis of cancer. Genetic testing might also help determine if you are at greater risk of developing the same cancer again or of developing another type of cancer.
According to Weinar, about half of patients who are initially evaluated through Eastern’s Cancer Genetics Program pursue genetic testing. So far, she estimates about one in 50 patients have tested positive for inherited risk.
Genetic testing also helps determine if your family members may have an inherited risk for cancer. Since Eastern’s Cancer Genetics Program is available only to patients, Weinar can refer interested family members to other genetic counselors in their geographic area.
Before and after genetic testing, you will have a counseling session. During this time, Weinar will help simplify the complex concepts into terms you can understand. The goal is to provide clear information about genetic risk factors and address your questions and concerns. Participating in an introductory education session does not obligate you to have genetic testing done.
If you wish to pursue genetic counseling and testing once you leave the hospital, Weinar will try to help you find someone close to home.
Results of genetic testing
Genetic testing can help you make informed decisions about how to manage future risks of cancer. For example, if it is determined that you are at greater risk than the “average” patient for breast cancer recurrence, your CTCA doctor may recommend adding breast MRIs to your routine screenings.
Also, if you have breast cancer and find out that you have an inherited risk, you may be at an increased risk for developing ovarian cancer. Your CTCA doctor will present you with options to reduce that risk.
“When we identify people who have an inherited genetic risk, then we know that they are at greater risk for getting cancer again or for getting other cancers. We can then educate them regarding their options to reduce risk. We can also determine what other, unaffected, family members should be counseled and tested,” says Weinar.
The test results can help your CTCA doctor develop a plan of care individualized just for you. Test results can also be of great value to family members.
Psychological benefits and risks
Genetic testing also poses psychological benefits and risks. A negative result can bring a sense of relief and reduce some of your worry and anxiety. It may also eliminate the need for more frequent checkups and tests that are routine in individuals with a high risk of cancer.
A positive result can help to relieve uncertainty and help you take steps to reduce the risk of recurrence or of developing another cancer. At the same time, a positive result can also cause some anxiety. You may experience feelings of guilt if you learn that you are positive for a gene mutation and that you passed this mutation onto an offspring.
However, it’s important to remember that testing positive for a gene mutation is not a guarantee of developing cancer. Some people who test positive for a mutation never get cancer.
Your entire CTCA care team is available to address all of these dimensions of genetic testing. For instance, the mind-body medicine and pastoral care teams can help you cope psychologically with the results of genetic testing. The nutrition team can also help you maintain your nutritional well-being to boost your immune system and reduce the risk of recurrence.
Together with Eastern’s other clinical departments, the Department of Genetics will educate, counsel, support, and empower you throughout your cancer care.