One in eight women will be diagnosed with breast cancer, and one in seven men will be diagnosed with prostate cancer in their lifetimes. In some cases, these diagnoses may be traced to hereditary gene mutations that increase a person’s risk of developing specific cancers. Women and men should be aware of their cancer risk, just as they know their blood pressure, cholesterol level and body mass index. The cancer experts at the High-Risk Program at the Cancer Treatment Centers of America® (CTCA) in Philadelphia have developed a program designed to help patients reduce their risk of cancer or to help find cancer at early stages when possible.
Inherited gene defects have been linked to up to 10 percent of all cancer diagnoses, according to the National Cancer Institute. Researchers have identified dozens of mutations that may be responsible for a variety of cancers. For example, BRCA genes, called tumor suppressors, typically stop tumors from forming and protect against cancer. A mutation in these genes may prevent them from working properly. There are dozens of potential mutations with the BRCA1 and BRCA2 genes alone. And since the genes’ discovery in 1994 and 1995, 18 additional genes have been identified that are associated with breast cancer.
Genetic risk factors may play a role in cancer’s development in several ways:
- Women with BRCA mutations are at high risk of developing at least one primary breast cancer and ovarian cancer.
- Men with BRCA2 mutations are at an increased risk for developing male breast cancer and prostate cancer.
- Men and women with BRCA2 mutations and a family history of pancreatic cancer have an increased risk for pancreatic cancer.
The High-Risk Program at CTCA® in Philadelphia is designed to educate patients about the risk associated with gene mutations and employ strategies aimed at reducing cancer risk. These strategies are designed to help patients prevent cancer or have access to an early diagnosis that may improve their treatment outcomes.
The High-Risk Program at CTCA in Philadelphia provides screening, education and structured surveillance for women and men who are at increased risk for cancer based on hereditary factors.
The program offers patients an individualized assessment that may include:
- Discussing potential cancer risks with a genetic counselor
- Developing a care plan for screening and prevention
- Determining a care plan, if necessary, with a nurse practitioner, breast surgeon, gynecological oncologist and/or plastic surgeon
- Scheduling screening and/or surgery, if necessary
The High-Risk Program provides patients with an in-depth evaluation, incorporating individually tailored counseling in genetics and risk management. It also offers patients information about prophylactic steps designed to lower the risk of cancer and provides them with up-to-date information on risk-reducing surgery. Screening and prevention steps may include:
- Breast cancer screening starting at age 25 for women with BRCA mutations with biannual clinical breast exams, annual mammograms and an annual breast MRI
- Prophylactic oophorectomy (ovary removal surgery) by age 35 for women with BRCA1 mutations
- Prophylactic oophorectomy by age 40 for women with BRCA2 mutations
- Consideration of a prophylactic mastectomy with reconstruction for all women with BRCA mutations
The High-Risk Program at our Philadelphia hospital is led by Melanie Corbman, a licensed, certified Genetic Counselor. Corbman serves on the adjunct faculty and the advisory board for Arcadia University's Genetic Counseling Master’s Program and is a member of the National Society of Genetic Counselors. Corbman also works with FORCE (Facing Our Risk of Cancer Empowered), a national support group for individuals with hereditary risk for breast and ovarian cancer.