By Katie Stoll, MS, Genetics Counselor, Providence Regional Cancer Center
“I know I’m going to get cancer. It’s just a matter of time. Cancer just seems to run in my family.”
These sentiments are echoed by many patients I see for genetic counseling. People are often convinced that it’s inevitable they’ll develop cancer. Or they’re sure they’ve passed cancer risk on to their children – and they often feel powerless to prevent it.
The goal of cancer genetic counseling is to provide information to help people understand the risk factors for cancer in their family. And, if a genetic risk is present, genetic counselors can make recommendations and provide support to individuals and families to reduce cancer risk.
Nearly All Families Touched By Cancer
Cancer statistics are sobering: one in three women and half of all men will develop cancer. That means most of us will be touched by the disease during our lifetimes – be it through our own diagnosis or one of our loved ones. It’s rare for a family tree not to include at least one or two relatives with cancer. And, most of the time, cancer isn’t thought to be due to strong inherited causes.
We see can in families due to shared genetic and/or environmental or lifestyle factors, or just due to chance coincidence alone. About 5-10 percent of cancer is thought to have a strong inherited component. In these families, genetic testing may help clarify who’s at increased risk for cancer and who isn’t.
Will everyone with a strong genetic risk develop cancer?
Fortunately, no. A genetic counselor can help determine who’s at risk in a family, make recommendations to improve early detection and reduce the risk for cancer as much as possible. In some cases, genetic testing may identify a risk factor that’s being passed from generation to generation and increasing the risk for certain types of cancer. If you’re found to carry this genetic change (aka “mutation”), then you can take steps to reduce this risk.
For instance, women who are determined – definitively – to have an increased risk for breast cancer may elect to have preventive surgery (such as mastectomy) to reduce their risk. They may take medication (such as Tamoxifen) to reduce their risk of breast cancer or they may decide on more frequent screening (such as annual breast MRI and mammogram).
If a person is confirmed to be at an increased risk for colon cancer, we may recommend more frequent colonoscopy screening starting at an earlier age. On the other hand, in some families, genetic testing allows us to also determine that some family members aren’t at an increased risk – in which case increased screening, surgery, or other interventions wouldn’t be necessary.
You Maybe Have a Genetic Risk for Cancer If …
- Signs that you may have a genetic risk for cancer in your family:
- Multiple relatives on the same side of the family have had cancer
- Cancer diagnosed at particularly young ages – for instance, breast or colon cancer before age 50
- Individuals who develop cancer more than once in their lives (for example, breast cancer and then later ovarian cancer)
- Unusual or rare cancers (for instance, a man with breast cancer)
If any of these qualities apply to you or your family members, a meeting with a genetic counselor may be beneficial. It typically involves a careful review of your personal and family medical history and a discussion of the possible risk factors. In some cases, genetic testing may be helpful to clarify the risk in a family.
There are many genes that can play a role in cancer risk and a genetic counselor can help to determine the most appropriate testing for high-risk families. The decision to undergo genetic testing is a very personal one. A genetic counselor can help you consider the potential benefits, risks and limitations of genetic testing options and support you with next steps.
For More Information
Genetic counseling services are available at a number of Providence and affiliate locations – generally on a referral basis. If you believe you’d benefit from genetic counseling or testing, talk to your primary care provider or cancer care team for a referral.