Cancer Genetics Program
Offering Genetic Counseling to Help Determine Cancer Risk
Some families have hereditary, or genetic, factors which may greatly increase their chances of developing cancer. Identifying these genetic factors and following appropriate screening, risk reduction, and prevention recommendations can significantly reduce the risk for breast, colorectal, endometrial [uterine], and ovarian cancers.
The Cancer Genetics Program at MD Anderson Cancer Center at Cooper provides risk assessment and counseling, as well as recommendations for screening, risk reduction measures, and prevention options to people at high risk for - or who have been diagnosed with - these cancers.
.“Knowing what your risk is allows us to help you start to reduce that risk,” said Certified Genetic Counselor Dana Farengo Clark, MS. Clark is part of a genetics team along with medical oncologists Generosa Grana, MD, FACP and Rob Somer, MD.
Genetic tests [blood tests] are available for breast and ovarian cancer [the BRCA1 and BRCA2 genes] and colorectal, endometrial, and other gastrointestinal cancers [the MLH1 and MSH2 genes]. People with a BRCA1 or BRCA2 mutation have a 56 to 87 percent lifetime risk for breast cancer and a 27 to 44 percent lifetime risk for ovarian cancer, compared to 7 percent and less than 2 percent, respectively, for other people. People with a MLH1 or MSH2 mutation have a 70 to 82 percent lifetime risk for colorectal cancer and a 42 to 61 percent lifetime risk for endometrial cancer, compared to 2 percent and 1.5 percent, respectively, for other people. The parents, children, brothers, and sisters of people with these mutations have up to a 50 percent chance of having the same mutation.
The risk for breast, colon, endometrial, and ovarian cancers can be significantly reduced by identifying people at hereditary risk and taking appropriate steps. For example, taking a drug called tamoxifen reduces the risk for breast cancer by 49 percent and removal of the ovaries can reduce the risk for breast cancer by up to 53 percent and ovarian cancer by 96 percent. For colorectal cancer, the American Cancer Society estimates that 90 percent of people who are diagnosed would survive if their disease were detected earlier; therefore, increased screening is recommended for those at high risk based on genetic testing, which fosters early detection.
The Cancer Genetics Program specializes in making cancer genetics understandable. Center staff members provide the information people need to make their own decisions about testing and medical management. If the results identify a mutation that predisposes to cancer, they help the patient inform his / her family through letters, brochures, and videos / DVDs. The team works with each patient to develop a personalized plan of care which includes screening and prevention, and then works with the patient’s primary care physician or oncologist to implement the plan.
“Whatever patients choose, they’re happy with their decision,” said Farengo Clark. “They’re happy they were given a chance to be proactive about their health.”
Who can benefit from the cancer genetics program?
- People who are concerned about their family or personal history of cancer may benefit from cancer risk assessment. This may be especially helpful for:
- People who have been diagnosed with any cancer at an early age (younger than 50)
- People with two or more close relatives (siblings, parents, children, grandparents, aunts, uncles), on the same side of the family, with the same or related types of cancer (for instance breast and ovarian, colon and uterine)
- People who have had more than one type of cancer.
- People with a rare cancer (for instance, male breast cancer, sarcoma, medullary thyroid cancer, or pheochromocytoma)Families that have a known cancer predisposition gene
What happens before my appointment?
Before your appointment, you will be asked to gather information about your family and its medical history. From this, we will develop a family tree. We may need to request medical records to help us clarify the information.
What happens at my appointment?
You will meet with a board-certified genetic counselor for an hour to an hour and a half. This counselor will review your personal medical history and your family history of cancer. Based on this information, we will determine the likelihood that your family has a hereditary risk for cancer and how this can impact you and other family members. You will also meet with an oncologist who will help to develop a plan for your medical management based on your personal and/or family histories of cancer.
We will provide information about how inherited and environmental factors may increase the risk for cancer in you or your family. We will also discuss a number of issues:
- The process of genetic testing (a simple blood test), including the risks, benefits, limitations, and costs
- Genetic testing and insurance
- Your cancer screening options
- Your possible participation in available research studies
- Ways that information about cancer risks may affect you and your family. Finally, we will provide referrals to appropriate services and specialists, including radiology, surgery, gynecology, social work, and nutrition.
Does everyone who has genetic counseling have genetic testing?
Education and cancer risk assessment is the first step and can be done without genetic testing. Genetic testing is a personal choice and is not for everyone. Cancer risk assessment can help you decide if testing may be helpful to you and/or your family members.
Brief cancer risk assessment
Do any of the following statements apply to you:
- I have been diagnosed with cancer before age 50
- I have been diagnosed with two different types of cancer have two or more close family members (sisters, brothers, children, parents, grandparents, aunts, or uncles) diagnosed with the same type of cancer
- I have breast or ovarian cancer history and Ashkenazi (Eastern European) Jewish ethnicity
- I have a relative with a known cancer gene mutation
- I have a male relative with breast cancer
If you answered "yes" to any of the above statements, you may be a candidate for a genetic testing.