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Understanding your cancer risk with genetic counseling

Sample of DNA being pipetted into a petri dish over genetic results

When it comes to your health, knowledge is power. This statement has new meaning in the rapidly evolving field of cancer genetics. As geneticists learn more about mutations in genes that are linked to certain cancers, there is an increasing amount of knowledge to be gained by undergoing a clinical cancer genetics evaluation, including cancer genetic counseling. And, this knowledge may enable you to make important decisions about your health, including incorporating new strategies to help lower your risk for developing cancer.

“We all know people who have been touched by cancer, but some more than others,” says Dr. Kenan Onel, Director of Northwell Health’s Center for Cancer Prevention and Wellness. “Genetics touches everything and everyone. Through genetic counseling, we are empowering individuals to understand certain risks, including whether or not they have genetic variations that predispose them to developing certain types of cancer.”

Is cancer genetic counseling right for you?

The primary benefit of cancer genetic testing is to gain a better understanding of your risk for developing the disease. While undergoing cancer genetic counseling is not for everyone, it can be beneficial if you:

  • Have had cancer diagnosed at an early age, such as breast cancer before the age of 50 or if you have a close family member who was diagnosed with cancer at an early age
  • Have two or more close family members diagnosed with the same cancer or related cancers, such as breast and ovarian cancer, or colon and uterine cancer
  • Have had more than one cancer or a close family member with more than one cancer
  • Have a family member known to have an inherited cancer syndrome
  • Are from certain ethnic groups, such as Ashkenazi Jews, in which inherited cancer predispositing variants are more common than in other ethnic groups
  • Have been diagnosed with a rare cancer, such as medullary thyroid cancer

Genetic tests cannot determine if you’ll develop cancer. Rather, they identify if you have a specific gene mutation that may put you at a higher risk for developing cancer. In other words, a positive test result doesn’t necessarily mean you’ll get the disease, and a negative result doesn’t guarantee that you’re not at risk. Your chance of developing cancer also changes over the course of your lifetime due to aging, as well as lifestyle choices. This is why counseling before and after testing is so important.

If you do test positive for an inherited factor or gene mutation, your doctor can help you develop a plan for managing your risk. This may include:

  • Making lifestyle changes that can reduce the risk factors that you can control
  • Starting cancer screening tests earlier or undergoing tests more often
  • Obtaining more detailed screening tests that are specifically used for individuals who are at an increased cancer risk
  • Closer monitoring for signs or symptoms of that type of cancer
  • Learning about drugs or surgery that can help reduce the risk of certain types of cancer

But what about direct-to-consumer genetic testing?

Direct-to-consumer (DTC) genetic tests are now widely marketed to consumers and can provide some insights into your genetic background. However, they do have drawbacks. They look at a much narrower spectrum of possibilities when it comes to your cancer risk, as compared to testing performed as part of a comprehensive cancer genetics evaluation. Additionally, recent research has suggested results from raw data analysis tools may be false positives or false negatives up to 40% of the time. Finally, they provide no guidance on next steps. In contrast, the process of undergoing a genetic evaluation is extensive, beginning with a complete evaluation of personal and family health history, options for genetic testing, including clinical confirmation of DTC testing results if applicable, a thoughtful discussion of the risks and benefits of genetic testing, and recommendations for preventive screenings and treatments.

Through the Center for Cancer Prevention and Wellness, part of Northwell Health, you gain access to the most updated information in cancer genetics. Currently genetic testing can identify hereditary gene mutations for a variety of cancers and conditions linked to cancers, including but not limited to:

Breast cancer and ovarian cancer – Genetic testing can help determine if you’re at a greater risk for developing breast and ovarian cancer due to inherited gene mutations in the BRCA1 and BRCA2 genes or other genes associated with an increased risk for breast and ovarian cancer.

Colon Cancer – Approximately three percent of colorectal cancer cases are due to an inherited condition known as Lynch syndrome. Genetic testing for the diagnosis of Lynch syndrome can identify if you’re at an increased risk for developing certain types of cancers, such as colorectal, stomach, small intestine, gall bladder ducts, upper urinary tract, brain, skin, ovarian and endometrial.

Renal cancer – Testing can also identify the inherited condition von Hippel-Lindau disease which can put you at higher risk for developing kidney (renal) cancer.

Prostate cancer – Men who have a father or brother with prostate cancer are at more than double the risk for developing the disease. Genetic testing can help men with a family history of prostate cancer better understand their risk. As well, testing is available for men, with early stage or localized prostate cancer, to help them determine their risk category and guide treatment decisions.

Pancreatic cancer – Some individuals may be at increased risk of pancreatic cancer because of a family history of the disease. This may be due to a specific genetic syndrome. Some gene changes that increase pancreatic cancer risk can be tested for. Knowing if you’re at increased risk can help you and your doctor decide if you should have tests to look for pancreatic cancer early, when it might be easier to treat.

Skin cancer – Genetic testing for melanoma looks for mutations on the CDKN2A gene. Having this mutation significantly increases your chance of developing melanoma.

Thyroid cancer – Several genetic mutations are linked to increased risk of certain types of thyroid cancer.

Call the Center for Cancer Prevention and Wellness at 516-918-4800 to schedule an appointment to learn more about your personal or family risk for cancer and to develop a personalized plan to minimize that risk.

And, learn more about managing your cancer risk. At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

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