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Published on June 07, 2013

Genetic Counseling Helps Patients Understand Cancer Risks

COLUMBIA, Mo. — Patients with the BRCA1 and BRCA2 gene mutations associated with the hereditary breast and ovarian cancer syndrome often face tough decisions: should they take aggressive steps, such as radical mastectomies, to prevent cancer?

At Ellis Fischel Cancer Center, those patients can consult with mid-Missouri’s only certified genetic counselor specializing in cancer to help with these tough decisions. Stacey Miller helps patients and their families understand their risks of developing certain types of cancer and how to take steps toward early detection and prevention.

At least 5 to 10 percent of cancers are the result of inherited cancer syndromes. This translates to approximately 76,500 to 153,000 new hereditary cancer cases each year. Through a hereditary risk assessment and genetic testing, men and women can understand their likelihood of developing certain types of cancer. Hereditary syndromes are associated with almost all forms of cancer including, but not limited to, breast, colon, ovarian, endometrial, thyroid, kidney, stomach, skin, pancreatic and brain cancer.

By looking at a combination of personal history and at least three generations of family history, Miller can determine if patients are at risk of having genetic mutations that could put them at a higher risk for developing cancer. “If you have concerns about your personal risk and your family risk of cancer, a cancer risk assessment will look at family history and personal risk factors to determine if you are at a higher risk for cancer,” Miller said. “Even if you are not a candidate for genetic testing, if you are at a higher risk for developing cancer based on your personal and family history, we can adjust your cancer screening and prevention plan accordingly.”

A cancer risk assessment involves six steps:

  • Collect a detailed cancer-focused personal and family medical history.
  • Determine whether the history is suggestive of an inherited cancer syndrome.
  • Provide patient education and answer questions about cancer testing.
  • Assess the person’s risk of developing cancer and review medical management options with or without genetic testing.
  • Provide psychosocial support and facilitate communication between patients and families.
  • Relay risk assessment information to the patient’s physician.

If the cancer risk assessment determines a patient is a candidate for genetic testing, Miller works with the patient to understand the genetic testing process. Using either a blood sample or a cheek swab, DNA is collected and is tested for specific mutations.

Many genetic mutations associated with cancer risk are dominant, meaning that if a patient carries a mutation, there is a strong possibility that his or her immediate or extended family members are at risk for having the mutation as well. By helping patients understand why cancer is prevalent in their family, Miller can help patients understand and evaluate their screening, treatment and prevention options.