“Everybody in our family gets cancer if they live long enough.”
Unfortunately, that is a statement heard too frequently when doctors are asking patients about their family’s health. For these patients, nagging thoughts may occasionally surface, such as “I wonder if I’ll get cancer too,” “If I get cancer, will there be any warning or will it just be too late when I find out?” or “I wish there was something that I could do to break the family pattern of suffering with cancer.”
For many years, those worries just resided in the back of their minds like a cloud hovering in the background, but to quote Bob Dylan’s song, “The times, they are a changin’.” As the mapping of the human genome project got underway, there was an explosion of research in the scientific community and private lab businesses. Much like the space race, everyone wanted to be the first to discover a link between changes in certain genes and disease risk. And we now know that certain changes in specific areas of our genes can put us at greater risk for cancer.
For instance, there is a specific genetic change that, if present, can raise a woman’s lifetime risk of developing breast cancer to as high as 87%. And although that’s a very depressing statistic, that is not the end of the story. Knowing they may be at increased risk allows a person to be more active in preventing it, such as undergoing early and additional screenings with mammograms and more per evidence-based guidelines for high-risk patients. Elective surgery can also reduce risk. For example, people with a high risk of hereditary breast and ovarian cancer can choose a bilateral mastectomy (where a surgeon removes most of the breast tissue) as which reduce their lifetime risk of breast cancer by up to 90%.
There are known genetic links to several types of cancer now. The most common cancers that may have a genetic link are breast, ovarian and colon. A family history of any of these listed cancers developing at age 50 or younger indicates a greater potential for an inherited link and germline genetic testing is usually recommended. Testing for genetic links is very simple, and usually just requires a spit test or needle stick for a small tube of blood. However, the issues surrounding genetic testing are very complex, so it is recommended that a person interested in getting it done have a good understanding of the process and possible outcomes. A counseling session prior to genetic testing will give the person being tested a chance to think about these issues and be informed beforehand, which, in turn, should help them understand the results even better.
Thanks to these new testing options, there is great optimism that family trees can be changed through screening and preventive health measures. Just think: perhaps one day soon, people will be able to say “Cancer used to run in my family.”