February is National Cancer Prevention Month

Since cancer touches so many lives, it is fitting that an entire month is dedicated to building awareness of the many strides being made in unlocking its secrets. Every day, more is discovered that enables earlier and more accurate risk assessment, detection and precise treatment.

One of the most difficult challenges with cancer is how random it is  

Everyone has a chance of developing a cancer, but why do some get it and not others? We know that age, lifestyle habits and environmental exposures increase risk, yet young children, non-smokers and even dedicated fitness buffs are stricken.

But there are people for whom cancer is a known threat, because they have inherited an increased risk for cancer in the genes they’re born with.  In other words, it runs in their family.

The role of genetics in cancer risk

All of us are born with two sets of genes – one from our mother and one from our father, which carry the genetic material of the generations before them. Certain traits – like the color of our eyes, or the risk of certain cancers – are transmitted through these genes. They are hereditary.

Most cases of cancer begin with a spontaneous change, or mutation, in one or a few genes in the body. However, about 10% of all cancer is hereditary, which means it can be traced to an inherited mutation in one of multiple genes that are important for protecting the body against cancer. People who carry such mutations are more likely to develop certain cancers than the general population. The level of risk and the types of cancer depend on the gene mutation.

Are you at-risk for hereditary cancer?

If you have a family history of certain cancers, and answer “yes” to any of the following questions, you may want to discuss genetic testing options with your healthcare provider:

• Do you have one or more close relatives who have been diagnosed with cancer at an early age?
• Do you have more than one blood relative with the same type of cancer? If yes, is that same cancer found in more than one generation?
• Has anyone in your family had more than one type of cancer?
• Has anyone in your family had cancer in both sides of a pair of organs, such as their  breasts, ovaries, or kidneys?
• Have there been unusual cases of a specific cancer type (such as male breast cancer)?

If you think you may be at-risk for hereditary cancer, there’s no need to panic, because patients diagnosed with most hereditary cancer syndromes do not necessarily develop cancer. Most  importantly, there are genetic tests that can help you better understand your individual cancer risk, and do what you can to guard against the disease.

Genetic testing can provide critical answers

There are two categories of genetic testing that most people are aware of – the direct-to-consumer (DTC) tests that are widely advertised on TV and online, and clinical genetic tests that are prescribed after consultation by a physician or genetic counselor.

The critical differences between these two types of tests is thoroughness and the involvement of a medical professional. So if you suspect you may have an inherited risk for cancer or another disorder, you should discuss clinical testing with your healthcare provider. Positive test results can forewarn you and your family members about increased cancer risks, so you can make informed decisions regarding lifestyles changes, continued monitoring, and possible prevention options.

For example, women with positive BRCA1 or BRCA2 results (the highest risk factor for breast and ovarian cancers) will know they need earlier and more frequent mammograms. They may even opt for surgery that significantly reduces their risk.  Those with high risk for colorectal cancer will know to have earlier and more frequent colonoscopies, and men with a high genetic risk of prostate cancer may watch their PSA levels more closely.

Where should I go if I want clinical genetic testing?

The first place to start is with a healthcare provider. For example, you can search for a Genetic Counselor near you through the National Society of Genetic Counselors. Review your family history with them, providing as much detail as you can about all the cancers that occurred in past and current generations. Then together you can decide if genetic testing is right for you.