These two questions are commonly asked when someone realizes that they (or their family member) have an increased risk to develop a particular cancer in their lifetime. It should be understood that every living person has a small chance to develop various cancers throughout his/her life. Cancers are a group of more than 100 diseases that occur because of abnormal cell growth - cell growth that happens more than it should. During our lifetime, our cells will grow, divide, and die in an orderly fashion. Our cells are programmed with instructions from our genes and DNA to do this. However, when there are mutations in our DNA and/or broken repair mechanisms from our genes, which allow cells to grow without the usual controls in place, cancer develops in our body.

Usually, cancer may not develop in us because some are rare and slow growing, unless the cancer produces signs/symptoms or is found by routine screening. Screening tests are used to find cancers before someone has symptoms.Once the cancer is found, a treatment plan can be put in place. In the case of hereditary breast and ovarian cancer, which represents 5-10% of all breast and ovarian cancers, we in the healthcare field can more accurately pinpoint who is likely to develop cancer, which family members should be informed, and educate them on appropriate screening/treatment recommendations.

Some cancers can be avoided by changing your lifestyle, like cancers caused by tobacco use and alcohol consumption. However, you cannot avoid the gene mutations that may have been passed down to you. Does that mean there is nothing to do in the case of hereditary cancer? No. For these cancers, prevention comes in the form of high-risk screening and/or surgically removing the location where the cancer (or pre-cancerous cell change) is likely to develop.

Each person's screening recommendations will be tailored to them, and you should discuss your plan with your healthcare provider. There are many factors to consider. Many of us follow the National Comprehensive Cancer Network's (NCCN's) 2015 Guidelines for hereditary breast and/or ovarian cancer syndrome (details can be found at www.nccn.org). This type of high-risk screening (for women and men) can be performed by a family/primary care physician, breast surgeon, OB/GYN, physician assistant, or RN/NP.

Other hereditary cancer syndromes associated with breast and ovarian cancer (such as Li-Fraumeni, Cowden, hereditary diffuse gastric cancer, Peutz-Jeghers, and Lynch syndromes) have specific screening and management recommendations tailored to those with gene mutations that cause the syndrome.

If you are concerned about the risk for developing these cancers and screening/prevention recommendations, you should have an initial risk evaluation by the appropriate genetic specialist (medical geneticist, genetic counselor, oncologist, surgeon, oncology nurse, or other health professional with expertise in cancer genetics). They will be able to give you accurate information and help guide you through the next step of your journey.