September 10, 2016
Inheriting a greater risk of cancer
BY Clayton Boldt, Ph.D.
Hereditary cancers are caused by genetic mutations passed down from parents to children. The National Cancer Institute estimates these genetic “mistakes” play a role in about 5 to 10% of all cancers.
More than 50 hereditary cancer syndromes have been identified, and genetic tests have been developed to detect many of these.
“New patients want to know, ‘Why did I get this disease and is my daughter at risk?’” says Karen Lu, M.D., chair of Gynecologic Oncology and Reproductive Medicine. “In some cases, we can actually give them that answer.”
Knowing that a particular cancer is hereditary is extremely powerful, not only for patients but also for their families, says Banu Arun, M.D., professor of Breast Medical Oncology.
Lu and Arun are co-medical directors of MD Anderson’s Clinical Cancer Genetics program. Launched in 2002, the program employs 13 counselors in multiple MD Anderson clinics to advise patients diagnosed with inherited forms of cancer.
“Physicians in those clinics are aware of the importance of genetic testing and champion the program,” says Arun. “The process is simple.”
Counselors first meet with patients to discuss family history and determine if testing is necessary. Patients who decide to proceed undergo a simple blood draw. Results are back within weeks. Counselors and patients discuss the results and potential next steps.
When Nonnie Arriola was diagnosed with breast cancer at age 37, her first question was, “Why?” No one in her family had cancer, and Arriola was surprised to be diagnosed with the disease at such a young age.
“I thought it might be genetic,” she says. “I worried about my family and my children.”
After undergoing genetic testing, Arriola learned she had a BRCA1 mutation, which significantly increases the risk of developing breast and ovarian cancers.
After completing treatment, she had a double mastectomy to reduce the risk of the cancer recurring. Earlier this year, she completed reconstructive surgery and is doing well.
First-degree relatives — parents, siblings or children — of people with cancer-causing genetic mutations have a 50% chance of inheriting the same mutation, which dramatically raises their own cancer risk.
They’re treated in MD Anderson’s high-risk clinics, where they may undergo more stringent cancer screenings, take anti-cancer drugs, are encouraged to adopt healthier lifestyles, or even have surgery to remove ovaries, fallopian tubes and/or breasts — an option known as preventive or prophylactic surgery.
“It’s a positive ripple effect for the family,” says Arun. “We’ve found when relatives are tested and take preventive measures, they can avoid the devastating cancers that run in their families.”
After undergoing genetic testing, Arriola’s mother and daughter discovered they carry her same BRCA1 mutation. They’re taking action.
“My mother was having yearly mammograms but is now going every six months.
She’s also having her ovaries removed this year,” Arriola explains. “My daughter is only 20, but she’ll start screening early and is considering future options. She wants to have kids one day, and now knows she may need to start earlier than planned.”
Arriola also is undergoing regular ovarian cancer screenings.
Read more about genetic cancer syndromes and testing that’s available in MD Anderson’s Conquest magazine.