By Nancie Petrucelli, senior genetic counselor and coordinator of the Cancer Genetic Counseling Service at the Barbara Ann Karmanos Cancer Center and Wayne State University School of Medicine
When a patient of mine, Shamika Long, 37 of Detroit, received a breast cancer diagnosis in July of 2008, the news was devastating to her.
“When I heard the diagnosis, I cried all day,” she said. “I was told that cancer wasn’t painful. My tumor was painful. I was looking for a good diagnosis.”
Shamika came to the Barbara Ann Karmanos Cancer Center for treatment, undergoing six rounds of chemotherapy, a double mastectomy, the removal of 16 lymph nodes, and radiation treatments.
“I have never been so sick in my entire life,” she said. “After my first chemotherapy session, I was hospitalized for four days.”
Despite the harrowing experience, Shamika wanted to take additional proactive measures in fighting her cancer and preventing any additional cancer diagnoses. She learned about the Karmanos Cancer Genetic Counseling Service and I met with her in October 2008 for genetic counseling to discuss her cancer risk assessment, a process that would help determine if she had a hereditary form of cancer, as well as the option of genetic testing.
“I wanted to have the test because of my father’s (health) history” she said.
The mystery of genetics
As the senior genetic counselor and coordinator of the Cancer Genetic Counseling Service at Karmanos and Wayne State University School of Medicine, I’ve found that many people are intrigued with the concept of how genetics plays a role in a person’s health and how one person is afflicted with a particular disease while another person remains disease-free. The same is true for cancer.
Apart from the Cancer Genetic Counseling Service, scientists at the Barbara Ann Karmanos Cancer Center study how genes control the development of cancer cells and how they sometimes spur them into spreading to other parts of the body.
Do you have a family history of cancer?
I advise people who visit the Cancer Genetic Counseling Service at Karmanos that having a family history of certain cancers may increase their own risk for developing the disease. While most cancers occur by chance, it is estimated that about 5-10 percent of cancer cases run in families (i.e. are hereditary).
My colleagues and I help individuals learn about the impact their personal and family history has on their chance of developing cancer, as well as the risk to other family members. Our goal is to help them understand their cancer risk and become more involved in ways to reduce their risk by modifying their lifestyle and developing a personalized screening and treatment plan.
Should you consider genetic counseling?
If you are anxious or are concerned about your cancer risk, I hope you’ll contact us, especially if you have any of the following:
- Several relatives with cancer.
- A personal or family history of a rare or unusual cancer, such as male breast cancer.
- A relative with more than one type of cancer.
- A personal and/or family history of cancer under the age of 50.
What can you expect during an appointment?
When individuals are interested in genetic counseling and/or testing, I tell them they can expect:
- A complete evaluation of their family history by a genetic counselor and doctor who specialize in cancer genetics.
- A risk assessment
- An estimation of their chance to develop specific cancers based on their family history and other risk factors.
- An estimated chance that cancer might be passed along through the genes in their family.
- A discussion of genetic testing options. If an individual pursues testing, results are shared with them during a return visit.
- Information about ways to lower their risk of getting cancer and ways to find it early when it is most easily treated.
What is genetic testing for cancer?
When genetic testing is performed at the laboratory, testers look at a person’s genetic information (DNA) for changes associated with an increased risk of developing certain cancers. This testing may reveal whether the cancer risk in a family is passed through their genes (i.e. is inherited). The procedure requires me to take only a small blood sample and when possible, I begin with a family member who has had cancer. If you are eligible for testing, the choice is yours. I also will discuss with you the cost, insurance coverage, and the risks and benefits of testing to help you make the choice that is right for you.
What difference can cancer genetic counseling make?
An evaluation with the Cancer Genetic Counseling Service could save your life! The information that we discuss with individuals during their appointments informs them of their own cancer risk and ways they can reduce this risk. It also allows their health care provider to develop a management program unique to their own needs.
Finally, this information will help family members who may be at an increased risk of developing certain cancers and may benefit from frequent cancer screening. Family members who may not be at an increased risk of developing cancer and may not need unnecessary cancer screening will also benefit from this service.
Knowledge is power, so I encourage you to consider genetic counseling if you have concerns that you may be more susceptible to being diagnosed with cancer. To meet with one of our genetic counselors, please call 1-800-KARMANOS (527-6266) or e-mail firstname.lastname@example.org to set up your appointment. You can also visit our Web site at www.karmanos.org for more information.