Because one out of every three Americans will develop some form of cancer in their lifetime, many people wonder if they have inherited a risk from one or more family members who are diagnosed with the disease. Patients with a family history of cancer can receive cancer risk assessment and counseling about options for testing and prevention from the comprehensive Cancer Genetics Program based in the Department of Human Genetics at Emory University School of Medicine.
In the decade since scientists discovered altered genes that increase the risk of some cancers, including breast, ovarian, and colon cancers, the field of cancer genetics has expanded tremendously. Statistically, only about 5 to 10 percent of cancers have a hereditary basis, but it is important to identify those families with an increased risk so that family members can proactively take steps to reduce their risk or to keep the cancer from developing.
The Cancer Genetics Program at Emory provides patients with the most current information about inherited risks for cancer and guidelines for cancer screening. Usually referred through their physicians, patients have a chance to share their concerns at an initial individual session with a genetic counselor. At this session, which generally lasts about two hours, patients receive a personalized risk assessment and information about options for genetic testing.
Should a patient decide to pursue genetic testing, the counselor schedules a follow-up visit. Genetic testing for cancer is typically performed on a blood sample, which is sent to a laboratory for analysis. "A positive result doesn't necessarily mean cancer will develop in the future," said Kenneth Loud, MS, CGC, co-director of the Cancer Genetics Program and a certified genetic counselor. "But it predisposes people to a greater lifetime risk."
Women who inherit a mutation in one of the breast cancer genes, BRCA1 or BRCA2, are three to seven times more likely to develop the disease than women without a mutation. Moreover, the risk for ovarian cancer is 16 to 60 percent, compared to less than 2 percent for women without a mutation. Studies have found that the risk for certain types of cancer may be increased depending on which gene is affected.
The complexity surrounding the science of inherited cancer risk has led to the development of a whole subspecialty of genetic counseling, said Loud. "Colon cancer is an emerging area, with better genetic tests than there were five years ago to detect a risk of developing the disease." He expects that as scientists uncover additional "cancer genes," tests will be developed to assess the risk for other forms of cancer.
The Cancer Genetics Program has an advantage through its association with the Winship Cancer Institute, where prophylactic surgical procedures or medical therapies can be used to minimize the risk of developing inherited cancers. Genetic screening and counseling is important even for those who have already been diagnosed with cancer, said Loud.
Along with Loud, the staff of the cancer genetics team includes Christine Stanislaw, MS, CGC, who, like Loud, is a board-certified genetic counselor; Medical Director Paul M. Fernhoff, MD, FAAP; and clinical geneticists Daniel Gruskin, MD, FAAP and Margaret Adam, MD, FAAP. The Cancer Genetics Program is located at 2165 North Decatur Road, a mile east of Emory's main campus. In addition, patients can pursue clinical consultations at Emory's Winship Cancer Institute.
For more information about Emory's Cancer Genetics Program, visit its website at http://www.genetics.emory.edu/genservices/cancer_genetics.php including a referral form for genetic cancer risk and an extensive family history questionnaire.