Your Genes Could Hold Answers to Your Risk for Cancer

Anyone can develop cancer, but some people may be at higher risk due to genetic abnormalities that are passed down in their families. Luckily, hundreds of these abnormalities (also known as mutations) can be identified through a process known as genetic testing.

To help people understand the testing process and if they are eligible, board-certified genetic counselor Andrea Smith, MS, LCGC, with The Gregory and Lorraine Harper Cancer Risk and Genetic Assessment Program at Lehigh Valley Topper Cancer Institute, has answered the most common questions her patients ask:

Genetic testing for cancer risk looks for certain mutations, or changes, in a person’s genes that cause them to work improperly.

“Most of the genes tied to cancer risk are ones that control how cells grow. When these genes are mutated, it causes cells to grow out of control and become cancerous,” Smith says. “If someone has one of these known gene mutations, they are often at higher risk for developing one or more types of cancer.”

According to the National Cancer Institute, it is thought that up to 10 percent of all cancers are caused by these gene mutations.

You should consider genetic testing if you:

• Were diagnosed with any type of cancer at a young age (under 50) or someone in your family was
• Were ever diagnosed with a rare type of cancer (such as ovarian cancer, sarcoma or male breast cancer) or someone in your family was
• Have been diagnosed with multiple types of cancer in your lifetime or someone in your family was
• Have several family members who developed cancer (on the same side of your family)
• Have Ashkenazi (Eastern European) Jewish ancestry
• Have been diagnosed with a hereditary cancer syndrome (which is a known risk factor for hereditary cancer)

“If you meet any of these criteria, many insurance policies will cover your genetic counseling and related testing,” Smith says. “Even if your insurance won’t cover it, a genetic counselor can walk you through your out-of-pocket options and help you anticipate costs.”

If you are considering genetic testing, you will meet with a board-certified genetic counselor. They will go through your personal and family health history, and help you determine if you are a good candidate. If so, your genetic counselor will walk you through your options and answer any questions you have before collecting a blood or saliva sample for testing.

“Once your test results come back, your genetic counselor will meet with you to go over your findings in detail,” Smith says. “We will tell you whether you are positive for any gene mutations that could increase your cancer risk and answer any questions you have, regardless of your results.”

If your test results show a gene mutation that increases your chance for developing cancer, your genetic counselor will provide guidance on what type of clinician to see next. Certain doctors and nurse practitioners will be able to provide recommendations for cancer screening and prevention specific to your level of risk.

“They may recommend that you get screened for certain cancers earlier or more frequently, start taking certain medicines to lower your risk or undergo preventive surgery,” Smith says.

Your genetic counselor also will discuss what your results mean for your family members and provide guidance on informing your children and other relatives.

“A lot of people are concerned that the results of their genetic testing could negatively impact their health insurance coverage,” Smith says. “Luckily, there are laws in place that prohibit health insurers from making coverage decisions based on genetic information.”

While these laws also cover employment discrimination in certain circumstances, they do not extend to life, disability or long-term care insurance.

“While some companies offer at-home options, it’s important to know that many of them only look for a small number of gene mutations,” Smith says. “Genetic testing with a genetic counselor offers a more personalized approach, allowing you to be assessed for your specific cancer risk and get tested for many more gene mutations.”

The Gregory and Lorraine Harper Cancer Risk and Genetic Assessment Program is the largest genetic counseling program in the region, providing cancer risk assessment services to more than 600 new patients each year.

In addition to genetic counseling and testing, the program also offers a high-risk multidisciplinary clinic, which provides yearly follow-up appointments and additional care for individuals found to be at higher risk for cancer through genetic testing.

“Through this clinic, individuals receive personalized recommendations for cancer screening and prevention, and referrals for these services,” Smith says. “We also regularly check in with our patients to make sure they are staying on track with their routine care and answer any questions or concerns they have.”