8-19-2016 10-15-04 AMLet’s face it; cancer is an unfortunate fact of life. The American Cancer Society predicts that over 1.5 million Americans will be diagnosed with a form of cancer in 2016, and almost 600,000 will die from the disease. Fortunately, we are learning more about who is most at risk for cancer and ways to help detect cancer at earlier stages, or prevent it altogether. Most cancers develop by chance, and are influenced by a combination of factors including behavior/lifestyle (examples: smoking, lack of physical activity), environmental exposures (examples: asbestos, sunlight), and normal genetic variations which may make some people more at risk for certain cancers than others. In approximately 1 out of 20 people who develop cancer, the disease is caused by an abnormal gene change, or mutation that was inherited from one or both parents. This type of cancer, known as hereditary cancer, has been linked to multiple genes in the body. Mutations in genes associated with hereditary cancer may dramatically increase the risk for cancer in specific organs, including the breast, colon, pancreas, prostate, kidney, and more. Examples of hereditary cancer genes include BRCA1 and BRCA2 (hereditary breast and ovarian cancer), MLH1 and MSH2 (Lynch syndrome/hereditary colon cancer), and CDKN2A (hereditary melanoma). You should suspect possible hereditary cancer in your family if three or more relatives have been diagnosed with the same cancer; cancer has been diagnosed at an earlier age than usual in your family (less than age 50 for breast and colon cancer); multiple unrelated cancers have been diagnosed in the same person; cancer has occurred in the sex not usually affected (breast cancer in a man); or you belong to a higher risk racial/ethnic group (example: breast cancer in Ashkenazi Jews). Advances in gene discovery and genetic testing have made it possible to test for mutations in multiple hereditary cancer genes with a simple blood test. Most insurance companies, including Medicare and Medicaid, now cover genetic testing for hereditary cancer if you meet certain criteria. If your personal or family history is suggestive of hereditary cancer, then genetic testing may help you understand your risk for cancer and make decisions about your health. Genetic testing may also provide information to relatives who may be at risk, such as your children. 8-19-2016 10-15-17 AM A positive result may lead your health care provider to recommend that you have cancer-screening tests earlier or more frequently. If you do develop cancer, finding it early (when the cancer is small) often means that treatment is more likely to be helpful. You may undergo screening tests that are used only for people known to have an increased cancer risk (example: breast MRI for hereditary breast cancer). Also, there may be options to help reduce the risk of cancer, such as drugs or surgery. You should notify your doctor of all cancer diagnoses in your family and discuss whether genetic counseling and testing is appropriate for you. By: Dr. Shanna Ndong

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