How do genetics play a role in cancer?
Women with a strong family history of breast cancer and or ovarian cancer may choose to undergo genetic counselling to help or understand their risk of having same cancer or one of the cancers from the same group. Genes carry the instructions to make proteins which do much of the work in our cells. Certain unwanted changes in the genetic setup can cause uncontrolled growth of cells and cause cancer.
Are all cancers in the family genetic?
A parent may have the gene and do not develop cancer but, their child who inherits the same gene does develop cancer. Cancer may or may not skip a generation e.g. Risk of developing a certain type of breast cancer, bowel cancer, or ovarian cancer is higher if you have a close relative 1st degree and 2nd degree who developed the same condition. The family history of cancer should include 1st-degree relative – Father, mother, siblings as well as 2nd-degree relative, if possible, aunt, Uncle, Grandparents. A note has to be made of what type of cancer occurred, at what age as well as the age at which the person died.
Is genetic testing a good idea?
Yes, definitely, screening the person for genetic disease must be done. If you have a strong family history. However, all cancers are not hereditary. Therefore, you must meet a genetic counsellor who would make a pedigree chart for you and assess your risk of having cancer. Based on your risk they would advise you which genetic test is to be done.
What impact on diagnosis and management of a patient’s genetic screening test is positive?
When a person is genetically tested for a cancer gene and comes out to be positive. It means he/she is at risk of acquiring that cancer. In women, breast, ovarian, and even uterine are hereditary.
If a cancer patient is found to have a mutated gene for example an ovarian cancer patient is found to have BRCA Gene (a gene that determines the risk of breast and ovarian cancer) then, the patient also needs to be evaluated for breast cancer and should get MR Mammography done yearly. Also, there are drugs available specifically for these patients which can be used as maintenance therapy or at times of relapse.
What is the impact on the family if the patient is screened positive?
If your close relative is found to have genetic cancer, then you must get yourself checked. There is a certain prophylactic measure that can be taken in case of hereditary cancers for example in the case of Carcinoma ovary, OCP can be prescribed and risk-reducing removal of fallopian tube and ovary can be done. In the case of breast cancer yearly MR Breast and Prophylactic breast removal surgery can be done at the age of 30 years.
Dr. Satinder Kaur, Clinical Lead & Senior Consultant – Gynae Oncology & Dr. Kanika Sharma, Clinical Lead & Senior Consultant – Radiation oncology at Dharamshila Narayana Superspeciality Hospital, Delhi
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