Genetic cancer screening offers some relief, but no guarantees
Written by Justin R. Kalmes | | news@toledofreepress.comCharlene Larson’s struggle with breast cancer is one the 56-year-old Jasper, Mich., resident said she wishes upon no one.
So when Larson received a cancer-screening test that looks for genetic alterations that can increase a person’s risk of breast or ovarian cancer, and the results came back positive, she knew it was her responsibility to inform her family, which includes two daughters, of the
disheartening news.
“I figured if I could help them not go through this journey that I had to go through — the unknown — that would make me so happy,” said Larson, who still receives chemotherapy treatments every week though three years have passed since her diagnosis. “It’s hard, but being blindsided is harder.”
Larson informed her daughters that she carried the BRCA2 (breast cancer 2) gene mutation and that they also might be at risk to developing breast cancer. Both daughters chose to be tested. Lori, 32, did not carry the gene; Lisa, 34, did.
Larson said she couldn’t help but feel responsible for Lisa’s positive result.
“I guess I felt the biggest guilt because I felt like I gave [the BRCA2 gene] to her,” she said. “But she encouraged me and was so grateful … because now she can plan ahead and get things taken care of before [breast cancer] attacks her.”
Those who test positive for the BRCA1 or BRCA2 gene mutation have up to an 85 percent chance of developing breast cancer and a good chance of developing ovarian cancer as well, said Dr. Tim Kasunic, medical director of the genetics clinic at Flower Hospital in Sylvania. Though just 5 percent to 10 percent of breast cancer cases are due to an inherited genetic disorder, he said, those patients that fall within that range are more prone to aggressive cancers that progress at an earlier age and are often undetected by mammograms.
“Identifying those patients is extremely important,” Kasunic said. “It certainly can be life-saving.”
Persons Kasunic said he recommends being tested are those individuals under 50 who have a personal history of breast cancer or anyone who has a family history of breast or ovarian cancer. He said anyone who is concerned about their risk of developing those types of cancers should be referred for genetic testing.
Most third-party insurance companies reimburse patients for genetic cancer screening, which can also be used to detect the risk of developing hereditary colorectal and uterine cancers, said Colette Gaba, genetics outreach coordinator for the University of Toledo Medical Center, which has offered genetic cancer screening since 2000. The typical cost of processing a BRCA1 or BRCA2 test is about $3,000, Gaba said. Hereditary nonpolyposis colorectal cancer genetic tests cost about $2,000, she said. Both tests involve taking a small blood sample from the patient.
Bowling Green resident Cheryl Critton, 49, decided to get tested for the BRCA1 and BRCA2 genes because she had undergone hormone replacement therapy for 16 years and had a family history of breast cancer.
The negative test result allowed her to inform her daughter that she could not inherit either gene mutation, Critton said.
Before her doctor informed her of genetic screening, Critton had been considering more drastic steps because she was anxious after receiving a biopsy earlier this year, she said.
Though genetic screening can help lead to the detection of cancer at an early stage, Kasunic said it couldn’t guarantee a person will never develop cancer if their result comes back negative. A negative result only means the patient is at as much risk of developing cancer as the general population, he said.
“What we don’t want [patients with negative results] to leave here with is, ‘I’m never going to get
cancer,’ ” Kasunic said.
Testing for the BRCA1 and BRCA2 genes started in 1996 through Myriad Genetic Laboratories in Salt Lake City. Flower Hospital has had 48 referrals for the test since it started testing in April 2006 and has administered it to 33 patients. Gaba estimated the UT Medical Center has seen several thousand patients for genetic cancer screening.
