The Cancer Genetics Program at Newton-Wellesley Hospital’s Vernon Cancer Center was created for individuals and families who are concerned about their cancer risks due to a personal or family history of cancer.
Some of the services we offer include:
- Comprehensive risk assessment of a patient’s medical and family history.
- Genetic testing for inherited cancer syndromes if appropriate.
- Ways to manage and lower cancer risks based on genetic test results and/or family history analysis.
The majority of cancer cases are thought to be sporadic and due to a combination of environmental exposures, aging and unknown factors. Family history, however, is important when determining increased risk for certain health conditions.
About five to ten percent of cases of cancer are hereditary. A hereditary cancer means that there is an altered gene being passed down in a family that increases a person’s chance of developing certain types of cancer.
Several genes have been discovered that are associated with inherited cancer syndromes, such as hereditary breast and ovarian cancer and inherited colorectal cancer syndromes.
Some features seen in families who have inherited cancers include:
- Younger ages of onset (often less than 50)
- Multiple generations in the family affected with the same cancer or related types of cancer, such as breast, ovarian, colon or uterine cancers
- An individual with multiple primary cancers
- Rare cancers in the family, such as male breast cancer
Importance of Risk Assessment and Testing
Finding an altered gene in the family allows your physician to understand if you have increased risk for certain cancers. Using this information, we can help tailor a screening and prevention program that would detect cancer at an early stage or prevent or lower the risk of cancer.
Also, if you have recently been diagnosed with cancer, finding an altered gene may affect some of your treatment decisions. It also has important implications for your family members.
Creating a Family Health History Record
Information about your family’s health history can help you make decisions about ways to prevent certain conditions or, in the case of cancer, begin screening tests for the purpose of early detection. In the case of most cancers, early detection increases the likelihood of more effective treatment and survival.
The following suggestions can help you create a record of your family’s health history:
- Talk directly with your relatives for the most accurate health history information. Explain to them that their health information can help improve prevention and screening of diseases for all family members.
- Ask your relatives about any health conditions they have had, including a history of chronic illnesses (such as heart disease), pregnancy complications (such as miscarriage), any developmental disabilities and cancers. Note the age of cancer diagnosis. Cancers diagnosed at a younger age have a higher risk of being hereditary. Get as much specific information as possible.
- It is most useful if you can list the formal name of any medical condition that has affected you or your relatives. When complete, show your family health history information to your primary care physician.
- If you are planning to have children, you and your partner should each create a family health history and show it to your physician.
Identifying Patients for Risk Assessment at Newton-Wellesley Hospital
At the Auerbach Breast Center and Women’s Imaging Center at Newton-Wellesley Hospital, our standard of care is to take a thorough family history using the HughesRiskApps software and identify patients that are estimated to have a 10 percent or greater risk of a BRCA1/2 mutation. The patient and the referring physician receive a letter recommending genetic risk assessment at the Vernon Cancer Center or, if the patient has a prior history of breast cancer, through his or her oncologist’s office.
We are also implementing the same screening standard of care in our Adult Gastroenterology Department with a version of the HughesRiskApps software modified with an algorithm to identify patients with risk for inherited colorectal cancer. In this setting a screening questionnaire is conducted by a study liaison with patients on a tablet at the time of screening colonoscopies. As with the hereditary breast and ovarian cancer screening, if a patient is identified as having an elevated risk for inherited colorectal cancer, the patient and the referring physician receive a letter recommending genetic risk assessment in the Cancer Center with a certified genetic counselor. In addition, the gastroenterologist performing the screening colonoscopy is also notified.
Approximately 5 percent of patients screened with this tool have been identified as having an elevated risk for hereditary breast and ovarian cancer, and approximately 2 percent for inherited colorectal cancer syndromes.
If you have questions about the Cancer Genetics Program, please call 617-219-1230.
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