Cancer can impact lives in far more ways than most people realize.
One of the most common but under-reported ways it does that is by making relatives of cancer victims constantly worry whether they will be next in their family to contract the disease, or if they have passed genes onto their children that make them especially susceptible to cancer.
But the fear of cancer doesn’t just stop there. Those who have already battled the disease are often severely stressed at the thought that it will return.
That’s why the Scully-Welsh Cancer Center at Cleveland Clinic Indian River Hospital is introducing a way for people to ease some of those worries.
At the very least, the clinic’s new Genetic Counseling and Testing Services are designed to help people whose close relatives have had cancer to find out if they are predisposed to the disease, and then counsel them about any steps they can take to reduce the likelihood of contracting cancer or catch it in its earliest, most treatable stages.
The service is also for patients who have already battled the disease.
“It’s for talking to patients who have had cancer and those who have a family history of cancer,” says Joy Kechik, who just joined the Scully-Welsh team as a genetic counselor.
It is about discussing “the genetic risks for cancer,” Kechik continues, “doing genetic testing and learning what we can tell them about their cancer history and what we can do about it.
“For some people, there’s a single genetic change we can find that explains the cancers that are in their family and if we know that they have those really high risks, we can do more screening.”
Kechik cites some examples: “If someone has a high risk for breast cancer, we’d start doing mammograms at a younger age and do them more frequently. Or if it’s for colon cancer, we can start colonoscopies younger. So really it’s about being able to do those screening options to try and reduce that risk as much as we can.”
Reducing the risk – for survivors, relatives and their children – also reduces the stress those people have to deal with.
According to Houston’s M.D. Anderson Cancer Center, “first-degree relatives (parents, siblings or children) of people with cancer-causing genetic mutations have a 50 percent chance of inheriting the same mutation, which dramatically raises their own cancer risk.”
But the famed Texas cancer center goes on to say, “we have found that when relatives are tested and take preventive measures, they can avoid the devastating cancers that run in their families.”
That’s a powerful message.
Asked if genetic counseling might even open the door for the use of newer targeted therapies, Kechik instantly replies, “Exactly. If the patient has had cancer, or if they do develop one, depending on their genetic status, that can allow certain therapies to be used more effectively. An example of that would be the use of PARP inhibitors for patients with BRCA mutations.”
Women with these mutations have a risk of breast cancer that is about five times the normal risk and a risk of ovarian cancer that is about 10 to 30 times normal. PARP inhibitors basically block a specific enzyme which, in turn, keeps cancerous cells from being able to grow and multiply.
“Depending on the genetic mutation that’s found in that individual,” says Kechik, “there may or may not be specific treatments or prophylactic surgeries, things that we can do. [But certainly], if you’re at higher risk, we can watch you more carefully, we can catch those cancers early so that they’re not lethal; we catch them in the early stages.”
If you opt for this service, you will need a referral from a primary care doctor or a specialist and can expect to pay about $200 for the counseling session, which will explore the results of your genetic test as well as the emotional, psychological and social implications of what it reveals. A blood sample is also required. The cost of drawing that sample may be covered by your insurance. If you are a cancer survivor on Medicare, the government insurance program will pick up that charge.
For more information on genetic testing and counseling, call a patient care navigator at Cleveland Clinic Indian River Hospital’s Scully-Welsh Cancer Center. The phone number is 772-226-3762.