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July 26, 2011 > When Cancer Discriminates

When Cancer Discriminates

Seminar Focuses on Cancer Risk Based on Family History of the Disease

Cancer. It represents the second leading cause of death in the United States, and though it is second to heart disease in its number of victims, it tends to instill more fear. Of the unknown. Of the unavoidable. And of the seeming randomness of who, when and why the disease will strike.

But there are other people whose fear of cancer is more concrete-people who have lost close family members to the same type of cancer. Referred to as a cancer syndrome, this type of genetic predisposition increases an individual's lifetime risk of developing cancer.

"An individual diagnosed with cancer who has some family history, or women with a mother or sister diagnosed with breast cancer, or anyone diagnosed with multiple cancers, such as breast and ovarian-these individuals are our target audience when talking about heritability and cancer," says Vandana B. Sharma, M.D., PH.D., an oncologist on the Washington Hospital Medical Staff and director of the hospital's Cancer Genetics program.

For these individuals in particular, knowledge can make all the difference in early detection and even avoidance of developing cancer, according to Dr. Sharma.

"By getting information early on and understanding their risk, people can positively impact their outcomes when it comes to cancer," she says.

Next Tuesday, Aug. 2, from noon to 1 p.m., Dr. Sharma and Nicki Chun, MS, CGC, a genetic counselor with the Stanford Cancer Genetics Clinic, will present a free Lunch and Learn lecture at the Washington Women's Center to discuss why and how genetic counseling can help individuals with a strong family history of cancer.

"Many people out there may not even realize that their risk for developing cancer is something they can alter," Dr. Sharma says.

She says she has had many patients tell her that they assumed, 'I would die of cancer because everyone else in my family has.' Dr. Sharma is adamant that this is not the case.

'Like a weight has been lifted'

"When we do genetic testing, we're able to implement strategies to diagnose the cancer earlier and sometimes even prevent it. If we do test the individuals and family members and an individual doesn't have the gene mutation-not gene-then they know that don't have an increased risk and therefore don't have to do the more frequent screening.

"It can be like a weight has been lifted."

"One of the reasons we want people to be aware of family history in regard to cancer is because we would potentially screen these individuals differently, simply because there are some very direct, immediate implications with family history in regards to cancer risk," Dr. Sharma says.

Likewise, individuals diagnosed with more than two cancers are more prone to a genetic predisposition that could be shared amongst family members-people whose screening schedules for cancer may change drastically based on this information.

"In the case of a woman with a mother diagnosed with breast cancer at 45, we would probably suggest a more intensive screening for breast cancer for that individual patient," Dr. Sharma explains. "Similarly, a man with multiple family members with colon cancer would potentially have his screening more often.

"The general screening schedule for colon cancer is beginning at age 50, and if everything is normal, a person is screened five to 10 years later. However, with a strong family history, the schedule increases in frequency to one to three years. We always recommend that people with a first-degree relative who has been diagnosed begin the screening 10 years younger than the age their relative was diagnosed. We wouldn't wait until the age the cancer was found in the family member."

Looking to the future with hope

Nicki Chun recommends seeking information rather than feeling anxious and uncertain about what the future may hold.

"Many people have relatives with cancer," Chun says. "During the talk, we'll discuss who might benefit from genetic testing, the basics of inherited cancer risk, what genetic tests are currently available and what might become available in the future."

She says people have a lot of unanswered questions when it comes to cancer risk, and genetic counseling is a good way of getting answers.

"Two of the most common questions people have when they come to genetic counseling are: 'What caused my cancer?' and 'What does it mean for my kids and relatives?' The other outstanding question is: 'How will this affect my treatment?'"

In addition to altering screening frequency, Chun says, treatment options for individuals with cancer frequently change based on knowledge about family history and genetic risk.

"In the case of a younger women diagnosed with breast cancer, treatment may be altered to limit radiation," she points out.

Treatment modalities and technology also change frequently in the realm of cancer care, which is why it's important to seek the latest information. Dr. Sharma emphasizes that no one should feel frightened or intimidated out of getting information about his or her genetic risk.

"Some people are afraid of being discriminated against, but there are federal and state laws that prevent employment or health insurance discrimination based on someone's genetic information," she says. "It's all confidential and genetic testing and counseling can make a significant difference.

"We very strongly believe that an individuals should go through genetic counseling and have an opportunity to speak with a physician who understands the implications of a positive, negative or ambiguous test result."

For more information about classes at the Washington Women's Center, call (866) 608-1301 or (510) 608-1301. To register for this class, call (800) 963-7070 or go online at

Cancer in the Family... Am I at Risk?

Bring your lunch, and learn more from Dr. Sharma and Ms. Chun about genetic counseling and cancer risk based on family history. "Cancer in the Family... Am I at Risk?" will take place on Tuesday, Aug. 2, from noon to 1 p.m. in the Washington Women's Center Conference Room, located at 2500 Mowry Avenue, Suite 150, in the Washington West building.

Who should attend?

* Individuals that have been diagnosed with cancer and have a family history
* Women with mother or sister who have been diagnosed with breast cancer
* Individuals diagnosed with multiple cancers (such as breast and ovarian cancers)
* Individuals with colon or uterine cancer
* Anyone with multiple family members affected by cancer
* Members of the community interested in learning more about genetics

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