Will I get cancer? When will I get cancer?
Those seem to be the questions I keep asking myself. Though there are no ways of knowing all the reasons why so
many people are affected by this disease, science has figured out several factors that make us more susceptible: smoking,
exposure to too much sun and poor diet are just a few. In spite of clean living, there still are many other components. A
factor we may have the least control over is genetics.
Most of us are used to our doctor asking about “family history” during a general checkup, but what about going a step
further? With my possible family history of ovarian cancer, my doctor recommended that I go to the Lifetime Screening &
Prevention Center at Moffitt for genetic counseling. Jennifer Brzosowicz, a genetic counselor for Lifetime, pointed out that
there are several reasons doctors recommend genetic testing for patients. Among them:
● Several relatives on one side of a family with the same or related types of cancer;
● Multiple generations of family members diagnosed with cancer;
● One or more family members developing cancer at an early age.
What Are Our Genes Telling Us?
By Marsha Droste
Moffitt Pinellas Partners Co-chair
By Marsha Droste
Moffitt Pinellas Partners Co-chair
But what is genetic testing? Jennifer explained that this is where an individual’s DNA is examined for possible mutations.
Genetic tests don’t identify cancer—just a patient’s likelihood to develop the disease.
With hereditary breast and ovarian cancer, for example, two genes—BRCA1 and BRCA2
(Breast Cancer 1 and Breast Cancer 2)—have been identified and account for the majority of inherited breast and ovarian cancer.
Everyone has these genes, but tests look for changes or alterations in the genetic material in them that lead to an increased risk of
cancer. A blood sample is sent for testing to a lab in Utah.
What to do with this information? Some might ask if they would want to know the results. Moffitt recommends that if a mutation
is found in the BRCA genes, for example, the patient knows to increase her screening, getting more frequent mammograms,
magnetic resonance imaging (MRI) studies and pelvic exams. Some even choose surgery to avoid the risk altogether.
Insurance companies have a say in all this, too. Depending on your carrier, screening can be partially covered if your doctor
requests it. The consultation can be around $400, where the genetic testing is up to $3,000. This may seem high at first, but it’s
comparable to the expense of other screening tests.
Some may fear that their health insurance companies could drop them, knowing their susceptibility to cancer. But under
federal law recently passed (called the Genetic Information Non-Discrimination Act, or GINA for short), health insurance companies
are not allowed to discriminate based on genetic testing results, even if they pay for the testing. However, there are no similar laws
protecting us against discrimination based on genetic test results when it comes to other types of supplemental insurance
coverage, such as life insurance or cancer coverage.
Genetic tests don’t identify cancer—just a patient’s likelihood to develop the disease.
With hereditary breast and ovarian cancer, for example, two genes—BRCA1 and BRCA2
(Breast Cancer 1 and Breast Cancer 2)—have been identified and account for the majority of inherited breast and ovarian cancer.
Everyone has these genes, but tests look for changes or alterations in the genetic material in them that lead to an increased risk of
cancer. A blood sample is sent for testing to a lab in Utah.
What to do with this information? Some might ask if they would want to know the results. Moffitt recommends that if a mutation
is found in the BRCA genes, for example, the patient knows to increase her screening, getting more frequent mammograms,
magnetic resonance imaging (MRI) studies and pelvic exams. Some even choose surgery to avoid the risk altogether.
Insurance companies have a say in all this, too. Depending on your carrier, screening can be partially covered if your doctor
requests it. The consultation can be around $400, where the genetic testing is up to $3,000. This may seem high at first, but it’s
comparable to the expense of other screening tests.
Some may fear that their health insurance companies could drop them, knowing their susceptibility to cancer. But under
federal law recently passed (called the Genetic Information Non-Discrimination Act, or GINA for short), health insurance companies
are not allowed to discriminate based on genetic testing results, even if they pay for the testing. However, there are no similar laws
protecting us against discrimination based on genetic test results when it comes to other types of supplemental insurance
coverage, such as life insurance or cancer coverage.
Dr. Tuya Pal, a geneticist for Moffitt, began the second part of the consultation by going over my family history. After
discussing my options, I decided I didn’t need the test and I would continue with my annual exams. She then explained a
program called Lifetime Database for Cancer Risk Assessment and Early Detection. This is a voluntary program that
stores your testing material for future studies, such as comparing the family history, diet and lifestyle of cancer patients
with non-cancer patients. I was impressed by this continuing research effort, now in its third year, and signed up right
away. With a small sample of blood drawn by one of the professionals, I was on my way. Feeling as though I had
contributed in some small way, and proactive in my personal research, I’m reminded that knowledge as well as helping out
feels pretty good.
To see a full list of services, visit www.MOFFITT.org and click on “Screening and Prevention” under “Helpful Links.”
discussing my options, I decided I didn’t need the test and I would continue with my annual exams. She then explained a
program called Lifetime Database for Cancer Risk Assessment and Early Detection. This is a voluntary program that
stores your testing material for future studies, such as comparing the family history, diet and lifestyle of cancer patients
with non-cancer patients. I was impressed by this continuing research effort, now in its third year, and signed up right
away. With a small sample of blood drawn by one of the professionals, I was on my way. Feeling as though I had
contributed in some small way, and proactive in my personal research, I’m reminded that knowledge as well as helping out
feels pretty good.
To see a full list of services, visit www.MOFFITT.org and click on “Screening and Prevention” under “Helpful Links.”
| Jennifer Brzosowicz Genetic Counselor at Lifetime |
| Marsha getting blood drawn for the Lifetime Database for Cancer Risk Assessment and Early Detection |