Your Family History Matters

How genetic counseling can help determine your cancer risks

All of us have busy lives. Whether it’s making sure the kids are ready for school on time, dinner is on the table at a decent hour, or trying to complete our latest project for work, time is a precious commodity.

While it’s good to focus on the present, it’s important to know and understand your family’s past. This means going beyond researching the standard family tree and educating yourself about your family’s medical history.

“Appeal to your mom, grandmother, aunts, or cousins to learn about any health issues in your family,” said Thuy Vu, a Carilion Clinic certified genetic counselor. “You don’t want to lose any of the information that could help your health and your kids’ health when older generations pass away.”

Talking about medical issues is never easy, especially for older generations. Often time family members don’t want to burden us with information that can be depressing or stressful. But it’s important to know your family ancestry and which diseases or conditions run in your family, particularly when it comes to cancer.

Unfortunately, cancer touches all our lives, whether it’s family members or friends. The majority of cancer is caused by various factors, such as personal and environmental influences. But 5 to 10 percent of cancer is hereditary. Hereditary cancers occur when a person is born with a genetic error or mutation that has been passed down by a parent. People with an inherited gene mutation have a 50 percent chance of passing the mutation on to each of their children.

It’s important to note, not everyone who is born with a gene mutation develops cancer.

You should consider a cancer risk assessment if:

  • You have a personal or family history of cancer.
  • You have three or more relatives on the same side of the family with the same type of cancer or related cancer.
  • You have more than one type of cancer or cancer in paired organs (e.g. cancer in both breasts) in the same family member.
  • You have cancer at an unusually young age.
  • You have a rare cancer.

“Some people are skeptical of genetic counseling because they don’t want to know if they are going to get cancer,” Vu said. “But if a genetic mutation is found, it doesn’t necessarily mean a person will definitely get cancer, they may just be at a higher risk.”

Genetic counseling shouldn’t be seen as something scary, but a proactive way you can help yourself and your family. By knowing your genetic makeup you and your doctors can tailor your screening and treatment plans.

A genetic counselor will conduct a personalized cancer risk assessment on your medical and family history to see if you are at a higher risk for developing certain types of cancers. If genetic testing is recommended after the assessment, a simple saliva or blood sample will be taken.

“I don’t just work with an individual patient, I work with their entire family,” Vu said. “I often help patients communicate their genetic testing results. This can be done by writing a letter or setting up a family meeting. A meeting can get the whole family talking about the results, asking questions, and sharing perspective.”

If a genetic mutation is discovered, a genetic counselor will develop a cancer risk reduction strategy. Depending on which type of cancer a patient may be at a higher risk for determines the plan of action.

For instance, a gene mutation in ether BRCA1 or BRCA2 significantly increases a woman’s risk for breast and ovarian cancers. If a gene mutation is present, mammograms and breast MRI screenings would be conducted at an earlier-than-recommended age.

“Two of the main concerns about genetic testing that I hear about from patients are, ‘Will my insurance cover testing?’ and “Will I be dropped from my insurance if a gene mutation is detected?’,” Vu said.

If genetic testing is recommended after a detailed risk assessment, most patients would meet their insurance companies’ criteria for coverage of genetic testing. Additionally, if a person was previously denied coverage for genetic testing in the past, it may be worthwhile to look into coverage again as insurance plans change and improve.

“You may now be eligible for testing, when you previously were not,” Vu said.

There are also now federal and state laws protecting patients against genetic discrimination by health insurance companies and employers.

Additionally, there continues to be updates to the genetic technology and discovery of new genes for hereditary breast cancer. If your family history is concerning for hereditary breast and ovarian cancer, but no BRCA gene mutation was previously detected, it may be helpful to have a genetic consultation. Your family may be recommended to have more genetic testing or be offered enrollment in a genetic research study.

Genetic counselors can’t prevent patients from getting cancer, but as with any type of cancer early detection is so important. Genetic testing can help you decide what the best strategy would be moving forward for your family’s health.

So, as you go through your daily routine, remember to keep your family’s health history a priority on your “to do” list. If you don’t know a lot about medical issues from past generations, start keeping records for your kids and your family’s future generations. Be proactive, because knowledge is power when it comes to your family’s health.

For more information about Carilion Clinic’s Cancer Genetics Program, call 540-525-2195 or visit CarilionClinic.org/genetics.

Laura Markowski is a writer for Carilion Clinic’s marketing communications department.