SEATTLE, Jan. 24, 2007 – Imagine if a simple blood test could determine gene mutations and predict who in a family is most likely to develop cancer.
That's now possible for some forms of genetically linked cancers and Swedish Medical Center in Seattle has established a new Hereditary Cancer Program to assist Northwest patients better understand their risks and treatment options.
As part of the Swedish Cancer Institute, the new program focuses on cancers with proven hereditary ties. Those include – but aren't limited to – breast, ovarian and colon cancers. Each year approximately 260,000 cases of breast cancer and 22,000 ovarian cancers are diagnosed in the United States. Best estimates are that 10 percent of these cases have hereditary links. There are roughly 150,000 colorectal cancer diagnoses each year, and 5 percent to 10 percent of these likely are caused by inherited gene mutations.
Robert Resta, M.S., C.G.C., is the new program's clinical coordinator and supervising geneticist. Certified in genetic counseling by the American Board of Medical Genetics and the American Board of Genetic Counseling, Resta has been with Swedish since 1983. Other key clinicians are medical oncologist and breast-cancer specialist Kristine Rinn, M.D., gynecological oncologist Pamela Paley, M.D., and colorectal specialist Rodney Kratz, M.D.
"Our primary goal is to integrate genetic-test results into patient care and surveillance for cancer," Resta said. "Testing helps determine appropriate screenings and medical procedures for a patient's close relatives who may be at elevated risk for cancer. If it develops, we can find the cancer at an earlier and more treatable stage."
For example, if a family member's genetic test reveals a mutation in the BRCA 1 or BRCA2 genes, which can cause hereditary breast or ovarian cancer, then she would be directed to have mammograms and MRI studies of her breasts every year, starting at about age 25. In addition, ovarian cancer is notoriously difficult to detect at an early and treatable stage. Women who have positive genetic test results often consider having their ovaries removed once they have completed their families.
Hereditary testing also can identify relatives who are not at increased risk and who no longer require frequent, intensive screening. This can offer significant release from stress and worry about cancer.
People who should consider genetic counseling include:
- Women with breast or uterine cancer before age 50
- Women with ovarian cancer at any age
- Men with breast cancer
- Men or women with colon cancer or polyps before age 50
- Men or women with a family history of breast, ovarian, uterine or colon cancer
- People who have had more than one cancer, especially at a younger age
- Anyone worried about their family history of cancer
Not everyone will choose to have testing, and testing may not be recommended for all patients. However, genetic counseling can help patients weigh the advantages and disadvantages of testing, and whether or not testing is right for them.
A genetic counseling session usually lasts 30 to 90 minutes and costs $100 to $200. Genetic testing, which starts with a simple blood draw, can cost from $350 to $3,200, based on a variety of factors unique to individuals. Typically, test results are available as soon as 28 days after a patient's blood sample is submitted. Most of the Hereditary Cancer Program's analysis work is performed at Myriad Genetic Laboratories, a Utah-based lab with patented processes and extensive experience.
All test results are confidential and many insurance companies cover genetic testing, but carriers have different criteria for what circumstances must apply.
The Hereditary Cancer Program office is located at the Swedish Cancer Institute, 1221 Madison St., Suite 1220 on Swedish's First Hill Campus. It is open Monday through Friday from 9:30 a.m. to 2:30 p.m. For more information or to schedule an appointment, call 206-386-3200.