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FOR MANY, the rapidly expanding world of genetics sounds more like alphabet soup than the cutting edge of medical research: There’s the “letters” of the genetic code, as used in the movie title Gattaca; the breast cancer susceptibility genes BRCA1 and BRCA2; and FAP and HNPCC, here-ditary forms of colon cancer, for example.
Yet, hiding behind these tongue-twisting encryptions and acronyms lies real information about the human body. In the past few years, scientists have discovered genes that, when damaged, lead to dramatically increased cancer risk. Blood tests that detect these damaged genes can identify high-risk patients long before cancer develops.
And that has prompted a new need – for clinicians and counselors who can help people make sense of their individual genetic codes and any predisposition to cancer that may lie hidden within. Increasingly, geneticists and genetic counselors are becoming important players in cancer care.
SINCE OCTOBER, the Cancer Genetics Unit at USC/Norris Comprehensive Cancer Center and Hospital has offered a place where patients can receive education and counseling about their cancer risk, explore their options for cancer predisposition gene screening and, based on their genetic status, plan preventive care or regular follow-ups to detect the first signs of cancer.
Robin Clark, associate professor of pediatrics and a specialist in medical genetics, heads up the unit.
“Hundreds, even thousands, of healthy people in Southern California alone may be able to prevent cancer in themselves and their loved ones by learning more about their genetic code,” Clark says. “We’re still working to get the word out that there’s now something you can do if these cancers run in your family.”
Inherited cancers make up only 5 to 10 percent of all can-cers; the rest are con-sidered “sporadic” and are thought to be tied to gene alterations that have occurred in the patient’s lifetime. So, a negative test for one of the genes doesn’t necessarily mean a patient won’t ever get cancer.
On the other hand, not every single person with an altered gene will develop cancer. These considerations, combined with concerns over possible genetic discrimination, the psychological stress of knowing you carry a high-risk genetic alteration and, for some cancers, limited options for interventions make the decision to get tested a complex one.
“People really need to think this through before they decide,” Clark says.
– Eva Emerson and Christopher Tedeschi
For information on the Cancer Genetics Unit at USC/Norris Comprehensive Cancer Center and Hospital, call 1-800-USC-CARE.
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