The Naperville Sun
Health Matters
Education is goal of genetic counseling
September 25, 2009
A cancer diagnosis stirs up many emotions. One of the most unwelcome is helplessness. A good antidote is arming yourself with information about your illness and what you can do about it.
For some people, such as Kimberly Jewett of Plainfield, this includes genetic counseling to learn if a predisposition to certain cancers came in the package of genes inherited from mom and dad.
"Knowledge is powerful," said the 32-year-old mother of two, who's both a breast cancer survivor and a woman on a mission. "I want to encourage people diagnosed with breast cancer to seriously consider genetic counseling and, when appropriate, testing."
"When I went in for genetic counseling after my chemotherapy, I was asked to compile a family history of who had what and at what age," Jewett explained. "After going over my history and goals, my counselor suggested testing for predisposition to cancers of the breast and colon. There was no hesitation. I really wanted to know, not just for myself, but also for my siblings and my children, who are 5 and 7."
According to Elyse Weber, a genetics counselor at Edward Hospital in Naperville, "Knowing that your type of cancer runs in your family helps your physicians understand how best to treat you and lessen the chance of recurrence. And your relatives may be advised to go on an accelerated schedule of screenings."
Breast cancer can be hereditary, familial or sporadic. Only five to 10 percent of cancers are hereditary. A hereditary syndrome is suspected when there's a strong family history of breast and/or ovarian cancer. Such a family history may include multiple family members on one side of the family from different generations who have had either breast or ovarian cancer; breast cancer that occurs before the age of 50; cancer in both breasts; male breast cancer.
Abnormalities (mutations) in genes BRCA1 or BRCA2 account for the majority of hereditary breast and ovarian cancer cases. Women with mutations in one of these genes have more than triple the risk.
Familial breast cancer patients have some family history of the cancer, but it may skip generations, occur at a later age or appear occasionally on both sides of the family. People with this history are believed to be at higher risk, but not as high as those with an identifiable hereditary syndrome.
There also are cases of sporadic breast and ovarian cancer, so called because they don't seem connected to the patient's family history.
Jewett had some family breast cancer history, but tested negative for both BRCA mutations and mutations relating to colon cancer. Nevertheless, she chose an aggressive route for prevention: a double mastectomy, rather than removal of just the cancerous breast.
"Some women will choose to have just the cancerous breast removed, even when they do have a BRCA mutation," said Weber. "It's a very personal decision. In either case, our job as genetics counselors is to make sure the patient fully understands her family history, her test results and her options. This way she can be informed and more comfortable making the decision that's best for her."
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