Fw: WSJ/Testing for Cancer Genes Allows for Earlier Detection

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FYI - for all of us at risk for cancer; especially now, Breast Cancer!

MM / NSIF

----- Original Message ----- From: ruby rahn

Ruby Rahn

Sent: Thursday, August 30, 2001 7:24 PM

Subject: WSJ/Testing for Cancer Genes Allows for Earlier Detection

WALL STREET JOURNALAugust 31, 2001Health JournalTesting for Cancer Genes Allows for Earlier DetectionBy TARA PARKER-POPE Staff Reporter of THE WALL STREET JOURNALSHOULD YOU BE tested for a cancer gene? Although most cancer isunpredictable, a small percentage of the population carries a gene mutation thatdrastically increases the risk for certain types. Cancer genes linked to breast,ovarian, colon, and some uterine and thyroid cancers have been identified.Testing for cancer genes can allow for earlier detection and preventivetreatments. But countless more people worry that they carry a genetic time bombwhen they may have no particular increased risk.Not everyone with cancer has the cancer genes, and simply having a relativewith cancer doesn't necessarily increase your risk for carrying the genes. At thesame time, some doctors and patients are ignoring critical information -- such asbreast cancer patterns on a father's side of the family -- that may make certainpatients good candidates for genetic testing.The most common cancer genes for which patients are tested are the BRCA1and BRCA2 genes, which increase risk for breast and ovarian cancer. About onein 700 women carries one of the genes, and the risk is about one in 50 amongEastern European Jews.THE LIFETIME RISK for breast cancer for the general population is 11% to12%, while the risk for ovarian cancer is 1% to 2%. The presence of abreast-cancer gene increases lifetime risk to 50% to 85%. Ovarian cancer riskjumps to 20% to 40% for the BRCA1 gene and 10% to 20% for the BRCA2gene.The MLH1 and MSH2 genes increase risk for colon and endometrial cancers.Generally, the risk of colon cancer is about 6% before the age of 70. However,people with the colon-cancer genes may have a lifetime risk as high as 70%.Gene testing is also available for less common cancers.Because there are so many variables affecting genetic risk, it's best to start witha genetic counselor. "It's hard to find a family tree that doesn't have somebodywith breast cancer," says Schneider, president-elect of the NationalSociety of Genetic Counselors. "That's why we pay attention to the pattern ofcancer in the family."Genetic counseling is free at some research centers, while other hospitals chargefrom $75 to $200. Insurance coverage varies. Most doctors can recommend acounselor, or patients can search for one through the National Society of GeneticCounselors Web site, www.nsgc.org/resourcelink.asp1.Genetic counselors take an extensive family history, often identifying patterns thataren't obvious to patients, or even to their doctors. Breast cancer that appears ina family when people are in their 20s, 30s or 40s, for example, is more likely dueto an inherited gene than cancer that shows up after age of 50. Although manywomen worry about breast cancer in their mother's family, half of those withbreast-cancer genes inherited them from their fathers. A family history of ovariancancer at any age puts a person at higher risk for a cancer gene.COUNSELORS USE computer models to determine the risk for carrying acancer gene. Generally, only people with a risk of 10% or greater for having thegene are tested. Even so, people who remain worried and still want the test areeligible to have it, but it's unlikely insurance will cover the cost. About half thosetested have had cancer but want guidance for future treatment. Lazar, 36, of Chicago recently sought genetic counseling because hermother died of breast cancer. But she hasn't decided whether to have the test.She already gets regular screenings and wouldn't opt for preventive drugs orsurgery if she tested positive. "Having someone in my family with cancer makesmy risk higher, but maybe not as high as I thought it would be," she says.To get the most meaningful result, genetic testers start with the person most likelyto have the gene mutation. For instance, a woman who wants gene testingbecause her aunt and mother developed breast cancer likely wouldn't be testedfirst -- the mother or aunt would be. If the cancer gene is found, other familymembers would be tested.Gene testing starts with a simple blood test, and results take about three weeks.The breast-cancer gene test costs $2,680 and insurance coverage varies. MyriadGenetics of Salt Lake City is the only company that does the initial breast-cancergene tests. Once a mutation is found, testing other family members costs about$315 each. Colon-cancer-gene testing is available through a handful of labs andcosts between $1,700 and $2,000.Many patients worry about losing coverage or paying higher rates if an insurancecompany knows they have a cancer gene, but experts say there hasn't been asingle such case reported. About two-thirds of the people Myriad tests haveinsurance pay, says medical director Tom .Once a patient knows they have a gene, they can opt for more regularmammograms or colonoscopies, preventive drugs such as Tamoxifen,prophylactic removal of their breasts or ovaries, or in the case of someone whohas had colon cancer, more extensive surgery to prevent recurrence."There are great differences in the medical management of people who don'thave these genes and people who do," says Jill Stopfer, familial cancercoordinator for the University of Pennsylvania Cancer Center.E-mail comments to healthjournal@... Hyperlinks in this Article:(1) http://www.nsgc.org/resourcelink.asp (2) mailto:healthjournal@... Copyright © 2001 Dow & Company, Inc. . Printing, distribution, and use of this material is governed by your SubscriptionAgreement and copyright laws. For information about subscribing, go to http://wsj.com __________________________________________________