Cancer Genetics

Q: I have heard people say that cancer is genetic. Does that mean that all cancers are inherited?

A: No. Only about 5-10% of all cancer is inherited. Most cancers are due to an accumulation of genetic mistakes in our cells over the course of time. This is part of the natural aging process, which is why most cancers occur at older ages. The majority of people who develop cancer acquire genetic mistakes over the course of a lifetime. In inherited forms of cancer, a genetic mistake, or mutation is carried in reproductive cells that are passed on from one generation to the next. A small number of individuals are at risk to inherit a genetic mistake from a parent that may predispose them to develop cancer.

Q: I have a family history of breast cancer on my father’s side of the family. Does that affect my risk for developing breast cancer?

A: Yes. Regardless of which side of the family has a history of cancer, you may be at increased risk to develop cancer based on a strong family history. Both men and women can carry genetic mistakes and pass them on to either their male or female children. For example, BRCA 1 and BRCA 2 are genes that are associated with an increased risk for breast and ovarian cancer. These genes may be carried and passed on by unaffected men to their daughters. These women would then be at increased risk for breast and ovarian cancer based on their father’s history.

Q: Does genetic testing determine if and when I will get cancer?

A: No. Genetic testing for cancer susceptibility genes determines whether or not an individual carries a known gene mistake that will predispose him or her to develop cancer at some point during his or her lifetime. Genetic testing may provide a more accurate assessment of whether an individual has a high chance of developing cancer. However, genetic testing can not tell whether an individual will definitely develop cancer, or at what age they would develop it.

Q: I want genetic testing. Do I need to have genetic counseling?

A: Yes. Genetic counseling by an experienced healthcare professional is an integral part of the genetic testing process. During the genetic counseling process the risks, benefits and limitations of genetic testing are discussed. Medical management options and accurate interpretation of genetic test results are also important parts of a genetic counseling session. Information regarding issues such as potential discrimination, screening guidelines, and implications for family members are also discussed.

Q: What is a genetic counselor?

A: Genetic counselors are healthcare professionals with specialized graduate degrees and training in medical genetics and counseling. Genetic counselors may provide genetic counseling in various settings, including prenatal, pediatric, or cancer counseling. Other healthcare providers such as advance practice nurses, oncologists, obstetricians, etc, may have additional training in the field of genetics and provide genetic counseling within the scope of their practice.

Q: Is genetic counseling the same thing as genetic testing?

A: No. Genetic counseling is a form of risk assessment. People who have genetic counseling learn about their specific risk factors based on reported information. Many individuals who have genetic counseling do not have genetic testing. Genetic testing in a cancer setting involves specific analysis of the blood to look for a genetic mistake that is associated with an increased risk to develop cancer.

Q: Can I be discriminated against if I have genetic testing?

A: Maybe. Genetic testing can reveal information about a person’s risks that might have otherwise been unknown. For that reason, the Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996. HIPAA is a federal law that protects individuals with group health insurance from being discriminated against based on a genetic test result. However HIPAA is specific to health insurance only, and life and disability insurance may not be similarly restricted. Individual states may have laws that are more specific and more restrictive than the federal laws