Health Guide Articles

Are you at Risk for Cancer? Hunterdon Regional Cancer Center Program Can Help Get You Answers

October 04, 2011 By Hunterdon Healthcare

Is there a way to find out if you may be at higher than average risk
for certain types of cancer?  Absolutely, says Jackie Hale, an Advanced
Practice Nurse who is coordinator of the Family Risk Assessment Program
for the Hunterdon Regional Cancer Center.

Of all cancers, 70 percent are sporadic or occurring for reasons
related to factors such as age, lifestyle, or environmental exposures.
About 20 percent are familial, meaning several people in a family have
the same kind of cancer, but not because they inherited it in their DNA.
It could be because they shared a lifestyle such as smoking, similar
diet, alcohol intake or obesity, Ms. Hale points out.

“Approximately 10 percent of all cancers are due to a gene mutation,
which can be inherited from either parent,” Ms. Hale says. This has
proven to be true with breast and ovarian cancers as well as colon,
kidney and uterine cancer and melanoma, for example.  Right now, there
is a lot of research investigating the genetic and hereditary risks of
many types of cancers, including lung, prostate and pancreatic cancers.


For those cancers where a genetic predisposition can be identified, a
blood test  may be suggested. “A woman may call me and tell me that
her mom had breast cancer at 42, her sister had it at 50 and her
grandmother at 58; that’s strongly suggestive of an inherited
predisposition,” Ms. Hale says. Other “red flags” include multiple
cases of breast (or other) cancer in a family, not necessarily in those
under age 50, and having family members who developed more than one kind
of cancer .

Also at potentially higher risk for hereditary breast and ovarian
cancer are those of Eastern European Jewish heritage.  Ms. Hale
explains, “Over centuries, as the Jewish population migrated across
Europe, they married within their own culture. It was not uncommon to
marry a distant relative.” That increases the risk for individuals of
Jewish heritage to inherit a “mutated” gene that was present in an
ancestor, she says.

“Everyone has two copies of two “tumor suppressor” genes, known
as BRCA 1 and BRCA 2 that protect against certain types of cancer when
they’re functioning normally. But if someone inherits a copy of the
nonfunctioning, or “mutated” gene, they are at increased risk for
these types of cancer. They could inherit this gene mutation from a
parent who might not have had that cancer, but is carrying the gene,”
Ms. Hale stated.


The average female has an 11 to 12 percent risk of developing breast
cancer, for example, Ms. Hale says. Those with a mutated BRCA gene have
an 80 percent risk.  A test of one simple vial of blood can detect a
“mutated” gene

by examining the DNA of the BRCA genes.

While all cancers come from mutated genes, Ms. Hale points out, not all
are
inherited.  Some genes mutate because of age, for example, she says.
“Every time your body makes new cells, it’s kind of like
“Whisper Down the Lane” - the DNA tries to copy itself
accurately, but it can acquire a mistake,” she explains.

When the cells divide, your chromosomes, carrying DNA strands,
separate, copy themselves, then rejoin in order to make new cells.
There’s a chance for something to go wrong each time this happens, she
says.  Those mutated genes cannot be isolated through the genetic test
on blood, Ms. Hale says.

But for those genes that can, what does the patient do next?  If
someone has an inherited mutated gene predisposing them to breast
cancer, there’s a 50-50 chance their siblings and each of their
children also have it, she says.  Some people frankly don’t want to
know, she admits, and won’t have the
test. “They don’t want to live with that concern at a certain point
in their life. But many of those same people will come back a few years
later because they are ready to have that information for their children
or extended family,” says Ms. Hale. Those who do have the test and
discover they have that mutated gene can do some things to reduce their
risk for breast or ovarian cancer, or to detect it at an early stage.
There are more intense screenings, such as having an MRI as well as
annual mammogram. Healthy diet and exercise are  encouraged, and there
also are medications that can be taken. Some women have chosen more
radical prevention such as having both breasts (risk reduction
mastectomies) or their ovaries (oophorectomies) removed before they
develop that type of cancer.

“They’ve seen other women in their family die,” Ms. Hale says.
“They feel that they don’t want to ‘sit around and wait for
that’. They want to live for their children.” With the recent
addition of MRI to high risk screening, risk reduction mastectomies are
less common , and fewer women are opting for these radical measures
before a cancer develops.

“I believe strongly in identifying those at risk,” she says. The
Family Risk Assessment Program invites everyone to learn more about
their risk even if they
don’t have the genetic test. The education Ms. Hale and her staff
provides
“is well worth it,” she says. “We make a difference and use that
information to empower families.”

For information on the Family Risk Assessment Program, call Ms. Hale
at
908-237-2330 or e-mail her at Hale.Jacqueline@hunterdonhealthcare.org
or
contact Rachel Rando, Genetic Counselor, at 908-788-2566 or
Rando.Rachel@hunterdonhealthcare.org.  For more information on
Hunterdon Regional Cancer Center visit www.hunterdonhealthcare.org.

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