Know Your Genetics to Lower Your Cancer Risk — and That of Your Family

A gene mutation that puts you at a higher risk of cancer is just as likely to come from your father as it does from your mother. Unfortunately, only 4 percent of those who undergo hereditary cancer gene testing are male, leaving a huge knowledge gap that could help you prevent cancer altogether or inform treatment decisions, according to a study published in the journal JAMA Oncology.

Louise Morrell, MD, genetics specialist and medical director of the Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health.

“Men don’t often look for tests and often don’t understand the importance of the information,” says Louise Morrell, MD, genetics specialist and medical director of the Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health. “The more accurate our information, the better our prevention guidance. In genetics, unlike other fields, the benefit extends to family members and perhaps to future generations.

Hereditary cancers

Today, up to 15 percent of cancers are linked to a hereditary link. Knowing about these connections can help you and other members of your family prevent or reduce your risk of cancer.

Scientists have identified many mutations that increase the risk of breast and gynecological cancers, some prostate cancers, colon cancer, gastrointestinal cancers, kidney cancer, and more. For example, a man with prostate cancer linked to a BRCA2 mutation can pass that mutation on to his son or daughter, increasing the risk of breast cancer in both children and prostate cancer in the son.

Awareness of the value of genetic assessment and testing, especially in men, is important to the experts at Lynn Cancer Institute and Miami Cancer Institute. As the field of genetics moves at a rapid pace, discoveries can affect everything from cancer screening guidelines to treatment options for people with cancer.

Although researchers have spent decades uncovering the links between genetic mutations and cancer, public knowledge grew when actress Angelina Jolie had her breasts removed in 2013 and her ovaries removed in 2015 because she carried the BRCA1 gene mutation linked to a breast cancer. higher risk of breast and ovarian cancer. Ms. Jolie’s mother, grandmother and aunt had died of cancer, and her decision to have her breasts, ovaries and fallopian tubes removed prophylactically to lower her cancer risk came after multiple tests and discussions with experts. The same BRCA1 and BRCA2 mutations that increase the risk of breast cancer in women also increase the risk of breast cancer in men by eight times, according to the American Cancer Society.

Asking questions

Arelis Mártir-Negrόn, MD, a medical geneticist and chief of the Clinical Genetics program at the Miami Cancer Institute, part of Baptist Health.

Whether you’re male or female, your family’s health history can hold the key to your future, says Arelis Mártir-Negrόn, MD, a medical geneticist and chief of the Clinical Genetics Program at the Miami Cancer Institute. ‘Because as many men pass on mutations as women do, you need to know your father’s family’s cancer history as well as your mother’s. Know your family history. Ask questions.” In general, the earlier cancer is detected, the better the chance of survival.

Just like Ms. Jolie, when Matthew Knowles, the father of artists Beyoncé and Solange, announced in 2019 that he had breast cancer, he put genetics in the spotlight. His mother, aunt and great-aunt had died of breast cancer and he learned that his rare male breast cancer was caused by a BRCA2 gene mutation. He understood that his daughters had a 50 percent chance of inheriting his mutation.

Genetic testing among blacks is much lower than among other races. Doctors would like to see that change, especially since some breast cancers with a poorer prognosis are also more common in black women. Fortunately, later tests showed that neither daughter had the mutation. mr. Knowles underwent a mastectomy.

Thinking of genetics as a recipe helps some people understand it better, genetic counselors say. All humans inherit two copies of each gene: one from their mother and one from their father. Variations in genes are normal and give us our diversity. A small change in the recipe may not make much of a difference, but the wrong ingredient or too much or too little of something can cause the recipe to change drastically. In addition, not all mutations carry the same risk.

“A BRCA mutation can lead to an 80 percent risk of breast cancer, but an ATM mutation can have a 20 percent lifetime risk,” says Dr. morrell. “These are very different, which is why having this information is so valuable.”

It’s important to note that just because you carry a mutation doesn’t mean you’ll get cancer. “There are many things we consider when assessing risk,” says Dr. Martir-Negrόn. “We can suggest lifestyle changes that can reduce their chances of developing cancer. There are times when we can also suggest drugs or present the idea of ​​preventive surgery.

The genetic teams at Lynn Cancer Institute and Miami Cancer Institute provide multidisciplinary care to patients—and often their family members who may also be affected—to better understand their risks, help them determine whether genetic testing is helpful, and help them understand of the results, whether positive, negative or inconclusive. The team is also developing personalized cancer prevention for “previvors,” the term used for people with a predisposition to cancer.

Fortunately, technological developments continue to make it possible to test for more genes. In recent years, improvements have speeded up testing and made it cheaper. In addition, the answers from genetic testing in someone who has already been diagnosed with cancer can help make decisions about treatment and surgery.

Who Should Consider a Cancer Genetic Assessment?

Men should consider a review if they:

Have had cancer themselves Starting cancer in their family at a young age Have a relative with multiple cancers Have a family tree with multiple cancers, especially on one side or the other Be a member of certain ancestors with higher rates of some genetic mutations, including those of Eastern European Jewish descent.

Couples who have a family history of cancer and are considering pregnancy also often use genetic assessment. “If you really want to be able to tell your kids that they’re not at risk of having a particular mutation, you need to test both parents,” says Dr. morrell. “The offspring can only inherit a mutation that the parents have. Mutations do not skip generations. The parent must also inherit it.”

For more information on genetic assessment, testing, and counseling at the Lynn Cancer Institute’s Morgan Pressel Center for Cancer Genetics, click here; for information on the Miami Cancer Institute’s Clinical Genetics program, click here.

Tags: genetic testing, Lynn Cancer Institute, Miami Cancer Institute

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