Questions & Answers about Genetics
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For Any Cancer Diagnosis
- Q.
Is genetic testing necessary or just helpful for treatment?
A.There are two main types of testing that can be helpful for treatment, although it is up to oncologists to determine whether or not genetic testing is necessary for specific patients. One type of genetic testing is predictive genetic testing, to see if a patient has a higher risk of certain types of cancer. Predictive genetic testing may affect the type of treatment suggested once cancer is diagnosed, due to existing knowledge about connected inherited cancers.
The other type of testing is when oncologists test cancer cells to determine the precise mutation that led to cancer, called genomic testing. This may be an inherited mutation, or may be an acquired gene change that occurred due to environmental or unknown reasons. Testing existing cancerous cells for their gene changes helps patients to have more information about recurrence rates, targeted treatment, and treatment choices.
To determine if genetic testing is necessary for a specific type of cancer, patients can ask their oncologists, or request to meet with a genetic counselor. A genetic counselor can help patients determine if genetic testing would be helpful, as many genetic mutations may not reveal concrete steps that affect treatment.
Getting genetic testing can affect patients’ levels of anxiety, and fear for the future, so it is important to take time either before or after the test to speak with medical professions who can help explain the statistics and information shown in a genetic test. Advanced testing of cancer cells may not be recommended by genetic counselors depending on the type of cancer, so it is important to speak with a patient’s medical team before determining treatment options.
Consider speaking with a professional about fear, anxiety, or stress connected to genetic testing. Some people diagnosed with cancer also join support groups, to connect with others who have had similar genetic tests. We also have many podcasts available with experts in the field discussing some of the benefits of genetics and genomic testing.
Answered by
Charlotte Ference, MSW, LCSW
For Triple Negative Breast Cancer
- Q.
How would a negative genetic result for a triple negative breast cancer benefit the patient herself? Are there any benefits for the patient or is it only that her relatives are less likely to carry the gene?
A.Many individuals and families impacted by TNBC have questions about genetic testing and its implications. It is first important to note that today there are numerous genetic testing panels, and that the currently available genetic tests are not able to pinpoint increased risk of a specific subtype of breast cancer but rather increased risk of breast cancer in general; there is not a genetic test at this time that is looking specifically for risk of triple negative breast cancer. Triple negative breast cancers and BRAC mutations have a higher percentage of being linked, but it is also important to note that the BRAC mutation accounts for a small percentage of overall breast cancers and not all cases of TNBC are caused by a genetic mutation.
As we are a staff of social workers at CancerCare and are not medical providers, I cannot provide specific medical guidance or treatment/testing suggestions. What I can share generally is that genetic testing (including the BRAC panel and others) can potentially have a physical, emotional and financial impact on the individual being tested as well as their family members. For this reason, it is always encouraged that you speak to your treating medical team as well as a genetic counselor prior to being tested so that appropriate guidance can be provided about what the test results may mean for you and your family. Receiving a negative genetic testing result means that you do not carry specific genetic mutations that are linked to an increase risk of breast and certain other cancers, but a negative result does not mean that one will never receive a breast cancer diagnosis. If an individual diagnosed with TNBC receives positive genetic testing results, having that information may impact not only the treatment and future health decisions of that person, but can aid that individual’s children and family in making decisions about genetic testing for themselves and their own health.
This is a very important topic, and it is understandable that genetic testing may raise questions and concerns. For additional information on genetic mutations and hereditary cancers or to speak to a genetic counselor for preliminary guidance, you may want to contact FORCE (Facing Our Risk of Cancer Empowered). They can be reached by phone at 866-288-7475 or emailed at info@facingourrisk.org.
Answered by
Stacy Chilton, MSW, LCSW