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Explaining genetic risks for cancer

Born with an altered BRCA (cancer) gene, Sandra Houston opted for preventive surgery and today, she enjoys regular Zumba® classes.

Sandra Houston’s grandmother and sister both died from ovarian cancer, so when a doctor suggested she see a genetic counselor, Sandra agreed.

“My Loyola counselor, Lauren, helped me understand my situation,” Sandra said. “Had she not explained everything so well, I probably wouldn’t have taken the test that ultimately saved my life.”

A complex test revealed that Sandra was born with an altered BRCA gene, which placed her at high risk for developing ovarian, fallopian tube and breast cancer. Sandra considered all of her options carefully. “I wanted to live,” Sandra recalls, “so I chose oophorectomy (surgical removal of one or both ovaries).”

Sandra made the right choice. During the preventive surgery, the surgeon found early-stage fallopian tube cancer, for which the Bellwood resident was treated with chemotherapy. She later opted for preventive bilateral mastectomy (surgical removal of both breasts).

“Genetic counseling is the key in determining cancer risks based on family history and it provides informational and emotional support for patients and their families during the process,” said Shelly Lo, MD, director, Cancer Risk Assessment Program, Loyola University Health System (Loyola). “When someone has a genetic risk, we work with the counselors to identify the best options.

Some patients choose to take medication to reduce cancer risk, some undergo risk reducing surgery. Others prefer enhanced surveillance, where we monitor their health very closely to detect cancer as early as possible. The choice is always left to the individual.”

The Cancer Risk Assessment Program at the Cardinal Bernardin Cancer Center is a multidisciplinary team that includes genetic counselors, physicians and nurses.
Their collaboration enables patients to understand their individual situation and take action to prevent or reduce their risk of developing cancer.

“During our initial visit, we thoroughly examine a patient’s family history of cancer and look for signs of genetic risk,” said Lauren Bowling, MS, certified genetic counselor and Loyola’s Cancer Genetics Program coordinator. “If the history suggests a gene mutation may be in the family, we identify the best person to be tested.”

“Most cases of cancer are not genetic. And patients who do test positive for a gene mutation, have the opportunity to be proactive and are able to work through their options at their own pace,” Lauren added.

Genetic testing also benefits patient’s relatives and can potentially save their lives. “If a BRCA gene mutation is found, there is a 50 percent chance that siblings and children inherited that same mutation,” Dr. Lo said. “They can get tested to learn if they have a higher risk of developing cancer and proactively consider cancer prevention.”

Sandra was grateful for her experiences with Loyola’s Cancer Risk Assessment Program but felt concerned about her family. “Lauren gave me the name of a Louisiana program where my sister and her daughter can be tested. Her compassion and support meant a lot.”

If you have a family history of breast or ovarian cancer, especially if you are of Ashkenazi descent, Loyola physicians encourage you make an appointment for a comprehensive risk assessment.

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