9 Common Questions about Genetic Testing for Cancer

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Your genes play a role in nearly all areas of your health. A gene is like an instruction manual for your body that tells your body how to function, develop and stay healthy. People have about 20,000 genes in their bodies. “Many health conditions have a genetic link,” says Breanna Mitchell, a genetic counselor at Mayo Clinic Health System in Eau Claire. “Genetic testing can help you and your health care team understand if you have an increased risk for developing certain conditions that are present in your family. If you are at risk, you may be able to take preventive measures to decrease your risk or undergo genetic testing to clarify your risk.”

Here are 9 common questions about genetic testing and cancer:

Do all types of cancers have a genetic component?

Most cancers are considered sporadic, meaning the cancer happens randomly or has environmental influences, such as smoking and lung cancer. About 25% of cancers are considered familial. This is when multiple members of a family are affected by cancer. These family members have some shared genetic factors in combination with shared environmental factors that lead to the development of these cancers.

What types of genes are examined during genetic testing?

A genetic test looks for specific harmful gene changes, called mutations or pathogenic variants, that can cause you to develop a genetic condition. Gene changes are like spelling errors within your body’s instruction manual. Most genetic tests look for changes in a group of genes called a panel. However, testing may look for changes in a single gene when there is a known genetic mutation in your family. The most common genes typically thought of related to cancer risk are BRCA1 and BRCA2. These genes are associated with breast and ovarian cancer.

Am I guaranteed to get cancer if I have a known gene?

No. Inheriting a harmful gene change means that you have an increased risk for cancer, but it does not guarantee that you will develop a cancer in your lifetime.

What criteria do I need to meet to have genetic testing completed?

Your health care team may recommend genetic testing based on guidelines established by the National Comprehensive Cancer Network (NCCN). These guidelines use factors such as your personal cancer history, family cancer history, ancestry or the presence of abnormal cells to determine if you qualify for genetic testing.

Can genetic testing help during cancer treatment?

If you are battling cancer, genetic testing can help your care team make recommendations for treatments and surgical procedures. “The results also can help other family members,” Mitchell says. “Potentially, your children, siblings, nieces and nephews could have inherited the same gene mutation. Knowing this information can help them establish early screening schedules and make healthy decisions about their lives.”

How can I prepare for a genetic testing consultation?

Gathering a detailed family health history is the most important thing to prepare for a genetic counseling appointment. Try to gather information about relatives, including types of cancer diagnosed, age of diagnosis, current age, or age at death. Also find out if any relatives have previously had genetic testing completed. If no previous genetic testing has been performed, often the best person to be tested is the family member with cancer but an unaffected person can still be tested.

Am I only able to get cancer if I have the BRCA gene or one of these other genes?

A common misconception is that you have one of these genes or you don’t. Everyone has the BRCA genes, and these other genes associated with cancer risk. The role these genes play in the body is to prevent cancer from occurring. It’s when a harmful change occurs in one of these genes that causes it not to work like it should. This leads to the increased risk for cancer to develop.

Am I more likely to inherit something from a parent of the same sex as me? Or the parent that I most resemble?

No. Every person has two copies of every gene — one copy inherited from each parent. If a parent has a harmful genetic change in one copy of a gene, it is random which copy they will pass on to children. Every child has a 50-50 chance of inheriting the typical copy or the changed copy, regardless of you or your parent’s biological sex, or whether you more closely resemble one side of the family.

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