082714 cancer genetics cases Flashcards
sporadic cancer
constitutes majority of cancer (60%)
onset after 50 yrs
only person in the family to have that cancer
hereditary cancer
only 10% of all cancers
attributed to inheritance of single gene
familial cancer
30% of all cancers
due to multiple genes and environmental factors
red flags for family with hereditary cancer syndrome
younger than expected age of diagnosis
many affected family members
more than one generation affected
pairing of cancers in the family
breast and ovarian, colon and endometrium
more than one cancer in the same person (ex-both breasts involved)
Ashkenazi Jewish heritage
because hereditary means the affected allele is in every cell of the body
hereditary cancer syndrome ex
- hereditary breast and ovarian cancer syndrome
- hereditary nonpolyposis colrectal cancer syndrome (Lynch)
role of cancer genetic counselor
explore psychological impact of genetic testing
work with insurance companies
address genetic discrimination concerns
introduce medical management options
talk about implications for family members
discuss option of DNA banking
give some reasons genetic testing is complex
multiple genes for a syndrome–not all of the genes may be testable
limitation of genetic testing
not able to detect all causes of hereditary cancer (there may be genes that we don’t know of yet or have tests for)
continued risk for sporadic cancers that aren’t hereditary
what is GINA?
genetic information nondiscrimation–federal law passed in 2008 that protects individuals from genetic discrimination i health insurance and employment
DOES NOT aply to life insurance, long-term care insurance, or disability insurance
other than genetic testing, what other things can help aid in pt management? for ex, pt doesn’t necessarily have need to test for gene due to just one grandmother affected in family at old age–what else can be done for her?
risk assessment models
what is it important to establish in a family with cancers?
what exactly causes the cancer–if something comes up positive for a family member that is AFFECTED with the cancer
what is the age over which genetic tests are done?
people over age 18
why should you always look at the specific family Hx?
because sometimes pts will claim it’s their sibling when could be half sibling
autosominal dominant pattern of inheritance of hereditary cancer syndromes
means that only one allele needs to be present for a risk for cancer
