Tuesday, October 25, 2016

Are You a Candidate for Cancer Genetic Testing Like Angelina Jolie?

Angelina Jolie lost her mom, grandma, and aunt to cancer. Three years ago, the famous actress and director chose to undergo a double mastectomy after testing positive for the BRCA1 gene. She confirmed her estimated 87% risk of developing breast cancer and a 50% risk for ovarian cancer.

Angelina Jolie's empowering story of taking control
of her health inspired The Angelina Effect
and landed her on the cover of TIME magazine
"Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness," wrote Jolie in her 2013 New York Times article. "But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action."

The good news is, genetic testing is now available in our country through Asia Genomics Philippines. Last week, I attended a talk by Dr. Marcelo Imasa, medical oncologist at St. Lukes Medical Center, held in Apotheca Integrative Pharmacy in Makati. 

Dr. Imasa revealed that global incidence of breast cancer has risen by 256% in the past 30 years with South East Asia increasing by 479%. Unfortunately, the Philippines has the highest incidence rate of the disease in the region. Did you know that 1 out of 13 Filipino women will develop breast cancer in her lifetime?

Dr. Marcelo Imasa emphasized the need to see a genetic counselor first
before undergoing genetic testing
Although majority (70-80%) of breast cancer cases develop in older people with little or no family history of the condition and no genetic risk, there is still that 5-10% of breast cancer that is hereditary. These individuals carry inherited mutations (damaged genes that control how cancer cells grow) that are born with them and do not simply develop over time.

On the other hand, 15-20% of breast cancer are "familial" or occur in many families with a history of breast and/or ovarian cancer that do not have an identifiable genetic cause. Dr. Imasa explained that these cases may be due to genes that have not yet been identified and/or shared factors such as environment or lifestyle.

the deal with hereditary cancer
So when should you suspect that you may have an inherited cancer syndrome? 

  • having a family member(s) whose cancer was diagnosed at an unusually young age
  • different types of cancer have occurred independently in the same person
  • cancer in both organs in a set of paired organs (e.g. both kidneys or both breasts)
  • several close blood relatives with the same time of cancer across multiple generations (e.g. a mother, daughter, and sisters with breast cancer)
  • unusual cases of a specific cancer type (e.g. breast cancer in a man)
  • presence of birth defects, like certain non-cancecerous or benign skin growths or skeletal abnormalities known to be associated with inherited cancer syndromes
  • being a member of a racial/ethnic group known to have an increased chance of having a certain hereditary cancer syndrome and having one or more of the above features as well

According to Dr. Imasa, genetic testing looks for specific inherited changes in a person's chromosomes or genes. The benefit of getting tested is that results may modify cancer surveillance options such as age of initial screening and treatment guidance as well as identification of family members who may be at risk.

Asia Genomics' cancer testing kits
One very important thing to note, though, is to see a genetic counsellor first before having a genetic test done. In case you get a positive result, he/she could help you deal with its harmful effects on emotions, social relationships, finances, and medical choices. Given devastating and life-changing news, patients could develop anxiety, depression, and anger as well as have difficulty making choices (e.g. to have surgery or not). This may also create tension in the family.

Of course, with every procedure, Dr. Imasa clarified that genetic testing has its limitations. "For instance, just because you have the gene doesn't mean you will develop the disease. Also, it cannot predict if and when the cancer will develop in high risk individuals," he described.

our group of interested learners with Dr. Imasa
(*gasp* I unknowingly blocked him! sorry, Doc!)
photo credit: Apotheca Integrative Pharmacy
Bridging the technology of the West to Filipinos, Asia Genomics results for genetic testing take around 7 to 14 days before they are released. The test for BRCA 1/2 costs P28k compared to P200k in previous years while a 49 genes full test (to check for cancers of the colon, kidney, pancreas, etc.), costs around P100k.

In case your doctor recommends you to undergo genetic testing and you find out you are at high risk for getting cancer, Dr. Imasa advises that it is best to make lifestyle changes as soon as possible and to see your doctor regularly. 

Live in the know and take the opportunity to live without fear. For more information, please visit asia-genomics.com.

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