As screening technology improves, Columbus-area doctors say more patients are undergoing testing to see if they have an elevated risk of developing the disease.<\/p>\n
Kathy Lynn Gray
\n\u00a0|\u00a0 Columbus CEO<\/p>\n
Ovarian cancer has upended Brooke Lane\u2019s life.<\/p>\n
But for her mother, Sharon Shealy, Lane\u2019s diagnosis and subsequent genetic cancer testing has been a lifesaver\u2014literally.<\/p>\n
That speaks to the power of such testing, says genetics counselor Leigha Senter.<\/p>\n
In 2018, Lane was a 35-year-old living in Bucyrus with her husband and two boys when she learned she had stage 3 ovarian cancer, often called the silent killer because its symptoms are vague. To help guide her treatment, Dr. Floortje Backes at the Ohio State University Comprehensive Cancer Center \u2013 Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, recommended screening to determine if the cancer was genetically linked.<\/p>\n
Lane tested positive for the BRCA1 (breast cancer gene 1) mutation, putting her at elevated risk for breast and ovarian cancer. Family members were tested and one\u2014her mother\u2014had the mutation, too.<\/p>\n
As a precaution, Shealy, of Cairo, Ohio, had a hysterectomy, and her surgeon found a hidden cancerous tumor. \u201cShe had no symptoms,\u201d Lane says. \u201cThey would never have caught it if we hadn\u2019t done the genetic testing. The genetic testing saved her.\u201d<\/p>\n
According to the National Cancer Institute<\/a>, about 10 percent of all cancers are believed to be caused by an inherited gene mutation. But the risk is higher for certain cancers. That includes ovarian cancers, which are hereditary 10 percent to 15 percent of the time, the Centers for Disease Control and Prevention estimates.<\/p>\n When it first became available in the mid-1990s, genetic testing was reserved for individuals and families at high risk, says Senter, interim division director of human genetics at the OSUCCC \u2013 James.<\/p>\n Even as late as 2007, the testing was mostly available only on the genes that carry the BRCA1 and BRCA2 mutations, says Nichole Morman, manager of genetic counseling at OhioHealth. Today, thanks to improved technology, 80 to 100 genes can be examined with one blood or saliva sample. In addition to breast and ovarian, cancers linked to hereditary mutations include colon, pancreatic, prostate, thyroid and stomach.<\/p>\n Any adult can seek genetic testing but Morman particularly recommends it for anyone with a rare cancer or a cancer diagnosis before age 50, as well as for individuals who have multiple family members with cancer. It\u2019s offered online and at area medical facilities, including The James and OhioHealth.<\/p>\n Genetic counseling can happen before or after testing, or both, Senter says, depending on the circumstances. Beforehand, a counselor gathers a patient\u2019s family history of cancer, explains what the tests can reveal and evaluates whether testing might be beneficial. After testing, a counselor interprets and explains the results.<\/p>\n Those fall into three basic categories, according to the National Cancer Institute. A positive result means a gene mutation that increases the risk of cancer was found. A negative result means no harmful mutations were found. A variant of uncertain significance (VUS) means a variation was detected, but it is unclear whether it increases cancer risk.<\/p>\n If a positive result occurs for someone without cancer, a genetic counselor can suggest ways to manage risk. Those might include increased screenings, screening at an earlier-than-normal age, medication, lifestyle changes and, in some cases, surgery. \u201cIt doesn\u2019t mean that person was born with cancer,\u201d Senter says. \u201cBut they have a higher likelihood of getting cancer.\u201d<\/p>\n Senter might also suggest other family members be tested. \u201cOnce we have a test result, it becomes the patient\u2019s job to share that with their relatives,\u201d she says.<\/p>\n When a VUS result is identified, a patient should keep in touch with the test provider in case the result is reclassified as a cancer risk in the future, the institute advises.<\/p>\n Dr. Hiral Shah, an oncologist at Zangmeister Cancer Center in Columbus, says that while genetic testing can cause stress and anxiety, patients are generally receptive. \u201cIt gives you a lot more information to make the best medical and lifestyle decision for yourself and for other family members,\u201d she says. \u201cAnd if you test negative, it brings a lot of relief from uncertainty.\u201d<\/p>\n But she cautions, \u201cA negative result doesn\u2019t mean you can keep smoking your cigarettes and you won\u2019t get cancer, and a positive result doesn\u2019t mean you\u2019ll get cancer.\u201d<\/p>\n A physician referral usually isn\u2019t necessary for genetic testing, Morman says, but health insurance may not cover it. To make it more accessible, OhioHealth has a flat self-pay rate of $250. Online tests can be purchased for about $300.<\/p>\n Senter says Ohio State\u2019s self-pay rate also is $250, but qualifying for financial assistance can reduce the cost.<\/p>\n Shah expects cancer testing to improve as more genes can be tested, and risks identified. But she doesn\u2019t expect it to become a regular part of everyone\u2019s medical screening because hereditary cancers are still in the minority. \u201cMy hope is that it\u2019ll lead to more early detection and a better survival rate,\u201d she says. \u201cAnd as more people become comfortable with genetic testing, we\u2019ll see more people get tested.\u201d<\/p>\n