Genetic Risk Evaluation And Testing Program

The Genetic Risk Evaluation And Testing Program started at Texas Oncology-Baylor Sammons Cancer Center in Dallas, Texas in 1998 and is now provided at a number of our cancer centers.  The program provides an in-depth cancer risk assessment for individuals with a strong personal and/or family history of cancer. Oncologists and nurse practitioners who have received special training in genetic testing and counseling provide participants with an individualized analysis to identify possible risk for hereditary cancer syndromes. Once testing is performed, these specialists provide patients with a comprehensive evaluation.

Genetic testing identifies whether an individual has an increased risk for certain types of cancer. While one cannot inherit cancer, one can inherit a higher risk for developing it. While only 5-10 percent of cancers can be traced to inherited mutated genes, genetic testing offers the potential of early detection and the opportunity to not only reduce the risk of cancer, but to save lives. Detecting cancer early is one of the best things people can do to protect their health and significantly increases the chances of successful outcomes.

Why is the risk for some cancers inherited?
Every person receives two of every gene – one from their mother and one from their father – and therefore can receive a mutated or altered gene from either parent. When a gene mutation or change occurs, the gene does not function correctly and a greater risk of cancer is inherited.

The risk of cancer being inherited is more likely if: 

  • Multiple family members have the same type of cancer
  • Cancer is diagnosed at age 50 or younger
  • Cancer develops in paired organs (both breasts, both ovaries, both kidneys)
  • Multiple types of cancer occur in one individual

What is genetic testing?
Genetic testing is the analysis of human DNA to detect inheritable disease-related gene mutations. An accurate genetic test can determine whether or not a person has a disease-related gene mutation that may increase the risk of certain cancers. Genetic testing also involves counseling both before and after the test is completed.

Who needs a genetic test? 
Genetic testing provides an in-depth cancer risk assessment for individuals with a significant personal and/or family history of cancer. An oncologist can help patients decide if testing is right for them. Download the forms to hand to your oncologist here.

What is the process for genetic testing? 

  1. Patients first complete a personal and family medical history, along with a counseling session.
  2. Patients then provide a small blood sample for testing. The sample is analyzed in a laboratory that looks for a change or mutation in the gene. While the lab test is very complex, only this blood sample is needed. Insurance companies may cover the cost of testing.
  3. Following the testing, patients receive comprehensive counseling based on the results of their test.

What happens after genetic testing? 
Following genetic testing, patients receive comprehensive counseling about the results of the testing. For those who are found to have a gene mutation and a higher risk of cancer, options for next steps are presented and discussed. These options can include closer medical surveillance, drug/hormone therapy for prevention, or surgery. What an individual chooses to do as a result of the testing is strictly a personal decision; genetic testing provides them with additional tools to make informed decisions.

If a family member has tested positive for a mutation, other family members are encouraged to be tested as well. This additional testing of other family members can determine which side of the family the gene mutation is from and who else has the mutation (and therefore is at a higher risk for developing cancer). The information from genetic testing enables family members to make decisions that could save their lives. It also can tell family members that they do not have the mutated gene.

Are the results of genetic testing confidential?
Yes, the results of genetic testing are strictly confidential. It is also against the law for insurance companies to discriminate against patients based on genetic information.
Benefits of genetic testing: 

  • Relief of uncertainty
  • Make informed medical and lifestyle decisions
  • Understand cancer risk
  • Provide helpful information to other family members

Risks and Common Concerns of genetic testing: 

  • Difficulty coping with known cancer risk
  • Impact on family and personal relationships
  • Concern about the privacy of results

Genetic testing can determine a patient’s risk for the following cancers:
Breast and Ovarian Cancer Syndrome (BRCA 1/2)
   Risk factors include: 

  • Breast cancer before the age of 50
  • Ovarian cancer at any age
  • Bilateral breast cancer
  • Male breast cancer at any age
  • Ashkenazi Jewish ancestry with breast or ovarian cancer at any age
  • Mutation positive relative
  • Individuals with both breast and ovarian cancer

Colon and Endometrial Cancer Syndrome (HNPCC) – also known as Lynch Syndrome
   Risk factors include: 

  • Colon cancer before the age of 50
  • Endometrial cancer before the age of 50
  • Other HNPCC-associated cancers in the family (ovarian, stomach, kidney/urinary tract, biliary, central nervous system, and small intestine)
  • Multiple cancers in the same individual

Hereditary Melanoma Syndrome (melanoma and pancreatic cancer)
   Risk factors include:

  • Multiple family members with melanoma
  • Individuals with multiple melanomas
  • Melanoma and pancreatic cancer in a family

Do you have cancer in your family?  For even more information, please view our fact sheet regarding genetic risk evaluation and testing.