Many factors can increase the risk of developing cancer, including some that people are able to modify through lifestyle changes and others that are beyond their control. Among the risk factors people can’t control are inherited genetic mutations that are known to increase susceptibility to certain forms of cancer—for example, mutations of the BRCA1 and BRCA2 genes, which are associated with greater susceptibility to breast cancer and other forms of cancer.
Although genetic mutations can’t be modified, they often can be identified through genetic testing. This tool gives doctors crucial insight on patients’ cancer risk and can help guide their approach to cancer prevention as well as treatment planning in the event of an actual cancer diagnosis.
Richard Phinney, MD, of The Toledo Clinic Cancer Centers explains, “Genetic testing is an analysis of the patient’s DNA, looking for a somatic mutation that puts the patient at increased risk of developing cancer at some point in his or her life. If the testing identifies a mutation associated with a known hereditary cancer syndrome, that information can influence how a patient is screened, for example through additional blood testing, endoscopic procedures, imaging studies, or other surveillance measures. It may also lead to prophylactic treatment, such as risk-reducing surgery or other procedures.”
It’s important to understand that having a genetic mutation known to increase cancer risk does not mean the individual is predestined to develop cancer. Furthermore, not every patient will benefit from genetic testing. According to Dr. Phinney, appropriate candidates for genetic testing include those with a strong family history of malignancy, a personal history of malignancy at a younger age, a personal history of multiple malignancies, and those who have no personal history but have a family member with a genetic mutation known to increase cancer risk. “Some hereditary mutations increase the risk of particular forms of cancer and some are associated with multiple cancer types, so it’s important to identify the specific mutation as well as which type of cancer or cancers the patient is at increased risk of developing,” he says.
The decision of whether genetic testing is appropriate for a particular patient is usually made in a genetic counseling session. Genetic counseling is the process of consulting with a physician or genetic counselor, either in person or remotely, to discuss the patient’s family history and what his or her cancer risk might be based on that information. Not every patient who takes part in genetic counseling meets the criteria for genetic testing.
The genetic test itself can be performed in one of several ways. “The most common approach is a blood draw, but it can also be done through a buccal swab, which simply involves swabbing the inside of the cheek to collect cells. In the era of COVID, remote genetic testing is becoming a more common option as well. In this case, a kit is mailed to the individual, who then provides a sputum sample and mails it to a lab for testing,” says Dr. Phinney.
In whatever manner it’s performed, genetic testing is likely to grow in prominence in the realm of cancer care. “In the modern era of cancer medicine and therapies, genetic testing will play an even bigger role in years to come. As we learn more about the human genome and actionable mutations in cancer, genetic testing will help drive advances in our medical knowledge and management of cancer in the future,” Dr. Phinney states.
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, also provides imaging, laboratory, chemotherapy and IV services. The cancer center consists of 7 medical and 2 radiation oncologists along with 8 nurse practitioners and 4 research nurses. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice level 3 recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition.
For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605.