I’ve been hearing a lot about the importance of understanding genes when it comes to developing, diagnosing and treating cancer. What should I know about genetics in order to best protect myself and my family?
Q: I’ve been hearing a lot about the importance of understanding genes when it comes to developing, diagnosing and treating cancer. What should I know about genetics in order to best protect myself and my family?
A: If you are a patient with cancer or a caregiver, you are probably very much aware that genes are important: They may have a role in determining your risk of getting cancer in the first place, and, if you are diagnosed with the disease, they may guide you in choosing which treatments are likely to work best. So here is the question: How much do you really understand about genetic risk and genomics beyond the words or reports your health professional may share with you from time to time? If you are like most folks, the answer is probably not much.
We are undergoing an explosion of knowledge and application when it comes to the genetic mechanisms of cancer. New markers are discovered almost daily, and new signals are found which may impact a person’s risk of cancer. However, we are far behind the science when it comes to educating consumers and health professionals about genomics. The situation is even more complex for diverse communities throughout the country, whose members may not have access to various educational tools or who may speak English as a second language, creating gaps in their ability to participate effectively in decisions about their care. These issues became clear recently at a meeting hosted by the National Human Genome Research Institute, which brought together representatives from professional, consumer and ethnic communities to learn more about what we need to do as a nation to address this growing need for genomic education.
Not everyone needs to understand exactly how a gene is supposed to function, how it can become mutated and what happens when it sends erroneous signals within the body. But, ideally, our whole society should know that certain types of cancer should always, in every case, be tested for genetic mutations. That’s because cancers including non-small cell lung, breast, colorectal and melanoma, in some cases, are driven by genetic mutations that can be treated with targeted drugs, and these drugs may be less toxic and more effective than chemotherapy. Everyone should also be able to recognize patterns of cancer occurrence in their families that suggest an inherited predisposition, and should know that members of these families may benefit from genetic testing and counseling.
Spreading this understanding will not be a simple task, and there is a lot of work to be done by medical societies and government. We need to develop relevant educational materials and programs at every level of need, so that everyone has enough knowledge to become comfortable in this rapidly changing genomic arena. This will allow us to better harness the power of science to improve the health of our communities and our nation.
Len Lichtenfeld, M.D., is deputy chief medical officer of the American Cancer Society.Send House Call questions to firstname.lastname@example.org.