By now, you’ve likely heard about U.S. Vice President Joe Biden’s moonshot initiative to cure cancer once and for all. At a time when 1.6 million Americans will be diagnosed with cancer this year, creating a future without cancer is an exciting proposition. It’s certainly a fight worth rallying around, to put an end to this devastating disease.
But as a genetic counselor, specifically one who specializes in the rapidly emerging field of genetic testing for inherited forms of cancer, I view this goal with a different perspective. My life’s work is focused on the precious time before a patient is diagnosed, before cancerous cells begin to divide, amass, and spread, threatening a person’s life. It is in this critical moment that I believe we can make the most significant, near-term impact on patient health.
Today, we know that between 5% and 10% of cancers are inherited. Families with a history of breast, ovarian, pancreatic, endometrial, or colorectal cancers, in particular, are at an elevated risk. But family history is only one potential risk factor. A woman without a family history of breast cancer could still be a carrier of a BRCA1 or BRCA2 genetic mutation, facing a 50% to 85% chance of developing breast cancer in her lifetime.
Having access to this potentially life-changing information should be well within a patient’s rights. Yet, access to screening for BRCA1, BRCA2, and other hereditary cancer genes, which are proven to have strong clinical value and utility for patients and their doctors, remains a significant barrier. This Cancer Prevention Month, I’d like to raise awareness around how available these screenings now are.
In the current fight against cancer, it is easy to donate to the nonprofit organization of your choosing to help advance research and awareness—people understand how they can participate. What many might not know is they now have the opportunity to take action in their own lives, to have a plan for prevention and proactive health monitoring.
When caught in early stages, the five-year survival rate for localized breast cancer is 98.6%. Early detection of cancer, or cancer risk, can help doctors take preventive action and design a plan that’s right for you. If you find out you’re at elevated risk of cancer or possess certain risk factors, there are usually a number of options available.
For example, some women at risk of ovarian cancer take birth control pills as a risk reduction strategy—and those who have been taking them for five or more years are at about 50% lower risk.
Another method of early detection is to conduct self-exams and get checkups done more frequently. People with elevated colon cancer risks could begin colonoscopies early and have them done more often than others. Women with increased breast cancer risk may opt to get mammograms earlier on in life and receive breast MRIs as well.
When some women find out they are a BRCA1 or BRCA2 carrier, they make the very personal decision to get preventive surgeries. Angelina Jolie Pitt has shined a light on this issue in recent years, openly discussing her decision to receive a double mastectomy (breast removal surgery) and bilateral salpingo-oophorectomy (surgical removal of the ovaries and fallopian tubes).
The National Cancer Institute says preventive mastectomies may reduce the risk of breast cancer for high-risk women by up to 90%. Oophorectomies can also reduce breast cancer risk, and can reduce ovarian cancer risk by more than 80%. It’s not a decision to be taken lightly, and even if you are at elevated risk, you should always consult with your doctor first before moving forward with any serious medical decision.
It is with these types of genetically inherited cancers that advanced knowledge can make a real difference in someone’s future. This is why we should consider a multifaceted approach to the fight against cancer. I agree that research and development of a cure should be the ultimate priority, but that may take several more decades to realize. In the meantime, government-led initiatives should equally stress the value of screening for genetic mutations widely associated with elevated cancer risk. An emphasis on proactivity and early detection is likely to save lives in the near term.
While we wait for the moonshot to take shape, there are things we can do here on Earth, in our everyday lives, to get ahead of cancer. Let’s not lose sight of that.