BRCA Gene Mutations and Cancer

genetic risk breast cancerBRCA gene mutations have been in the news this week since Angelina Jolie announced she has the BRCA1 gene mutation and opted to have a bilateral mastectomy to reduce her risks of developing breast cancer. She became aware of her risk because her mother developed breast cancer in her mid-40s and died at age 56. What exactly are the so-called breast cancer genes and who should be tested to see if they are a carrier?

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Pancreatic Cancer: What Are My Risks?

About 44,000 people will be diagnosed with pancreatic cancer in the United States in 2012, making it the tenth most common cancer.  This cancer will affect 1-2% of people in the population.  Unfortunately, because it can be difficult to detect, it is the fourth most common cause of cancer-related death.  Most pancreatic cancers (95%) are adenocarcinomas.

Genetic counselor Victoria Raymond consults with John Carethers, M.D., and Tobias Else, M.D.

There are some known risk factors that increase risk for pancreatic cancer.  Some of these risk factors relate to health behaviors.  Smoking is strongly linked to pancreatic cancer risk, and up to 15% of cases may be directly related to cigarettes1.  Other health conditions that affect the pancreas, including diabetes and pancreatitis (inflammation of the pancreas) can also increase risk.

Family history is also an important risk factor for pancreatic cancer.  If you or a family member have had pancreatic cancer, it may be worth talking with your doctor about the rest of your family history.  Some clues to inherited risk include:

  • Other cancers in family members including:
    • Pancreatic cancer
    • Breast cancer
    • Ovarian cancer
    • Colon cancer
    • Endometrial cancer
  • Cancers diagnosed at earlier ages than typically expected
  • Personal or family history of chronic pancreatitis

In some families, genetic testing may help to determine the cause of pancreatic cancer risk.  There are several known hereditary conditions that can increase risk for pancreatic cancer.  Many of these known conditions also cause high risk for other types of cancer as well.  Some families have two or more relatives with pancreatic cancer, but do not have other cancers in the family or a known genetic risk factor.  This is described as Familial Pancreatic Cancer.  Researchers are still working to identify additional genes that may contribute to Familial Pancreatic Cancer risk.

Many people who have a family history of pancreatic cancer are interested in learning about options for screening for pancreatic cancer.  Screening for pancreatic cancer is worth consideration for certain patients.  Current tests used to screen for pancreatic cancer include endoscopic ultrasound (EUS) and specialized MRI of the pancreas (MRCP).  There are risks and limitations to these tests, and patients at high risk may benefit from discussing their personal risk factors and a screening plan with specialists in the Cancer Genetics and Gastroenterology clinics.  The hope is that research in genetics and screening techniques will lead to earlier diagnosis and better survival for patients and at-risk family members.

Learn more about it:

University of Michigan Cancer Genetics Clinic

Endoscopic ultrasound

University of Michigan Multi-Disciplinary Pancreatic Tumor Clinic

  1. Am J Epidemiol. 2009 August 15; 170(4): 403–413

A Consequence of Obesity: Increased Cancer Risk

The statistics are alarming and worth sharing: over the past 20 years the number of overweight and obese children and adults continues to climb.  Only 1/3 of people in the United States maintains a healthy body weight — that means 2/3 of the population is considered overweight or obese.

We should be concerned. Excess weight has multiple consequences including enhanced risk for developing cancer, heart disease, diabetes, high blood pressure and stroke, among other conditions.

In fact, if you are a man and are obese, you have an increased risk of developing male breast cancer and cancers of the colon/rectum, prostate, pancreas, kidney, esophagus and others.

According to the American Cancer Society, 1 of every 3 cancers is related to excess body weight, poor nutrition or being inactive. If the rising trend in obesity continues, it’s predicted there will be 500,000 additional cases of cancer in the U.S. by 2030.

The National Cancer Institute says research reveals obesity and the development of cancer are linked together in a couple of different ways:

  • fat produces excess hormones (like estrogen and insulin) that encourages the growth of certain types of cancers
  • fat cells can affect cell growth regulation that may result in fostering  tumor growth
  • obesity can result in a chronic inflammation process which impacts the immune system function

Recently, HBO, in partnership with the Institute of Medicine, the National Institutes of Health, the CDC and others released an online documentary titled “The Weight of the Nation”. Watching all or just a few of the videos will be time well spent. It’s a great way to learn more about obesity and get suggestions for ways to take action for yourself, your family or your community.

What action you’ve taken for targeting or staying at a healthy weight? Post your answer below.

Learn more from our University of Michigan Dietitians:

Fresh Start: Changing Eating Habits                                                                         http://www.cancer.med.umich.edu/support/fresh-start.shtml

The Weight Battle: Strategies for Controlling Weight                                       http://www.cancer.med.umich.edu/support/weight-battle.html

Your Family’s History of Cancer- Talk About it and Pass it On

Researchers have known for some time that cancer is caused from changes in a person’s genes. This could be from exposure to something in the environment (such as cigarette smoke), inherited from a parent or grandparent, or a combination of these. Your genetic makeup is only one factor that determines whether you will develop cancer.

Most cancers occur in people without a known family history of cancer. But some types of cancer can be inherited.

Talk about it

Your family health history may extend to many different family members, so start by finding out who in your family has had a diagnosis of cancer. Cancer is common so  don’t be surprised if you learn that several family members have had cancer. Keep in mind that some may not wish to share private health information. In that case, explain that you are asking to help plan your own and other family members’ health future. That may make the person feel more comfortable sharing. Continue reading