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Drawing a pedigree, or building a family tree, can be
used for more than tracking long ago ancestors. They can
also help diagnose your risk for cancer. Cindy Merrill,
BSW, Oncology Genetics Counselor, has been helping patients
determine their cancer risk through genetics counseling and
testing for eight years with Lee Memorial Health System.
Cindy will be working at the Regional Cancer Center when it
opens Oct. 20. “Genetics counseling and testing helps people
gain a more accurate personal risk of cancer,” she says. |
When a physician refers a patient to Cindy, they start with a
self and family history that goes back three generations that helps
her to construct a family pedigree, or medical tree. Then, there is
a simple blood test. Some risk factors often seen in hereditary
cancers include clustering of certain cancer types, cancer occurring
at younger ages, cancer in more than one generation and the
occurrence of rare cancers, such as male breast cancer or medullary
thyroid cancer.
Cindy sees anywhere from 150 to 180 patients each year, and the
number keeps growing. She mostly does the BRCA testing, which looks
for the genes associated with breast and ovarian cancer. Other tests
include Lynch syndrome, which encompasses colon, stomach, brain,
gastrointestinal and ovarian cancers. “These tests help people gain
a more accurate idea of their own personal risk for cancer. A lot of
times, people overestimate their risk for cancer, and these tests
can offer reassurance,” she says.
The test can confirm that a patient has a high risk for certain
types of cancer. In that case, there are three medical management
options that patients and their physicians can discuss, says Cindy.
First, the patient can opt for increased surveillance, which detects
cancer at the earliest stage when it is most treatable. Second, the
patient can opt for chemoprevention. Third, the patient can undergo
prophylactic surgery before developing cancer.
How the patient approaches his or her medical management varies
depending on the patient, she says. “Medical management is a choice
that patients must make with their doctors,” she says.
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