March 21, 2019
Clinical Contributors to this Story
Angela Musial Fay, M.S. contributes to topics such as Cancer Care, Women's Health, Men's Health.
For years, companies like 23andMe have helped consumers learn more about their ancestry and health traits, but it’s what has happened most recently – with the addition of several health risk assessments, like one for cancer – that may be leaving people with more questions than ever.
“We see patients more frequently now who come in and tell us they’ve tried 23andMe and their results show they may be at risk for particular cancers,” says Angela Musial Fay, M.S., a cancer genetic coordinator at Jersey Shore University Medical Center and part of the team at its High Risk Genetics Clinic. “Many times they come to us feeling concerned and in real need of clarity about what this truly means for them.”
Currently, 23andMe screens for three mutations of the BRCA1 and BRCA2 genes, which are associated with a higher risk for breast, ovarian and prostate cancers. Here’s the caveat: If a person’s results come back positive for these genes, it does not always mean they will develop cancer.
“Not everyone who has the BRCA1 or BRCA2 gene will be diagnosed with cancer in their lifetime – it’s far more complicated than that, and there are many other factors that play into it,” Angela says. “That said, in every single case when results come back positive for one of these gene mutations, it’s important to follow up by speaking to a medical expert who can help a person understand the result and create a management plan.”
It’s also important to mention that a person’s 23andMe test for the BRCA1 and BRCA2 genes may come back negative, yet the person can still be carrying a mutation in one of these two genes. According to Angela, this is because the three mutations that 23andMe are screening for are specific to persons of Eastern European Jewish ancestry. Furthermore, BRCA1 and BRCA2 are just two of many genes that, when mutated, increase cancer risk, so it’s key that a person pursue a larger panel of genes to assess their complete cancer risk, Angela says.
“For anyone who is not of Eastern European Jewish ancestry, this test is not going to show them an accurate result,” Angela adds. “This test – or any genetic test – should not stand on its own. Family history and a person’s overall state of health must be considered.”
According to Angela, a genetic counselor can help people by recommending appropriate screenings based on their genetic test results and personal and family history.
“I cannot stress this point enough – not all gene mutations are the same, so we really look to the family history to guide us,” Angela says.
While, as mentioned, an instance of these gene mutations may not always mean cancer, a genetic counselor may have important recommendations for patients who do not currently have cancer, like more frequent screenings moving forward, or other preventative factors – like incorporating a better diet and exercise routine.
“The positive thing about the growing use of these at-home kits is that it’s getting more people to be proactive about their health,” Angela adds. “They see their results and they may be eager to take action to figure out what’s really happening and what their risk really is. However, they need to remember to consult with their physician or genetic counselor when making any health care decisions.”
Beyond prevention and screening, in the case cancer is found, genetic counselors can provide necessary support and ongoing counsel for men, women and their families who are currently living with cancer. According to Angela, she and other counselors work with a team of specialized cancer experts to guide in treatment options, as well.
Angela Musial Fay, M.S., is a cancer genetic coordinator at Jersey Shore University Medical Center, and part of the team at its High Risk Genetics Clinic. For information about the High Risk Genetics Clinic at Jersey Shore University Medical Center or to make an appointment, call 732-897-3580. To find a provider near you, visit www.HackensackMeridianHealth.org/find-a-doctor.
To learn more online about Hackensack Meridian Health’s cancer care services, visit www.HackensackMeridianHealth.org/learnmore.
- National Cancer Institute
- National Society of Genetic Counselors
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.