Handbook of Genetic Counseling/Ovarian Cancer

Ovarian Cancer Contracting Before we get started, I want to give you a chance to ask any questions or express any concerns that you may have. What issues do you want to make sure we discuss? What do you want to gain from our session today? Our plan: talk about your medical history and diagnosis discuss your family history in a little more detail talk about the genetics of hereditary cancers we'll explain what we see and discuss your risks talk about genetic testing - what it tests, limitations discuss ways for you to stay healthy Medical History Tell me how you got to this point. How was your ovarian cancer diagnosed? Fill out intake with details. Any other medical illnesses, surgeries, or hospitalizations? Family History Update pedigree with details. A pedigree is our "physical exam". Gives us clues as to whether the cancer is hereditary. It's important to know who has AND who doesn't have cancer. Very specific questions about the cancer in different family members Age at diagnosis Current age & screening practices Age at death & specific cause of death Primary site of cancer (type, location, stage, laterality) Metastasis or any new primary cancers Methods of treatment/surgery Any types of precancerous lesions Ethnic background Environmental exposures Lifestyle issues (diet, exercise, stress) Screening habits of "unaffected" relatives Any other medical conditions that may be associated with cancer any family hx of early heart attacks, blindness, deafness, birth defects, or multiple miscarriages Cancer Epidemiology Cancer is the uncontrolled growth of cells. All cancers are genetic, but not all are inherited. It is a multifactorial disorder, caused by both genetic and non-genetic factors. Cancer is a very common disease. 1 in 2 men and 1 in 3 women will develop some form of cancer in their lifetimes. The most common cancer sites are lung, breast, prostate, and colon. In the U.S., 1 in 55 women will develop ovarian cancer (1.8% lifetime risk) 5-10% of all ovarian cancer is hereditary (meaning that it runs in families) 90% of this is caused by a BRCA1 or BRCA2 mutation In the U.S., 1 in 8 women will develop breast cancer over their lifetimes. Average age of developing cancer is 62 (2/3 of the women will be over 55) 5-10% of all breast cancer is hereditary. Of this, 2/3 (66%) of it is due to a BRCA1 or BRCA2 mutation This gene is the link between breast and ovarian cancer. Red Flags How do we know when a cancer is hereditary? We look for clues (red flags). What makes us suspicious: more than one generation affected multiple close relatives affected on the same side of the family early age of onset (before 50) bilateral cancer or more than one type of cancer in the same person rare or unusual cancers Genes and Chromosomes Hereditary cancers are caused by a change in a specific gene that is passed on through a family Genes are made of DNA. They have all the instructions for how our bodies grow and develop. When there is a change in a gene, it causes the cell to not work properly, so it can grow out of control and become cancerous. Genes are packaged on chromosomes. Chromosomes come in pairs, and we inherit one from mom and one from dad. This gene is autosomal dominant, so only need one copy of it to inherit a higher risk of cancer. There is a 50% chance of getting it from our parents. If we carry the gene, then we have a 50% chance of passing it on. Notes The information in this outline was last updated in 2002.