When planning this series of seminars, community members told us that they needed trustworthy information so they could mindfully make good choices about life styles that would lead them to good health. Our first seminar focused on how to have proper diet and physical activity. Next we concentrated on how to deal with stress in a mindful, positive way.
This year we want to address mindfulness related to the prevention and early detection of cancer. Here are a few facts that led to this selection:
- During their lifetime about 40% of men and 38% of women will develop cancer.
- The risk of dying from cancer is about 22% of men and 19% of women
- All cancers are caused by mutations in a gene or genes in their DNA.
- About 87% of these mutations occur sporadically due to mutations that occur after birth because something goes wrong in the process of cell divisions that occur throughout our lifetime. These mutations are more likely to occur due to viral infections such as HIV or HPV, hepatitis B or C; chewing or smoking tobacco, exposures to x-rays or ultraviolet radiation, possibly some estrogen/progestin medications, etc.
- About 13% of the cancers are related to mutations in the genes inherited from their parent or parents.
For those who are at high risk for developing some cancers there are diagnostic, medical or surgical intervention that may be beneficial.
The complexity of the human race is written in a language of 4 chemicals (called bases) that are arranged in the form of a double helix known as DNA (deoxyribonucleic acid). Each person has 3 billion of these pairs in their genome. Only a few million of these base pairs are likely to differ from person to person. The order in which those pairs line up one after another acts as the blueprint to build each unique individual.
In 1993 researchers from USA, Europe, China, and Japan formed the HUMAN GENOME PROJECT pooled efforts to produce the first completely sequenced genome. Using supercomputers and cloud technology they accomplished this by 2003. The cost to produce a completely sequenced genome was 10s of millions of dollars. By the end of 2014 the cost was down to $10,000.
Personal genotyping began when companies brought the cost down to about $200 by sequencing only those parts of the entire genome most likely to vary from individual to individual. Direct to Consumer (DTC) companies such as 23 and Me, Ancestry, and National Geographic began marketing directly to the public by stating they do not perform predictive or diagnostic tests. Their reports seem to have entertainment value based on where your ancestors came from, some increased risk of several diseases related to a single gene variant (Alzheimer’s, Parkinson’s, etc. ) and certain traits such as liking coffee.
When you have used a genotyping service your genetic information is also the property of the company you sent it to. You do have the option to share your genome data with organizations using genomics to investigate health. This adds to a database for possible future studies.
On the other hand, there is always some risk of a breach of security involving your identity data and your genetic data could be put into the public domain and associated with your identity. Depending on your risk assessment your ability to purchase life insurance may be affected, but it could also be used to lower your premiums. Ask your life insurance provider The GINA act (Genetic Information Nondiscrimination Act of 2008) protects patients from being denied HEALTH insurance or employment. Law enforcement agencies have utilized these databases to solve crimes, so this is also something to consider when participating in direct to consumer products.
Another concertn is that is it not always clear about the implications of your test results. For example, 23andMe says they test for BRCA1 and BRCA2. Although it is stated in their disclaimer and it is easily missed that they test for only 3 variants in these genes while there are actually thousands of variants on the BRCA genes. This can lead to a fall sense of security.
By the end of 2018 over 12 million had submitted their DNA sample to more than 250 DTC companies. If you choose to use one of these companies, you should understand their possible benefits, harms, and limitations to you and your family. Multiple organizations including the American College of Obstetrics and Gynecology (ACOG) and the American College of Medical Genetics and Genomics (ACMG) caution the use of DTC genetic testing. “Direct and home genetic testing should be discouraged because of the potential harm of a misinterpreted or inaccurate result.” For a more in-depth conversation about implications, it would be beneficial to speak to a genetic counselor.
This is where MINDFULNESS comes in:
A carefully attained family history is very important when considering genetic testing. If one or more of the following situations apply to your or your immediate family, you may want to meet with a genetic counselor:
- Many of your relatives have had cancer
- Two or more of your relatives have had the same type of cancer
- You and a relative have had the same type of cancer
- You or a relative were diagnosed with cancer before age 50
- You or a relative have had more than one type of cancer
- You or a relative have had a rare cancer (like breast cancer in a male, ovarian cancer, or pancreatic cancer).
Alternatively, this is a nice article from the American Cancer Society: https://www.cancer.org/cancer/cancer-causes/genetics/should-i-get-genetic-testing-for-cancer-risk.html
One of our sponsors, Myriad Genetics provides an online Hereditary Cancer Quiz that lets you know according to medical societal guidelines if you are a candidate for testing with their Hereditary Cancer Panel. If it indicates testing is appropriate you should see your healthcare provider who will review your information, answer your questions, and possibly refer you to a genetic counselor to determine the next course of action. Here is a link to the quiz to get you started: https://www.hereditarycancerquiz.com/ .
Essentially all insurance carriers will cover the costs of the testing if you meet medical societal criteria. If you require testing and do not have insurance and cannot afford the testing, Myriad and other diagnostic genetic labs will work with you on an individual basis with their patient assistance programs.
If you are concerned about your DTC results. What should I do?
- Schedule an appointment with a genetic counselor.
- A genetic counselor can walk through your personal and family history, discuss the pros and cons of testing, recommend a genetic test through a highly certified medical lab (where your information will be protected by medical privacy laws), and talk you through the results.
- UCHealth offers oncology genetic counseling in Northern Colorado. To schedule an appointment with a genetic counselor, call:
- Fort Collins: 970-493-6337
- Loveland: 970-203-7080
- Greeley: 970-347-5780
- To find a genetic counselor for you or a family member who doesn’t live in the area, go to www.aboutgeneticcounselors.com
To learn more about cancer risks, prevention, and genetic testing, plan to attend our symposium on Tuesday, September 17th at Timberline Church. There will be medical professionals at breakout tables to answer your questions and see that you get the follow up you need. Register at: https://www.uchealth.org/events/events/take-charge-of-y…cer-prevention-2/