October 23, 2000
Hereditary Susceptibility to Cancer
John L. Ziegler, MD, MSc
About 10% of many common cancers are familial and are assumed to have a strong hereditary component. Recently, researchers have discovered specific gene mutations that confer an excess risk of cancer in about half of familial cancers. These mutations are passed on from fathers or mothers to their children. Knowledge of presence of mutations in a family may avert cancer development through vigilant surveillance or prophylactic surgery.
Begun in 1996, the UCSF Cancer Risk Program identifies families and individuals at high-risk for breast, ovarian, and colorectal cancer by analysis of the family cancer pedigree, assessment of heritable risk from mathematical models, and testing for specific gene mutations. A new high risk prostate cancer clinic is in development. Four trained genetic counselors and a multidisciplinary team of physicians offer an individualized risk assessment and follow-up recommendations for all clients and their families. The overall aim of the Program is to help individual family members learn their lifetime risk of cancer through genetic counseling and analysis.
There is much uncertainty at present about the best clinical options to offer high-risk cancer patients. The answers to questions about preventive surgery, use of hormones, chemoprevention, lifestyle changes, and screening procedures will come only from research and randomized clinical trials. The UCSF Cancer Risk Program, as part of its academic mission, aims to provide outstanding professional service to clients and to conduct high quality research on cancer prevention.
Since inception, the UCSF Cancer Risk program has counseled over 1000 individuals who are at risk for hereditary cancer, of whom half have been genetically tested for mutations in BRCA 1 and 2 (breast-ovarian cancer syndrome) or for mutations in mismatch repair genes commonly seen in hereditary colorectal cancer. Widely recognized in the Bay Area, the Program operates a satellite clinic at Sutter Cancer Center in Sacramento. A free educational outreach program for the lay community and for health care professionals will commence in the Fall 2000.
The best defense against cancer is prevention and early detection. Despite advances in treatment, many invasive cancers are ultimately fatal. Individuals at hereditary risk often develop more agressive tumors at an earlier age than the general population. Thus, if cancers "run in the family" it may be time to seek professional genetic counseling, and possibly genetic testing, to learn your cancer risk. The UCSF Cancer Risk Program can be reached at 415 885 7779 or toll-free 888 747 5422.
John L. Ziegler, M.D., M.Sc.
Professor of Medicine
Director, UCSF Cancer Risk Program
UCSF Cancer Center, Box 0808
2340 Sutter Street
San Francisco CA 94143
Tel 415 502 1883
FAX 415 502 3179