Women with family history of cancer need to have proper counseling, testing

In the wake of actress Angelina Jolie's public announcement that she recently underwent a preventive double mastectomy, Loma Linda University Medical Center urges women with a family history of cancer to have proper counseling and testing, if indicated, to see if they are at similar risk.

“Through her bold public disclosure, Angelina Jolie has created great awareness in the country; but now it is up to each woman to seek out the information and medical experts who can help them make informed and well-grounded choices.”

Jolie, 37, had her procedure after learning that she carries a mutation of the BRCA1 gene. BRCA stands for breast cancer susceptibility genes, a class of genes known as tumor suppressors, according to the National Cancer Institute. Mutations of the BRCA1 and BRCA2 genes sharply increase a woman's risk of developing breast cancer and ovarian cancer. Jolie's mother, actress and producer Marcheline Bertrand, died of ovarian cancer in 2007 at the age of 56.

"A non-invasive gene mutation testing, which is nothing more than taking a swab from inside the mouth, can determine if the woman is at risk and if the gene is mutated or not," says Maheswari Senthil, M.D., surgical oncologist and cancer liaison physician at the Women's Cancer and Surgical Oncology Center at Loma Linda.

According to Dr. Senthil, if a woman is carrying the gene, there is a 50 percent chance that her children might inherit the gene. Ideally, she says, the individual with the cancer is the best candidate to be tested, but if that can't happen then a similar test on the unaffected family member can be performed.

Dr. Senthil urges women who are potentially at high-risk due to family history to contact their primary care provider and make an appointment for an initial physician screening. At that time the physician will take a history of the patient and see if they qualify for the testing under guidelines developed by the National Comprehensive Cancer Network. If, as a result of the testing, it is revealed that the woman carries the mutated gene, various options for treatment will be confidentially discussed.

"Women who harbor this mutation need to know that medical and social support is available to them and their families," says Dr. Senthil. "Through her bold public disclosure, Angelina Jolie has created great awareness in the country; but now it is up to each woman to seek out the information and medical experts who can help them make informed and well-grounded choices."

Believing that coordination and communication are central to good health outcomes, Loma Linda University Medical Center (http://www.lomalindahealth.org) will open its new Women's Cancer and Surgical Oncology Center next month. The center will help ensure comprehensive, seamless care for the patient by bringing gynecology and surgical oncologists together with medical and radiation oncologists all under one roof.

Under this design each patient's individualized treatment plan is based on the collective input of medical, surgical and radiation oncologists, pathologists, radiologists, and an entire team of specialists. And it takes into account not only the patient's diagnosis but also his or her values and life circumstances. Helping implement this treatment plan is a team of specially trained nurse navigators who help guide the patient through the continuum of care and provide patients the support and education they need to prepare for surgery and ongoing monitoring. The center also encourages the involvement of families throughout the course of treatment, including during clinical as well as educational visits.