The relationship between family medical history and your health

How a genetic counselor can help you

interviewer: National Family History Day is Thanksgiving. Family history is one of the most reliable tools for predicting disease risk, so now is the perfect time to talk to your relatives about health concerns and health problems that run in your family.

wendy colemanGenetic Counselor at Huntsman Cancer Institute, let's talk about that and what you do as a genetic counselor to keep people healthy.

Wendy: In general, we all have a risk of developing the disease at some background level. Approximately 1 in 3 people will develop cancer during their lifetime, most of which is due to chance and aging. Some families may be at moderately increased risk. In general, if someone in your immediate family, such as a parent or sibling, has cancer, your risk of developing that type of cancer is about twice that of someone with no family history. Therefore, some people fall into this moderate risk group.

And, in rare cases, families fall into the high-risk category, where they tend to have more than one relative with a particular disease. Huntsman's specialty focuses on families with multiple cancers. Other red flags we look for are individuals who develop cancer at a much younger age than average or who develop multiple primary cancers.

If you see these types of patterns in your family, it may suggest that there are certain non-functioning genes that are passed down in your family, greatly increasing your risk. It is in these types of families in particular that genetic counselors can play a role, helping to identify high-risk families and understanding how this risk is communicated and what to do in terms of screening and prevention. can play a role in providing information about what can be done.

interviewer: Therefore, just because you have a family history does not necessarily mean you will get a particular disease.

Wendy: that's right.

interviewer: That's what you are trained to do, to understand how important this opportunity is based on your family history.

Wendy: It really helps people find out where they fall on the risk spectrum and what kinds of additional screening and prevention strategies might be beneficial to them based on their level of risk.

Specific questions to ask relatives about family medical history

interviewer: Thanksgiving, holidays, and Christmas are great times to talk to your relatives. When I went to the doctor's office the other day, I was asked about my family's health history. I knew a lot, but there were also a lot of holes. What are some specific questions to ask?Next, I want to talk about genetic testing and how it can help.

Wendy: Especially here in Utah, people are very interested in researching their family tree and family tree. We strongly encourage people to include medical history in their family research. In fact, knowing the specific cancer type, as opposed to general information that a relative has had cancer, is very important for risk assessment. Cancer is actually hundreds of different diseases.

We also collect the age at diagnosis. As I mentioned earlier, the risk of getting cancer increases with age, so it is very important to get cancer at a younger than average age. Another important thing to ask for family history clues is to ask about screening and prevention procedures. For example, in a family where a relative has had colon cancer, this may prompt other relatives to go for a colonoscopy. This means that rather than being diagnosed with cancer, precancerous polyps may be detected, removed, and prevented. Right now, you're asking your relatives about colonoscopies over Thanksgiving dinner, which probably isn't the best time.

interviewer: Not a very appetizing conversation.

Wendy: However, they are important information and important clues that can be used to identify families at increased risk.

Genetic testing to gather family medical history

interviewer: Okay. One way to gather family history is to actually talk about it. Another thing you can do is genetic testing.

Wendy: Genetic testing is very effective in increasing the information available from family history. It's not necessarily a substitute for looking at your family history and getting good information about it, but basically, if there's a pattern in your family that suggests a higher-than-average inherited risk, genetic Testing is an important tool. This tool allows us to actually look at a person's DNA and pinpoint what exactly is wrong with them, if they have a specific genetic variation or mutation that causes their genes to stop working properly. can. If we can pinpoint it, we may get more concrete clues.

For example, the BRCA1 and BRCA2 genes increase the risk of not only breast cancer but also ovarian cancer. So, for example, if you have a family that has seen multiple cases of breast cancer, and you find out that the risk is caused by a mutation in the BRCA1 gene, you can alert them and say, In addition to looking at your breasts, do you also need to think about ovarian cancer prevention?”

Also, most genetic mutations that cause an increased risk of cancer are passed on so that if a parent has the genetic change, their offspring have a 50/50 chance of inheriting it. So basically, the whole family isn't necessarily at risk. Therefore, to identify the genetic change that is causing your risk, you may want to test your at-risk relatives to see if they have inherited the change.

Whether something is found or not, an experienced genetic counselor will take the genetic test results, run them again against the person's family history, and leave the appointment with a personalized management plan. You can get it.

interviewer: Perhaps that's the key, right? Customized management as opposed to just comprehensive screening. When you turn 50, you'll start working on this. . .

Wendy: that's right.

interviewer: Understood. So what if someone doesn't know their family history, what if they're in that situation and there's no good way to get the information? Can they still benefit?

Wendy: Yeah. That's certainly something that happens. It's difficult because some people have probably been adopted and don't know their biological family, or sometimes have very small families and have very few relatives or perhaps some of their important people have passed away. To get information.

In general, we try to help people work with the information they have at hand. If someone has no information at all about their family history, we usually know that most of these conditions that pose a high risk of disease are very rare and we have no clues or clues that something runs in the person's family. If there is no evidence, try to reassure them. Because of their backgrounds that put them at high risk, we typically tell them to follow screening recommendations for the general population.

Advantages of in-person genetic counseling

interviewer: How is the service your company offers different from one of the genetic tests you could probably order over the internet?

Wendy: The tests offered by these internet companies do not look at your complete genetics. They have not fully analyzed specific genes known to be associated with higher risk of the disease. People are finding these to be interesting and a fun way to learn a little more about genetic makeup. Many of these companies can also provide information about a person's ancestry regarding where their family comes from.

So there's some really interesting information that you can get from those types of companies, but if you have a strong pattern of illness that runs in your family and you're concerned about it, it's really important that you talk to a professional who can identify it. is. Identify the most appropriate genes to test and ensure they are tested correctly and in the most thorough way.

interviewer: We have someone here at Huntsman Cancer Institute who is interested in genetic counseling. How can we achieve that?

Wendy: Huntsman Cancer Institute has a Family Cancer Assessment Clinic. This involves meeting with a genetic counselor or specially trained doctor to review your family history, talk about your cancer risks, and, as mentioned earlier, receive a personalized cancer screening program. This is a clinic where you have the opportunity to return. Our phone number is 801-587-955.

interviewer: So will insurance cover this?

Wendy: In general, our visits are covered by insurance just like any other doctor's appointment, and most insurance companies now also cover most genetic tests. Family gatherings, reunions, weddings, etc. are great opportunities to approach your relatives and not only ask them how they're doing, but how their health is.

_{Updated: November 28, 2024
First publication date: November 26, 2013}