Fact or Fiction

Busting myths about cancer risk assessments.

A cancer risk assessment explores an individual’s personal and family health history to determine the individual’s risk for developing cancer. In most cases, having a family history of cancer is what prompts people to seek a cancer risk assessment.

Photo courtesy of Cancer Care Centers of Brevard.

Alice Spinelli, APRN, AOCN

“We begin the assessment by drawing a genogram, called a pedigree, of the person’s first-, second- and third-degree relatives,” describes Alice Spinelli, APRN, AOCN, a board-certified oncology nurse practitioner at Cancer Care Centers of Brevard. “We plot out the relatives’ cause of death and when they passed. We look primarily for the incidence of cancer and the types of cancer.

“If the person being assessed has a small family or little information about their family, there are also computer models available that use algorithms to measure risk. There are algorithms that calculate risk for various types of cancer such as breast and colon cancer. We plot out that information as well.”

The main reason for gathering all of this information is to determine if the individual meets the criteria for genetic testing, if they desire to be tested. It also helps determine which genes to test. If the person’s pedigree is limited, providers might recommend testing a broad array of genes to compensate for the unknowns.

“Cancer risk assessments at Cancer Care Centers of Brevard are more than genetic testing,” Alice observes. “We also consider lifestyle and personal health factors when determining a person’s cancer risk. Unfortunately, there are certain myths about cancer risk assessments that cause some people to be fearful of the process.”

No Wrong Answers

The first myth is that most cancers are hereditary and can, therefore, be detected through genetic testing.

“People are often surprised to learn that most cancers do not develop from a genetic mutation passed down from an individual’s mother or father,” Alice elaborates. “Actually, we think just a little more than 10 percent of cancers are hereditary. The rest, almost 90 percent, occur due to mutations acquired during a person’s lifetime.

“Acquired mutations often occur as the result of aging, certain behaviors such as smoking or environmental factors such as exposure to the sun with skin cancer. In some cases, we do not know what causes the mutations. They simply occur randomly.”
The second myth is that a cancer risk assessment is synonymous with genetic testing.

“That is not true,” Alice asserts. “The purpose of the cancer risk assessment is education. It is a time for people to learn what their cancer risk is, then talk about whether testing is appropriate for them.

“At the end of that visit, I have done my job if I have helped people understand what their options are. They then have a choice to say, I want to get tested; I want to go home and think about it; or Thank you very much, but I do not want to do this. And none of these answers are wrong. Testing is an option.”

People who believe this myth will sometimes schedule a cancer risk assessment, but then cancel it or fail to show up for the appointment.

“After they schedule the appointment, they may talk to friends and relatives who may share other myths about genetic testing,” Alice suggests. “Their friends may say, You will never get health insurance and never get employed if you have a mutation. Your insurance company will drop you. The genetics lab will use your DNA for purposes other than what you intended.

“All of these statements are untrue,” Alice assures. “There is really no reason to fear a cancer risk assessment at Cancer Care Centers of Brevard.”

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