An important strategy to help evaluate a person's cancer risk is genetic testing, evaluating a blood or tissue sample for inherited cancer risk.
Genetic testing is a tool that allows doctors to help patients determine and proactively manage their cancer risk. But oftentimes fear and hesitation surround genetic testing: "How will it help me to learn I'm going to get cancer?"
In this episode of Meaningful Medicine, Novant Health gynecologic oncologist Dr. Matt McDonald demystifies the world of genetic testing. Listen to learn who can benefit from genetic testing, and how it can improve your understanding of your cancer risk so you and your doctor can make the best decisions for your care.
Detect cancer risks now for a brighter future.
Maggie McKay (Host): Meaningful Medicine, a Novant Health podcast, bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips to navigate medical decisions and build a healthier future.
Today, I'm sitting down with Dr. Matt McDonald, gynecologic oncologist, to talk about genetic testing for cancer. I'm your host, Maggie McKay. Before we get started, I'd love to know how this became a passion of yours, Dr. McDonald. What made you become an oncologist?
McDonald: You know Maggie, that's a really long question, or a long answer to an easy question. It's a journey. It takes many, many years through college, med school, residency, fellowship. But it's an interesting story. I mean, it's one that I think most people go into medicine because they like science. They like helping people. And then as you navigate through the medical community and trying to figure out what really speaks to you and where you kind of find a calling, I kind of found that in specifically GYN Oncology because it's the single specialty within medicine where you practice both surgical oncology as well as medical oncology within the same field.
So what's unique about that is you really get to take care of patients from the very beginning of the diagnosis, which for the cancer journey, usually is in the surgical part, end up operating on those patients and then manage and direct their postoperative management in the chemotherapy world and radiation oncology world.
So, it's a very rewarding job that we get to take care of patients from the very, very beginning through their treatment, through survivorship and etc.
Host: And let's start with, what is genetic testing?
McDonald: So, genetic testing is a really broad term. I'm going to speak specifically to the cancer landscape. If you ask just your primary care doctor and said, Hey doc, what's genetic testing? He or she may give you a very long answer because there's doing genetic testing for trying to figure out which pharmacologic agents, which blood pressure agents may work better for you based on your genetic makeup.
I can't speak terribly intelligently on that because that's outside of my clinical lane. But in the cancer space, we know that a person's genetics definitely carries a role or carries a risk with certain cancer subtypes. Most cancers have no genetic link whatsoever. In fact, right now it's estimated that about 90% of cancers do not have a genetic, or when we say genetic, we mean inherited risk, meaning I inherited something from my mom or dad when I was born that puts me at an elevated risk above the general population for a specific cancer.
And we're learning a lot about certain genes or certain mutations we may have inherited as a child that increases a person's risk for certain cancers. And that's the genetic testing within the cancer space, is trying to identify those patients that would benefit from genetic testing, offer genetic testing to those patients, because if we know about it, we can actually prevent cancer, save lives, and really prevent heartache through multiple generations within a family.
So that's what genetic testing really means in the cancer space.
Host: And how can understanding your predisposition for cancers help? Is the option only dread, or mastectomies?
McDonald: Oh, no, it's actually, I think that's a really difficult misconception and something we spend a lot of time really reeducating patients on. Cause, I think patients quickly go to a space where, why do I want to do genetic testing? You're just going to tell me I'm going to get cancer.
And that's, that's actually not the case. Really what it does is that if we find that a patient has an elevated risk of a certain cancer above the general population; like I'll give you an example real quickly. Breast cancer is an easy one for people to understand because it's in the literature a lot based on numbers that the general population risk for women across the world is about one in eight.
So one in eight women in their lifetime are affected with breast cancer, which is a horrifically high number. But there are certain genetic syndromes that increase that risk significantly, so up into the 60, 70% lifetime risk. And so, if we know about that genetic risk in that specific patient, there are screening modalities that we do differently for that patient to prevent the likelihood of her or him presenting at an advanced stage of breast cancer, save lives, and then there's medications and surgeries that we do that also prevent the onset of that cancer ever developing. And so specific to any genetic syndrome, there is a risk-reducing strategy for that genetic syndrome that's particularly aligned with those risk factors, that help us basically mitigate that risk for that patient. So it's really a very active risk-reducing or preventative strategies that we can do for women and men we're able to document one of these genetic syndromes.