UPdate Winter 2011 : Page 3

Hereditary cancer risk assessment Ellis Fischel introduces mid-Missouri’s only genetic counselor specializing in cancer xpanding our cancer screening services, Ellis Fischel Cancer Center recently introduced mid-Missouri’s only certified genetic counselor specializing in cancer. As a genetic counselor, Stacey Miller, MS, provides a cancer risk assessment for her patients — guiding them through the complicated process of genetic testing for inherited cancer syndromes. Research suggests that five to 10 percent of cancers result from inherited cancer syndromes, such as mutations in the BRCA1 and BRCA2 genes that can cause ovarian and breast cancers. While that percentage seems small, it translates to approximately 76,500 to 153,000 new cancer cases in the United States each year caused by genetic syndromes. Identifying patients at risk of inherited cancer syndromes can enhance prevention and treatment options, Miller said. For example, with no effective screening techniques, ovarian cancer can be difficult to detect until it reaches later stages and is harder to treat. However, a patient who knows she is at risk for ovarian cancer may choose to have her ovaries removed preventively. In another example, Lynch syndrome can cause colon cancer in young adults, long before colonoscopies are indicated for the general population. If a patient knows he has a genetic mutation that causes Lynch syndrome, however, he may choose to have regular colonoscopies beginning at a much earlier age. “My role is to give patients a better understanding of their risk for cancer and to help them come up with a plan for managing that risk,” Miller said. “I work with my patients and often their family members. I also communicate with referring physicians about what we find so the physicians can work with their patients to develop a treatment plan.” E Cancer risk assessments: Five steps 1. Miller works with her patient to create a pedigree, which is a family tree designed to highlight patterns in cancer occurrences among relatives. 2. If Miller finds a pattern that suggests a hereditary cancer syndrome, she will discuss the possible syndromes and counsel her patient through the decision of whether to have a genetic test. 3. If her patient chooses to have a genetic test, Miller facilitates the test by collecting and sending samples to laboratories for testing. 4. After the results are determined, Miller explains the findings and counsels her patient about plans for prevention or screening for early detection. 5. Miller provides psychosocial support to assist patients in communicating difficult-to-discuss findings to their at-risk family members. To refer a patient to Miller, please call (573) 882-8445 . Stacey Miller at a glance… Undergraduate education: Bachelor of science degree in biology from Rockhurst University in Kansas City, Mo. Graduate education: Master of science degree in genetic counseling from the University of Texas Health Sciences Center and M.D. Anderson Cancer Center in Houston Certification: Certified genetic counselor, American Board of Genetic Counseling When to refer to a genetic counselor A consultation by a genetic counselor may be helpful if: • Your patient or one or more family members of your patient have been diagnosed with: -Breast, colon or endometrial cancer under age 50 -Breast or ovarian cancer and has Ashkenazi (Eastern European) Jewish ancestry -Ovarian cancer at any age Tests available for genetic mutations Cancer Type Breast Colon -More than 10 colon polyps, or colon polyps developed before age 40 -Hamartomatous or juvenile polyps -More than one cancer occurrence in an individual (bilateral or two cancer primaries) -A mutation in a hereditary cancer gene -A rare cancer, including: • Medullary thyroid, retinoblastoma, male breast cancer, adrenocortical carcinoma, sarcoma, paraganglioma and pheochromocytoma -Rare skin findings, including: • Sebaceous tumors, keratoacanthomas, trichilemmomas, papillomatous papules or fibrofolliculomas • Two or more family members with the same type of cancer at any age • Three or more family members of your patient have been diagnosed with cancer. • Your patient’s family has a grouping of cancers that are known to be genetically related (i.e., breast and ovarian, colon and endometrial, melanoma and pancreatic, etc.). • Your patient expresses concern about cancer risk and a desire to learn more about prevention, screening and treatment options. Hereditary Syndromes Breast-ovarian cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome, Peutz-Jeghers syndrome and hereditary diffuse gastric cancer syndrome Familial adenomatous polyposis (FAP), Lynch syndrome (hereditary nonpolyposis colorectal cancer), juvenile polyposis, Peutz-Jeghers syndrome and MYH-associated polyposis Breast-ovarian cancer syndrome and Lynch syndrome Multiple endocrine neoplasia types 2A and 2B, familial medullary thyroid carcinoma, Cowden syndrome and Peutz-Jegher syndrome Von Hippel-Lindau syndrome, hereditary papillary renal cell carcinoma, Lynch syndrome, Birt-Hogg-Dubé syndrome, and hereditary leiomyomatosis and renal cell carcinoma Hereditary diffuse gastric cancer syndrome, Lynch syndrome, FAP and Li-Fraumeni syndrome Familial atypical multiple mole and melanoma, and Li-Fraumeni syndrome Breast-ovarian cancer syndrome (BRCA2), Li-Fraumeni syndrome, Peutz-Jegher syndrome, von Hippel-Lindau syndrome, familial malignant melanoma and multiple endocrine neoplasia type 1 Li-Fraumeni syndrome, Lynch syndrome, FAP , Von Hippel-Lindau syndrome, and multiple endocrine neoplasia type 1 Li-Fraumeni syndrome Ovaries Thyroid Kidney Stomach Skin Pancreas Brain Soft tissue (sarcoma) Visit Find a Physician at www.muhealth.org/findaphysician .

Hereditary Cancer Risk Assessment

Ellis Fischel introduces mid-Missouri’s only genetic counselor specializing in cancer Expanding our cancer screening services, Ellis Fischel Cancer Center recently introduced mid-Missouri’s only certified genetic counselor specializing in cancer.As a genetic counselor, Stacey Miller, MS, provides a cancer risk assessment for her patients — guiding them through the complicated process of genetic testing for inherited cancer syndromes. Research suggests that five to 10 percent of cancers result from inherited cancer syndromes, such as mutations in the BRCA1 and BRCA2 genes that can cause ovarian and breast cancers.While that percentage seems small, it translates to approximately 76,500 to 153,000 new cancer cases in the United States each year caused by genetic syndromes. Identifying patients at risk of inherited cancer syndromes can enhance prevention and treatment options, Miller said. For example, with no effective screening techniques, ovarian cancer can be difficult to detect until it reaches later stages and is harder to treat. However, a patient who knows she is at risk for ovarian cancer may choose to have her ovaries removed preventively. In another example, Lynch syndrome can cause colon cancer in young adults, long before colonoscopies are indicated for the general population. If a patient knows he has a genetic mutation that causes Lynch syndrome, however, he may choose to have regular colonoscopies beginning at a much earlier age. “My role is to give patients a better understanding of their risk for cancer and to help them come up with a plan for managing that risk,” Miller said. “I work with my patients and often their family members. I also communicate with referring physicians about what we find so the physicians can work with their patients to develop a treatment plan.” Cancer risk assessments: Five steps 1. Miller works with her patient to create a pedigree, which is a family tree designed to highlight patterns in cancer occurrences among relatives. 2. If Miller finds a pattern that suggests a hereditary cancer syndrome, she will discuss the possible syndromes and counsel her patient through the decision of whether to have a genetic test. 3. If her patient chooses to have a genetic test, Miller facilitates the test by collecting and sending samples to laboratories for testing. 4. After the results are determined, Miller explains the findings and counsels her patient about plans for prevention or screening for early detection. 5. Miller provides psychosocial support to assist patients in communicating difficult-to-discuss findings to their at-risk family members. To refer a patient to Miller, please call(573) 882-8445. Tests available for genetic mutations Cancer Type Hereditary Syndromes Breast Breast-ovarian cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome, Peutz-Jeghers syndrome and hereditary diffuse gastric cancer syndrom Colon Familial adenomatous polyposis (FAP), Lynch syndrome (hereditary nonpolyposis colorectal cancer), juvenile polyposis, Peutz-Jeghers syndrome and MYH-associated polyposis Ovaries Breast-ovarian cancer syndrome and Lynch syndrome Thyroid Multiple endocrine neoplasia types 2A and 2B, familial medullary thyroid carcinoma, Cowden syndrome and Peutz-Jegher syndrome Kidney Von Hippel-Lindau syndrome, hereditary papillary renal cell carcinoma, Lynch syndrome, Birt-Hogg-Dubé syndrome, and hereditary leiomyomatosis and renal cell carcinom Stomach Hereditary diffuse gastric cancer syndrome, Lynch syndrome, FAP and Li-Fraumeni syndrome Skin Familial atypical multiple mole and melanoma, and Li-Fraumeni syndrome Pancreas Breast-ovarian cancer syndrome (BRCA2), Li-Fraumeni syndrome, Peutz-Jegher syndrome, von Hippel-Lindau syndrome, familial malignant melanoma and multiple endocrine neoplasia type 1 Brain Li-Fraumeni syndrome, Lynch syndrome, FAP, Von Hippel-Lindau syndrome, and multiple endocrine neoplasia type 1 Soft tissue (sarcoma) Li-Fraumeni syndrome Stacey Miller at a glance… Undergraduate education: Bachelor of science degree in biology from Rockhurst University in Kansas City, Mo. Graduate education: Master of science degree in genetic counseling from the University of Texas Health Sciences Center and M.D. Anderson Cancer Center in Houston Certification: Certified genetic counselor, American Board of Genetic Counseling When to refer to a genetic counselor A consultation by a genetic counselor may be helpful if: • Your patient or one or more family members of your patient have been diagnosed with: - Breast, colon or endometrial cancer under age 50 - Breast or ovarian cancer and has Ashkenazi (Eastern European) Jewish ancestry - Ovarian cancer at any age - More than 10 colon polyps, or colon polyps developed before age 40 - Hamartomatous or juvenile polyps - More than one cancer occurrence in an individual (bilateral or two cancer primaries) - A mutation in a hereditary cancer gene - A rare cancer, including: • Medullary thyroid, retinoblastoma, male breast cancer, adrenocortical carcinoma, sarcoma, paraganglioma and pheochromocytoma - Rare skin findings, including: • Sebaceous tumors, keratoacanthomas, trichilemmomas, papillomatous papules or fibrofolliculomas • Two or more family members with the same type of cancer at any age • Three or more family members of your patient have been diagnosed with cancer. • Your patient’s family has a grouping of cancers that are known to be genetically related (i.e., breast and ovarian, colon and endometrial, melanoma and pancreatic, etc.). • Your patient expresses concern about cancer risk and a desire to learn more about prevention, screening and treatment options.

Previous Page Next Page

Publication List
Using a screen reader? Click Here