Cancer Runs in Families. Too Few Are Getting Tested.

Dr. Shoshana Ungerleider knew what her father’s pancreatic cancer diagnosis meant for his future. She didn’t realize what it meant for her own cancer risk. Steven Ungerleider’s doctors ordered genetic testing in 2022 to see if his cancer might respond to a new treatment. They found he had a mutation in the BRCA2 gene, which raises risks for cancers including pancreatic, breast and ovarian—and can be passed from parents to children.

Ungerleider and her sister got tested and discovered they had the same mutation.

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Doctors are recommending genetic tests to more cancer patients and their families. Testing costs have dropped, and the results are helping doctors choose newer targeted drugs and encourage relatives to confront their own cancer risk. “We can test you for dozens of genes at the same time, and it’s going to influence your treatment,” said Dr. Jewel Samadder, co-leader of the Office of Precision Medicine at the Mayo Clinic Comprehensive Cancer Center in Phoenix.

But few patients or their relatives get tested. Genetic counselors are scarce, and some doctors aren’t up-to-date on genetics training or guidance. After a cancer diagnosis, inherited risk isn’t a priority for many patients.

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Some 10% of cancers are associated with genetic inheritance, including the BRCA mutations linked to breast and ovarian cancer risk in the 1990s. BRCA mutations have since been linked to other cancers, and dozens more gene variations have been shown to raise cancer risks. Tests that hunt for these variations using blood or saliva samples cost around $250 out-of-pocket, down from around $4,000 a decade ago.

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The association with pancreatic cancer is news to me.