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Patients interested in cancer genetic testing should collect their personal and family cancer history (both maternal and paternal sides of the family). Cancers to consider include: breast, ovarian, prostate, pancreatic, gastric, colon, endometrial cancers and melanoma.
The test itself is non-invasive, just a blood draw or saliva sample.
What’s the turn around time for genetic tests?
It depends what test was ordered and what lab is processing the test.
Typically, a single site genetic test (for a known mutation in the family) takes several days. A panel genetic test can take 4-6 weeks.
How much does cancer genetic testing cost?
Several factors impact the cost of genetic testing; insurance coverage, personal and family history of cancer, or having a known mutation in the family.
Cost of the test can range from $0 to $6,000.
Many genetic testing labs offer flat test rates or financial assistance programs for those who qualify. The Hereditary Cancer Foundation is another resource for alleviating financial barriers to genetic testing.
Will my insurance discriminate against me?
The Genetic Information Nondiscrimination Act (GINA) was passed and signed into law in 2008. This legislation protects patients from insurance discrimination by their health insurance provider or employer. GINA does not apply to long-term care, disability, or life insurance providers.
What are the possible test results?
Positive – The patient carries an inherited mutation that may put them at an increased risk for developing cancer. When a patient tests positive, each first degree relative also has a 50/50 chance of carrying the gene as well.
When a mutation is identified in a family, family members have the ability to test for the one mutation that runs in their family (single site test). If relatives test negative, their cancer risk goes back to general population risk (unless there are cancers on the opposite side of the family or other personal risk factors that increase the individual’s likelihood of developing cancer). When a relative tests negative, they cannot pass on a mutation they do not have. Cancer gene mutations do not “skip” generations.
Negative – In the genes tested, the patient does not carry a mutation that increases their risk for hereditary cancer.
Patients who test gene negative (without a known mutation in the family) should be managed based on personal and family history. Every individual case is different, the patient should consult with their health care provider to establish a cancer risk management plan that is best for them.
Variant of Uncertain Significance – A genetic abnormality was identified. However, it has not been determined if this genetic abnormality increases a patients risk for developing cancer.
I already have/had cancer, how will genetic testing help me?
Genetic testing helps identify hereditary causes of cancer. Different gene mutations are associated with different cancer risks. Many gene mutations increase cancer risk for more than one type of cancer. Knowing if you’re a carrier can determine if you are a candidate for targeted treatments or therapies, if you’re at risk for other types of cancers, and may help guide your surgical decisions and options.
Additionally, knowing if your cancer is hereditary can determine who else in your family testing may be appropriate for.
Who can order a genetic test?
A certified genetic counselor or your local health care provider can counsel you and order a cancer genetic test.
Cancer genetic testing has been around for decades. As with all new technology, genetic testing has improved and become more comprehensive over time.
At one time, patients may have only had genetic testing for mutations in the BRCA1 and BRCA2 genes. Although mutations in these two genes dramatically increase the risk of breast cancer, they are not the only genes associated with breast cancer risk. Patients who were only tested for BRCA (or a small “breast cancer” specific panel) may consider discussing “update testing” with their health care provider. An update test would include a panel of genes that were not previously tested.
Patients should keep a copy of their test results. As research progresses, genetic panels will continue to expand and offer patients the most comprehensive look at genetic risk as possible. Having a copy of your results will help you and your health care provider determine if you should have update genetic testing.