Colorectal cancer is the fourth most common cancer in the United States and the second leading cause of cancer-related death. Approximately one in twenty Americans will be diagnosed with colorectal cancer. On average, five to ten percent of all colon cancer diagnoses are due to a specific genetic condition that has a very predictable inheritance pattern within a family. Although these conditions account for a minority of all colorectal cancers, given how common colorectal cancer is, this translates to a large number of patients with a genetic condition. For those who do have a genetic mutation that puts them at a higher risk for developing the disease, it not only has significant implications for the patient, but it also affects entire families. The Hereditary Cancer Clinic at the University of Colorado Cancer Center works with patients to not only discover whether or not a cancer is hereditary but also helps to prevent it.
“Knowing if there is a cancer mutation in your family is very powerful information,” says Michelle Springer, Instructor and Certified Genetic Counselor at the CU Cancer Center. “It helps individuals understand what is increasing the risk for cancer in their family. Additionally, it can provide important information regarding other potential cancer risks, as many hereditary cancer genes are associated with multiple cancer risks. Furthermore, when a mutation is identified in an individual, it provides a tool to test other family members to better determine which individuals have inherited the cancer predisposition. This information is very empowering for patients and their families.”
The clinic is overseen by Swati G. Patel, MD, a Gastroenterologist, who sees patients in conjunction with a board-certified genetic counselor.
“We see patients who have a personal history of young onset cancer and/or a strong family history of cancer that may indicate the presence of a genetic condition. There are a variety of known genetic mutations that can increase risk of colon cancer,” says Dr. Patel. “We work to identify patients who possess these genetic conditions in an effort to implement screening recommendations for these patients that are more aggressive with the goal of preventing cancer.”
A typical visit to the clinic includes a careful medical and family history to determine whether a patient and their family may benefit from genetic counseling and testing. If a genetic component is discovered, other implications are discussed with the patient and their family, including medical, psychosocial and financial impacts of learning about a genetic condition within the family.
“This is a very unique clinic because we focus not only on the patient, but their entire family. We often see families together,” explains Dr. Patel. “I do my best to advise patients based on the most up to date medical developments and research. Genetics is a rapidly evolving field, so a large part of my job is also explaining to patients the vast areas of nuance and uncertainty and how to navigate the unknown.”
Risk factors for hereditary colon cancer include:
- You or a family member has been diagnosed with colorectal cancer before age 50
- You or a family member has a history of ten or more pre-cancerous colon polyps
- You have multiple family members with colon cancer and/or uterine cancer
“A lot of patients see a genetic condition as a foregone conclusion. Although it is overwhelming to learn about a genetic condition that pre-disposes to cancer, I try to highlight that KNOWING the cause of cancers within the family is actually empowering,” says Dr. Patel. “We may not be able to prevent every possible cancer, but just knowing about the diagnosis restores some degree of control.”