LOCAL | HEALTH FORUM

Hadassah focuses on inherited cancer risk

BY CATE MARQUIS, SPECIAL TO THE JEWISH LIGHT

Some Jewish women of Eastern European descent inherit a higher risk of breast cancer. Knowing your risk is a step towards combating the disease.

To help, St. Louis Chapter Hadassah offered a health education program on the topic, "The Link Between Ashkenazi Jews and Breast Cancer" last week.

Two experts on the genetic risks of breast cancer and other inherited cancers spoke at the event, which included stories from cancer survivors and members of the presenting organization.

Jerri Livingston, Hadassah Vice President - Health Division, and denison@hadassah.org">Joan Denison, St. Louis Chapter Hadassah Executive Director, spoke and introduced the speakers, genetics counselor Jennifer Ivanovich and Dr. Susan Luedke, who specializes in breast cancer treatment.

Ivanovich, genetics counselor at Washington University, spoke on the genetics of breast cancer. Ivanovich is a Board Certified Genetic Counselor who is Manager of the Hereditary Cancer Core at the Siteman Center and current director of the Young Women's Breast Cancer Symposium.

"When you talk about genetics, what you are asking is 'does this family have hereditary cancer,' cancer running in the family, and there are real reasons to try to figure that out," Ivanovich said.

While cancer is associated with cellular mutations, most commonly those mutations are due to environmental factors, like exposure to carcinogens, not inherited genetic mutations. However, if a family has a genetic tendency for cancer, then doctors can take steps to help, like increased testing or preventative surgery, Ivanovich noted.

"We can use testing to figure out, in a family, who is at high risk and who is not," she said.

"Whenever I talk about genetic testing, I always get mixed reactions," she said. She noted that people worry about having the knowledge or feel guilty about passing along a defective gene. "First of all, our genetic history is what it is, we can't change that," she said. "All we can do is respond to it in a way that is healthy, with appropriate medical care."

Ivanovich outlined the steps in determining if a family has a genetic cancer risk. The first step is to look at family history of cancer, and make a chart that lists the occurrence of cancer in at least three generations.

"If nothing else from today, take away know your family history, as much as you can." She told the attendees to learn what kinds of illnesses people had in the family and your particular ethnic background, on both sides of the family, and share that information with your children. "It is this that we use, not just in cancer genetics but as we learn more about genetics, in a variety of health issues, heart disease, diabetes, this will become more critical," she said.

Although breast cancer gets the most attention, it is not the only cancer associated with the BRCA1 and BRCA2 genetic mutations, Ivanovich said. Ovarian, prostate and colon cancers also run in families with these mutations. She noted that the healthy form of the genes seem to act as tumor suppressors. Cancer genes often follow a dominant pattern of inheritance, where a single copy of a gene can lead to cancer, as is the case with the BRCA genes, so it can be inherited from either parent.

Ivanovich noted that families with a history of cancer often think that the cancer-free family members should be tested first but she noted that it is the family member diagnosed with cancer who should be tested first.

"The newest area is trying to use inherited genetics to figure out if people respond differently to chemotherapy," she said. "This is very early, but I think it will be very promising in trying to target therapies to women with breast cancer."

Luedke spoke on breast cancer treatment options and prevention. In designing treatment, one has to look at a number of factors, Dr. Luedke said.

"Interplay of genetics and environment, multiple areas within the breast cells that can go wrong, for many of which we can use targeted therapy now, reaction processes," she said.

Luedke said knowing how other family members with the same genetic cancer had responded to chemotherapy could be critical. Both Ivanovich and Luedke noted that there are more tests than treatments for genetic cancers, so testing could be a difficult choice.

The program was one in the Hadassah Heath Education Series, sponsored by St. Louis Chapter Hadassah. The free event was offered with support from Susan G. Komen for the Cure and St. Louis Men's Group Against Cancer. Members of the Komen for the Cure organization also attended the event. Hadassah focuses on women's health and other issues affecting women.

The "The Link Between Ashkenazi Jews and Breast Cancer" program will be repeated in spring 2009. The date, time and location are to be determined but will be available on the St. Louis Chapter Hadassah Web site at www.stlouis.hadassah.org.