When Cancer Runs in the Family
While doctors can rarely pinpoint a single reason why people develop cancer, they can say with certainty that a faulty gene is to blame in some families.
Westmead Hospital’s Familial Cancer Service works to help families with a strong history of some types of cancer to reduce their risk of developing the disease.
Director of the service, Associate Professor Judy Kirk, says some families have a genetic mistake that can be passed down from one generation to the next and can mean a very high lifetime risk of cancer. These families usually have a strong family history including multiple cases of cancer on one side of the family, for example breast/ovarian cancer, bowel/uterus cancer, melanoma i.e. several generations, often at a younger age than is usual.
“It’s a big and difficult job to find the mistake, and we are not always able to find it,” she says. If they find the gene fault, they can offer family members a test to see if they are likely to get cancer. For families affected by bowel cancer they can have colonoscopies to look for early changes to their bowel, such as precursor polyps (growths on the lining of the bowel). For breast cancer families early screening and risk-reducing surgery is offered.
“It is important to identify those with the gene fault because familial cancer tends to occur much earlier than cancer that is not caused by a genetic fault, when people aged in their 30s’ or 40s are not looking for it”
It’s also important that people find out if they don’t have the genetic fault, she says, as it means hey have the same risk as the general population and won’t need extra screening tests.
Professor Kirk says women who have the genetic fault causing bowel cancer or breast cancer can also be at much greater risk of cancer of the uterus and ovary. ”There’s no good screening test for these cancers, so we recommend surgery after women have finished having children.” She says people who have two or three relatives diagnosed with breast/ovarian or bowel/uterus cancer (especially if under 50) should be assessed at a familial cancer service.
The Familial Cancer Service at the Crown Princess Mary Cancer Centre Westmead and Nepean Cancer Care Centre
Westmead’s service has been operating since 1994 and sees more than 500 families a year. The service is part of the Sydney West Cancer Network and has outreach services to Nepean Blue Mountains and Wagga/Bathurst/Orange (by Telehealth).
The Westmead Familial Cancer Service provides advice, genetic counselling and genetic testing to families with a strong family history of cancer or to those who have been diagnosed with a rare or early onset cancer.
Who can access this service?
The service provides advice to families, specialists and multidisciplinary teams on appropriate referrals.
What is needed to make an appointment?
A referral to Professor Kirk from your general practitioner or specialist is needed to be seen by the Familial Cancer Service together with a summary of the family history, stating whether genetic testing has already happened in the family.
The referral can either be faxed (02 9845 9217) or posted to the Familial Cancer Service at The Crown Princess Mary Cancer Centre Westmead PO Box 533 Wentworthville NSW 2145.
What happens next?
On receipt of referral a family history questionnaire will be sent or a genetic counsellor will contact the patient and arrange for the family history to be taken in detail. An appointment will then be arranged. There is no charge to individuals with a valid Medicare card.
Individuals referred to the Familial Cancer Service will be asked in detail about their family history including members both affected and unaffected by cancer. This is an important process prior to an appointment being made.