Cancer Genetics and Prevention

Cancer Genetics and Prevention Overview

• Dana-Farber Cancer Institute developed one of the first clinical cancer genetics and prevention programs in the world. The program was first developed based on the fundamental work of Dr. Frederick P. Li, one of the founders of the field of cancer genetics and one of the physicians who first recognized Li-Fraumeni syndrome.
  Today, we provide expert comprehensive care for cancer patients, survivors and families who have had cancer, for their family members, and for individuals who hope to avoid cancer.
  A visit to the Cancer Genetics and Prevention Clinic usually includes time with both a physician and a genetic counselor, both of whom have expertise in all forms of inherited cancer syndromes. We educate patients about cancer risk and its implications for them and their family members. Working with referring physicians, we design individualized programs to monitor for the earliest signs of cancer — diagnosing if it occurs, and, in many cases, preventing it from arising.
  If you or your doctor thinks that you are at increased risk of developing cancer or may have an inherited risk of cancer, we can provide an estimate of your risk as accurately as possible, and work with you, and your health care team to provide strategies to help lower your cancer risk.
  

  Our expertise

  Dana-Farber Cancer Institute's Center for Cancer Genetics and Prevention includes a team of expert health professionals – medical oncologists, gastroenterologists, geneticists, gynecologists, psychologists, surgeons, nurses, and genetic counselors — who provide cancer risk assessment and comprehensive recommendations for managing cancer risk.
  As part of risk assessment, we offer genetic and genomic testing to determine risk for inherited cancer syndromes such as breast and ovarian cancer syndromes (BRCA1 and BRCA2), Lynch Syndrome, and various rare cancer syndromes.
  We also conduct research into many aspects of cancer risk and its management.
  The landscape of the field of genetics is rapidly changing. We provide advanced options in genetic testing across the spectrum of new and established inherited cancer syndromes. The syndromes include, but are not limited to:
  

• Hereditary Breast and Ovarian Cancer
  We partner with medical oncologists and gynecological oncology surgeons, geneticists, and genetic counselors to evaluate your personal or family history of breast and ovarian cancers and other associated cancers. Patients learn what steps they can take to reduce their risk of developing breast and ovarian cancer. Research studies have shown that up to 23 percent of individuals with ovarian cancer have a genetic predisposition to this malignancy. We work closely with Dana-Farber's Gynecologic Oncology Program and high risk gynecology surgeons to provide comprehensive testing for these individuals. We also work closely with specialists in our Breast Oncology Program to identify individuals who may be at higher risk for developing breast cancer.
• Hereditary Gastrointestinal Cancer Syndromes
  Colorectal cancer can run in families, and about 5 to 10 percent of colorectal cancer is thought to be hereditary. We offer advanced genetic testing to determine an individual's risk for colorectal cancer. Our practice follows patients who have an increased risk for polyps, colorectal cancers, gastrointestinal cancers, pancreatic cancer (see below), Lynch Syndrome, and related cancers.
• Lynch Syndrome
  Lynch Syndrome is a genetic condition that increases the risk of certain cancers (especially colon and uterine cancer). So far, five genes that are part of or associated with the DNA mismatch repair process have been shown to cause Lynch syndrome: MLH1, MSH2, MSH6, PMS2, and EPCAM (also known as TACSTD1). In the United States, about 140,000 new cases of colorectal cancer are diagnosed each year, and approximately 3 to 5 percent of these cancers are caused by Lynch syndrome.
• Li-Fraumeni Syndrome
  We offer heightened surveillance using whole body MRI, and the opportunity to participate in other research studies. We collect information about individual and family cancer history, and collect specimens from patients and family members with Li-Fraumeni Syndrome. We collaborate with the International Li Fraumeni Consortium to hasten new knowledge.
  Learn more in our article, Researchers and patients join forces against Li-Fraumeni Syndrome
  
• Familial Pancreatic Cancer
  There are some families with multiple close relatives or several generations affected with pancreatic cancer. We offer risk assessment and genetic testing for individuals who may be at increased risk for pancreatic cancer and determine eligibility for screening studies. We also encourage patients to take part in our family registry.
• Hereditary Paraganglioma-Pheochromocytoma Syndrome (PGL/PCC)
  The Paraganglioma-Pheochromocytoma Genetics Group is a collaborative initiative of Dana-Farber's Cancer Genetics and Prevention Program and Brigham and Women's Endocrine Division – with endocrinologists, geneticists, oncologists, and genetic counselors dedicated to providing patients with personalized hereditary risk evaluation, genetic testing, recommendations for screening and prevention, and long-term follow-up.