Since beginning my clinical practice as a gynecologic oncologist at Texas Tech University Health Sciences Center in El Paso nearly three years ago, I have been concerned about my Hispanic patient population. I saw many Hispanic women younger than 50 who had breast cancer and ovarian cancer.
My colleague Dr. Harvey Greenberg and I, and our advanced nurse practitioner Kayla Castaneda at the Texas Tech Division of Gynecologic Oncology clinic, decided to obtain additional training in genetic cancer risk assessment at the City of Hope Comprehensive Cancer Center in Duarte, Calif.
This detailed cancer risk assessment measures a patient's risk for developing a hereditary cancer like breast, ovarian, uterine and colon cancers.
Genetic testing
Since our genetic cancer risk assessment clinic was launched, we have tested nearly 100 patients specifically for hereditary cancer risk. Many of our Hispanic patients have come up positive for some of these hereditary mutations. These mutations were thought to be specific to certain founder populations in Europe, like those of Ashkenazi Jewish ancestry.
We are continuing to enroll patients to be part of a collaborative study looking into these mutations in the Hispanic population. We test not only our own patients but also the patients of other community physicians and departments at Texas Tech University Health Sciences Center. Many patients have also come to our clinic by word of mouth.
The test entails a blood draw
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that is sent to a lab out of town. But before that, our nurse practitioner consults with the patients to determine whether they meet test criteria, getting their personal and family history of cancer and plugging that data into genetic cancer risk software. If they meet the criteria, the blood draw is performed to check for these genetic mutations. If the test comes up positive for a gene mutation, we provide prevention and surveillance strategies, such as more-frequent mammograms or MRIs of the breast. For ovarian cancer prevention, we test with tumor markers and vaginal ultrasound every six months or annually. For patients at risk for colon cancer, a colonoscopy every one to two years is available.
We provide all patients and their affected family members with follow-up care and counseling.
Recently, we tested a 40-year-old woman. Her mother has had breast and ovarian cancer and tested positive for a mutation of the BRCA gene, which is associated with hereditary breast-ovarian cancer syndrome. The mother is undergoing treatment for recurrence of ovarian cancer.
The 40-year-old daughter is also BRCA positive, but she has not developed cancer. She is in an excellent position because she still has many options to prevent cancer through prophylactic surgery and other surveillance options. This is wonderful news and exactly why we do what we do.
A genetic cancer risk test costs $3,200 and is covered by most insurance plans or Medicaid. A patient assistance program is also available for those who meet financial criteria.
Free lecture
Along with our advanced nurse practitioner, I will be giving a free lecture and question-and-answer session on hereditary cancer at 5:30 p.m. July 30 at the Paul L. Foster School of Medicine, 200 N. Concepcion, Medical Education Building, Room 1140. Refreshments will be served and parking is free.
J. Salvador Saldivar, M.D., M.P.H., is an assistant professor in gynecology oncology in the department of OB/GYN, Texas Tech University Health Sciences Center at El Paso, who is board-certified in obstetrics and gynecology. He has completed research and clinic training in gynecologic oncology at the MD Anderson Cancer Center in Houston and the University of British Columbia/British Columbia Cancer Center in Vancouver, Canada.