Physicians involved in the program, which began with 3 families in 1996, are now seeing about 15 new families a month from across the province. In an attempt to curb the surging numbers, a detailed protocol for referral has been sent to all BC physicians. Also included are women under age 36 in whom breast cancer has been diagnosed and women under age 51 in whom ovarian cancer has been diagnosed, as well as men or women under age 51 for whom a diagnosis of colon cancer has been made. Other cancers are included because the presence of either BRCA gene places patients at higher risk for them, too. They are encouraged to bring as many family members as possible to the counselling session, which reviews the family tree and discusses sporadic versus hereditary cancers.
Patients learn whether their risk is higher or lower than they thought.
A diagnosis of cancer has not been made for most of the women who participate, but they still fear that they may be predisposed to the disease because of their genes, says Karen Panabaker, the program's genetic counsellor. If genetic testing is considered appropriate for a patient, a family member who already has cancer is the candidate of choice for testing, although 2 people are sometimes tested for increased accuracy. In rare cases DNA from banked blood or biopsy tissue is used to study the genes of a relative who died from breast or ovarian cancer. With several hundred mutations identified in the BRCA1 gene and at least 170 for the BRCA2 gene, analysis of the simple blood test is a complex process. Because of limits on the technology and staff, it can take several months to obtain results.