FM Talk 1065 Podcasts
Time for a Check - Michelle Dean from Southern Cancer Center talks about Genetic Testing
[MUSIC PLAYING] This is midday mobile with Sean Sullivan on FM Talk 1065. Welcome back, FM Talk 1065 and midday mobile. And time for a checkup. And good to see Michelle and Sam Ferdin from Southern Cancer Center back in studio. Thanks for coming in. Thank you for having me. Last time you were in, we talked about genetic testing. And what you all do with Southern Cancer Center kind of the wise for genetic testing. And those are to recap up. What are you all doing with that? If you test positive for a gene that could predispose you to cancer can be very valuable. Because that way we can screen you so that we can catch cancers earlier. So we can catch it at a very small stage and avoid maybe surgery, maybe chemotherapy could be avoided. And then also, I think once you know that you're predisposed to something, you kind of take a better responsibility for your health. It may make you lose weight, eat a better diet, exercise more. Things that you can do to prevent the cancer from occurring in the first place. That could just generally affect your overall health. Sometimes there are medicines that we can give you to prevent the cancer, especially like in breast cancer. If you have a high enough risk, there are medications that we can use to prevent the cancers. Sometimes there are surgical options. You realize what you're saying though for a lot of folks. I know this is what you do overtake, but you're saying preventable cancer. 20 years ago, that would have been crazy talk, right? I mean, you take a medicine to-- it's really exciting. If there is, for breast cancer, you can take aromatase inhibitors or tamoxifen for five years. And that can provide you greater than 10 years protection of getting breast cancer. So we can get the woman through those kind of crucial years around their 30s that they discovered that they're predisposed to having breast cancer greater than 30%, then they would be a candidate for those medications that could prevent the breast cancer from occurring at all. It really is amazing, Kevin, to get the thought that-- because so many of us in our mind, cancer-- like somebody else doctors said, something cancer center-- here comes cancer. Now we're going to treat and get rid of the cancer or attempt to mitigate it versus this idea. We're going to test you ahead of time, see what you might be predisposed to, and give you medicines to prevent it. I mean, it's really exciting. So the genetic test you'll do, or what types of genetic-- I mean, is this-- because people will be texting in saying, well, why don't I just get my 23andme or my ancestry.com? Is this the same thing? No, it's not the same thing. So the type of test that you get over the counter from 23andme is looking at SNPs, which are just looking at the DNA sequences and not doing a real deep dive into it. If a positive comes up, it needs to be confirmed. And it doesn't also not test for all the genes. So it definitely tests for BRCA 1 and 2. I think there's a couple other mutations for breast cancer that are major that it tests for. But there are 18 different genes that can cause breast ovarian, pancreatic, and prostate cancer. So they are not all included in those direct-to-consumer tests. So you might think you're safe because you've got a clean 23andme, but have a significant family history. But in real life, you weren't tested for all those genes. And again, it's just looking at SNPs, which is not actual-- So SNPs, yeah. Help me. SNPs are single nucleotide changes. So it's changes in the DNA sequence. Easy for you to say. Single nucleotide-- OK. So it's changes in the DNA sequence, but it doesn't really do a deep dive into that change. Just say, oh, does this cause a change that would cause the cancer 100%? So the test that we do is looking at next generation sequencing. It's actually doing a deep dive into the genes, each part of the gene. So no matter how long that BRCA gene is, it's going to look at the significant portions of it that cause cancer. And it's going to do a deep dive into the DNA instead of just kind of skimming over it. And it is the test that we use. We use a couple of two different companies. And one is the founder of next generation sequencing testing. So we know and can trust that company. They're the ones that discovered it. They're monitored by the different outline facilities, like the American College of Pathologists, have guidelines for them to make sure that their tests are being run accurately. And that if they get a positive, it's checked. OK. Yeah, that's wrong. So how do you-- Given to the patient. OK. They go back and look at it again. That's how you can make sure that they're valid. Yes, right. They have validity testing. I guess for these companies too, if they were doing this correctly, they would be out of business. And they would be out of business if they didn't get the information that-- it seems like they're obviously doing things correctly more than not because you're in business. Because when this first came out, next generation sequencing was very profitable. And so a lot of pop-up companies came up overnight. OK. Whether or not they were actually doing it correctly, because I'm not sure that they were all being regulated, is questionable. So we use the companies that we know and trust. This was saying those two that you use have proven to do it correctly. That they are pioneers in it and that they do do it correctly. Yes. There are companies that you could go to that you wouldn't know their background. And you don't know if they're confirming results. Well, it's good to have Southern Cancer Center. It's your business to know this, where I got no idea. Yeah, right. Exactly. You need somebody that you can trust, and that is trust. Well, the fact that you all are trusted. I mean, you're using-- I'm going to trust them, yeah. So how are these different from these genetic screening tests from diagnostic tests? So this one is-- the 23andMe is not diagnostic, per se, because it has to be confirmed. The next generation-- OK, educate me. OK, education time, Michelle. So diagnostic means that, oh, you do have cancer, for sure. OK. So the genetic test, that 23andMe does not say that you have cancer, for sure. It doesn't even say that you're predisposed to cancer, for sure. The type of genetic testing we would do would just say that, if you're positive, you're predisposed to it. It would tell you what percent chance you would have of getting that cancer in a lifetime. It doesn't say you have cancer right now. No, it does not. Then we would actually have to test you and make sure that you don't have that cancer. So if you tested, oh, positive for a 30% chance of having breast cancer, we would make sure that you've had your mammogram recently. And then we would also give you an MRI, so that you would get imaging every six months to make sure that there isn't any cancer going on in your body. So that would prompt-- So there would be another-- OK, more screening. So one begins the next. All right, so if we want to engage in this, getting this started, Michelle, how do we get this process started with you? You can just call our office and make an appointment with a genetics counselor. If you meet the criteria that's on our website or you can talk to your primary care doctor, your GYN, your urologist to see if you meet criteria. And again, it's usually a couple of people in your family that have the same kind of cancers, like breast, prostate, pancreatic, and ovarian are kind of a group of cancers. So if that runs in your family, more than a couple of people have it, or somebody had it earlier than 50, we would worry about that. And colon cancer also, if you have colon cancer, especially before the age of 15, your family, more than two people, we would worry about that. All right, if that raised your eyebrow, reach out and make that appointment with Southern Cancer Center today. Michelle, thanks for coming back in.