To screen or not to screen?
For five years, Laura Berry lived with the knowledge that she would likely develop breast or ovarian cancer.
She underwent a genetic screening after losing one breast to the disease and finding a lump in one of her ovaries. The test showed a genetic mutation that made her susceptible to certain cancers. After her mother and aunt died of pancreatic cancer, Berry took the drastic step of having her healthy breast removed last spring.
Berry’s situation is becoming more common as DNA screening becomes available for a wide spectrum of diseases, including colon and thyroid cancers and melanoma. Positive test results engender a unique mental burden. DNA tests can suggest treatment options, many patients say, but they don’t provide easy answers. Indeed, many people worry that positive test results will only cause them anxiety.
However, one study suggests genetic screening can help people feel better and rarely makes them feel worse. Researchers at Georgetown University in Washington, D.C., followed a group of women for six months after they were tested for a genetic mutation like Laura Berry’s. The study found that women who tested negative were happier at the end of the study than they were at the outset. Those who tested positive usually felt the same as when they started.
A positive result can actually be a relief, says Cindy Hunter, a counselor who specializes in guiding people through genetic screenings at the Indiana Familial Cancer Center in Indianapolis. Once people know for sure that they are at risk, which many already suspect, they are more prepared to monitor their health through frequent checkups, she says. A positive result can resolve lingering guilt for people who have had cancer, she says; realizing it was not within their control rids them of a sense of responsibility.
Sometimes, though, people who learn they aren’t carriers have a hard time knowing they are “safe” while their relatives are sick or dead. “People sometimes feel they are no longer a member of the[ir] family,” Hunter says. “They feel a little estranged.”
For many, including Berry, a genetic screening put her mind at ease. Even before the screening, she worried about a cancer relapse. “There were days when I’d say ‘I wonder if today’s the day it’s going to come back,'” says Berry.
She has three daughters, each of whom has an even chance of being a carrier. The oldest is considering a DNA test. “When I had the mastectomy, I was 40 years old and I had three children,” Berry says. “She’s 23, and she’s just in her first serious relationship”
KNOW YOUR RISK
GENES AREN’T FATE ONLY 5 PERCENT OF BREAST CANCER CASES ARE DIRECTLY LINKED TO KNOWN DNA MUTATIONS. ENVIRONMENT AND LIFESTYLE ARE POWERFUL FACTORS. CHECK OUTTHE HARVARD SCHOOL OF PUBLIC HEALTH’S NEW WEB SITE TO ASSESS YOUR RISK FOR A VARIETY OF DISEASES: www.yourdiseaserisk.harvard.edu.
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