Genetic tests like 23 and Me have blown up in popularity in recent years, helping estranged families connect or to assist people in learning about their cultural heritage.
But genetic testing ranges far beyond identifying where your ancestors were born and finding out you’re 2 per cent Latina.
Genetics can warn you about susceptibility to certain diseases, especially hereditary diseases. Doctors can test the BRCA gene (pronounced “bra-KAH”), which can develop into various cancers such as ovarian and breast cancer.
You are also at a higher risk of developing prostate, pancreatic, or possibly others, though they are less common, according to HealthLink BC.
Although only people with ovaries can get ovarian cancer, everyone is able to develop breast cancer unless they’ve already undergone a mastectomy (surgical removal of breast tissue).
Not everyone will need genetic tests. They are not recommended for people younger than 18 unless there is worry about developing childhood cancer.
The Canadian Cancer Society outlines an important factor of genetic testing to keep in the forefront of your mind: a positive test does not mean you are doomed to get cancer, and a negative test doesn’t mean you’re fully in the clear.
A positive BRCA test only means that because of mutations found in your genetic code, you are more likely to develop cancer than other people. A negative test means that you are just as likely to develop cancer as the rest of the population.
BRCA 1 and BRCA 2 are genes that control normal cell growth, according to HealthLink BC.
The BRCA gene test does not test for cancer, but tests for any abnormalities in the gene that could cause irregular cell growth – the root cause of cancer.
When working properly, a study from NIH says these genes are tumor suppressors, meaning they actively work against cancer. This is why abnormalities in the genes can indicate a possible future cancer diagnosis.
My Health Alberta says BRCA testing is done through a blood draw, usually through a needle in the patient’s arm.
Once testing has been recommended but before the blood draw, your doctor will likely refer you to genetic counseling.
“Most people will see a genetic counselor, who will explain how cancers are inherited and how inheriting certain genetic changes can increase the risk of cancer,” reports the Canadian Cancer Society. “They will discuss the benefits and drawbacks of genetic testing and help answer any questions you have. They can explain how genetic testing may affect you and your family. They can also suggest which other family members may want to consider having a genetic test.”
Another type of counseling to consider is therapy. Learning that you have a higher risk of developing cancer is scary and anxiety inducing. As is knowing other family members may also carry the genetic mutation and that you can pass on the BRCA gene mutation to biological children.
Therapy, particularly talk therapy or cognitive behavioural therapy can help work through difficult emotions, create coping strategies, and change your mindset around the situation. Check out The Health Insider’s article on therapy options for anxiety here.
Procedures and Surgeries
If you get a positive BRCA gene test, it’s time to take measures to prevent and/or identify cancer early on, when it’s easiest to treat.
HealthLink BC recommends yearly mammograms and breast MRIs starting at age 25. While this will not prevent cancer from forming, it can identify cancer during the early stages where you have the greatest chance of success of eradicating cancerous cells.
A method with a higher success rate of preventing cancer is preventative surgery. Although effective, it is a challenging and very permanent decision to make.
Preventative surgery options include a bilateral oophorectomy (removal of the ovaries) and a bilateral mastectomy, according to the Canadian Cancer Society. The ovaries and breasts are the most common places for cancer to develop with a BRCA gene mutation. This method reduces your risk by 90 to 95 per cent, according to a 2023 study.
Hormone therapy is an option available in Canada to prevent cancer formation. Medications available in Canada include:
Canadian Cancer Society explains how hormone therapy for cancer prevention works. “Hormones are substances that control some body functions, including how cells act and grow. Changing the levels of hormones or blocking certain hormones can slow the growth and spread of breast cancer cells.”
But, they continue that hormone therapy will not work on everyone. First, your doctor will test your breast tissue to find out if it is hormone receptor positive. If it is, this treatment option may be able to help.
Medications should be covered by provincial drug insurance plans across Canada. Ask your doctor if you have any concerns about coverage.
The Bottom Line
There is no way to conclusively test if you will get cancer, but if you have a family history, it may be in your best interest to test BRCA genes and find out your risk.
BRCA isn’t the only genetic test available. Talk to your doctor about family history and if there are any genetic tests they recommend.