Debate raised over genetic cancer testing

By Bridget Maiellaro

While Illinois’ Senate Bill 12 requires insurance companies to cover screening for breast cancer earlier in a woman’s life if she is considered high risk, a new concern for hereditary breast cancer has developed. Its underlying issue is whether or not insurance companies should pay for genetic testing when a patient’s family members have cancer.

“I think that the insurance companies should definitely pay for it,” said Jill Jurevis, sophomore in LAS, whose grandmother was a breast cancer survivor. “Not only does it help save lives, but insurance companies will have the possibility of saving money that would be spent in the future on surgery, chemo and other treatments.”

The controversy stems from the fact that those who have a family history of breast cancer are at higher risk than those who do not. According to the National Cancer Institute’s Web site, 192,000 American women are diagnosed with breast cancer each year. Of those women, 5 to 10 percent have a hereditary form of the disease.

“Even if insurance companies covered costs, anybody who has a family history of breast cancer should work with a genetic counselor,” said Stephanie Ceman, assistant professor in the College of Medicine. “They are trained to know the risks of each cancer case by determining how related they are to you.”

Hereditary breast cancer involves two inherited alterations in the genes known as breast cancer 1 and breast cancer 2, which genetic testing screens for. If a woman has one of these altered genes, her chances of having breast cancer increase significantly. Also, she is more likely to develop cancer at a younger age and is subject for ovarian and/or colon cancers.

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    However, not all women who inherit the breast cancer 1 or breast cancer 2 genes will develop those cancers.

    “If the gene is mutated, it leads to an elevated risk,” said Ceman. “Even if you have those mutations it’s not 100 percent certain you’ll get cancer. However, the risk will be around 45-60 percent, which is certainly higher than the population average.”

    Genetic testing for altered breast cancer 1 and breast cancer 2 genes can be very beneficial for families. Unlike other medical tests today, genetic tests can uncover information about both the person being tested and his/her family members. However, mutations in those genes only seem to cause 20% of breast cancer, Ceman said.

    Stephanie Weissenstein, junior in ALS, is one of the many students who have had breast cancer occur in her family. Her second cousin just finished treatments of chemo and radiation and is now in remission.

    “She is like in her early 30’s with three kids,” said Weissenstein. “It was kind of sad, actually.”

    While the older members of her family have had mammograms, they have not had genetic testing.

    “It may be beneficial to them but some families do not have the means to pay for it, but if insurance companies are willing to pay for it, that’s completely different,” said Weissenstein. “Otherwise, people just need to make a healthy lifestyle and go to the doctor regularly.”

    While the College of Medicine does not conduct any type of genetic testing, referrals are made to the genetic counselors at Carle Foundation Hospital.

    “The college doesn’t provide clinical services itself,” said Ceman. “It’s more of a business for educating.”

    Breast cancer is the second leading cause of cancer deaths in women, next to lung cancer, and is the most common cancer among women. Therefore, the government is attempting to make more citizens aware of the life-threatening disease. As the breast cancer rate has increased, Gov. Rod Blagojevich has continued to make funding increases in women’s health programs including the “Stand Against Cancer Program;” breast and cervical cancer funding; and the “Ticket for the Cure,” the nation’s first lottery ticket benefiting breast cancer.

    “I wouldn’t be surprised if Blagojevich made insurance companies cover such costs in the near future,” said Jurevis.