What to Do (or Not Do) after Genetic Testing


Hereditary risk of cancer, genetic testing, and personalized medicine are terms that are now often heard in the media. Much research is being conducted to identify how and why certain individuals may have a higher risk of developing cancer or reacting differently to treatment. Genetic testing and subsequent counseling play an important role in this process. As part of our three-part introductory series on cancer prevention, Dr. Meghana Bhandari, a medical oncologist in Sugar Land, discusses pertinent aspects on this topic.

– Vivek S. Kavadi, MD

By Dr. Meghana Bhandari

While the majority of cancer happens by chance, scientists have found that some cancer risks are inherited or are caused by a genetic change. If a certain kind of cancer appears to “run in a family,” it could indicate a possible hereditary link. Genetic testing can discern if there’s a genetic connection for certain cancers. But what happens after testing?

Genetic testing is a tool that looks for changes in DNA to help determine if you are at high risk for certain cancer types. It allows those with a significant personal and family history of cancer to take steps for cancer prevention or early detection.

Genetic testing can help you make informed medical and lifestyle decisions, and provide useful information for other family members. State and federal laws protect patient privacy and prohibit health insurance discrimination based on genetic information. Still, it is not for everyone, and it’s important for counseling, both before and after, to accompany testing.

A medical professional with specialized training evaluates family history to determine if a hereditary cancer is suspected and what testing would be useful. Texas Oncology’s Genetic Risk Evaluation and Testing Program can help determine if you should be tested and provide counseling to help you make an informed decision. If your family history suggests a higher risk, genetic testing may be right for you. What you will do with the test results is also an important consideration. Each patient is unique, but options include:

If results are negative (no genetic change is found), your healthcare provider will review your personal and family history with you to discuss your cancer risks and determine the best personalized screening schedule.

If results are positive (a genetic change linked to cancer risk is found), you may have several choices which vary based on the type of genetic mutation for which you test positive. These choices often include heightened surveillance, chemoprevention, and prophylactic surgery. Your healthcare provider will discuss what your test results mean for your relatives, as they may also be at increased risk and need testing.

Heightened surveillance means that you receive screenings more frequently and/or starting at a younger age than usual, or have a different kind of screening, for the type of cancer for which you have high risk. Heightened screening schedules can help detect cancer in the earliest stages, when it is most treatable. Not every type of cancer has a widely-used screening method, but many most common cancers do, and doctors are constantly investigating new screening methods.

Chemoprevention uses medication to help reduce risk of cancer. Medications already used in cancer treatments and new medications are being developed and tested for use as prevention tools. Chemoprevention cannot prevent cancer with 100 percent certainty, but it can lower risks for certain types of cancer.

Prophylactic surgery, or risk reducing surgery, prevents cancer by removing the organs that have a higher cancer risk. Surgery is always a major step and the decision to have or forego a prophylactic surgery is a significant choice, to be made in consultation with a physician.

Regardless of your family’s cancer history or your genetic risk status, everyone can live a healthier lifestyle and stay current on cancer screenings, which are some of the best ways to fight cancer and lower your disease risk.

For more on genetic testing, healthy living, and cancer prevention, visit TexasOncology.com.


Dr. Meghana Bhandari is a medical oncologist at Texas Oncology–Sugar Land at 1350 First Colony Blvd. in Sugar Land, Texas.