Making a huge impact on cancer care, High-Risk Genetic Oncology Screening Clinic, located at the National Center for Cancer Care and Research (NCCCR), a member of Hamad Medical Corporation (HMC), has made a positive impact on hundreds of individuals from genetic counselling, risk assessment and identifying at risk individuals for hereditary cancer, resulting in decreased cancer risk through early detection, prevention and targeted treatment.
The clinic, which is part of NCCCR’s cancer genetics programme, provides genetic counselling, risk assessment, and genetic testing for certain individuals at high risk of cancer due to personal and/or family history, said Dr. Reem Al Sulaiman, an Assistant Professor and an American Board Certified Genetic Counselor at NCCCR.
Inherited gene faults are responsible for around five to ten percent of all cancers. “Advances in the field of genomics and precision medicine means that the cancer genetics programme is becoming a core part of the care offered to cancer patients and their families in Qatar.
The programme is first-of-its-kind in the region and was established to care for those who may have a hereditary cancer disease due to their cancer or may have a higher risk of developing cancer during their lifetime due to hereditary and other risk factors,” said Dr. Al Sulaiman.
The cancer genetics programme was established on 2013 under the leadership of Dr. Salha Bujassoum, Senior Consultant at the NCCCR. Over 2,500 patients have been assessed at the clinic in 2018.
The programmes run as three genetics clinic per week which occupies an average of 50 patients weekly in addition to two medical oncology surveillance clinics that runs twice a week dedicated for high risk individuals.
“The programme is supported by a multidisciplinary team of oncologists, genetic counsellors, nursing, and internal and external molecular laboratories, as well as a number of expertise from different specialties including surgery, gastroenterology, gynecology, dermatology, urology and others,” said Dr. Al Sulaiman.
“The multidisciplinary clinic aims to identify patients with or at risk of hereditary cancer due to young-onset diagnosis of cancer, strong family history of cancer, or due to having a known fault in a cancer gene. The cancer genetics program serves patients with or at risk of developing hereditary solid and hematological cancers such as breast, ovarian, colon, renal cancer as well as leukemia’s as well as a number of rare cancers,” she added.
Genetic counselors play an important role in assessing patients and identifying those at risk and offering them the right genetic testing in addition to interpreting testing results.
In addition, genetic counselor help patients understand their risk of cancer based on genetic testing results in addition to discussing the right risk reducing strategies including surveillance, prophylactic surgeries, or targeted therapies based on the identified cancer gene to reduce the risk of developing certain cancers or improve their treatment if they were affected.
Dr. Al Sulaiman cited the example of a case involving a patient found to have early-onset breast cancer and a specific gene mutation, such as the BRCA gene, which is associated with a higher risk of developing breast and ovarian cancers. In this case and as one way to reduce her risk for another breast cancer, prophylactic bilateral mastectomy is usually offered.
In addition, based on the patient’s age and other risk factors, prophylactic removal of both ovaries is sometimes recommended to reduce the patient’s risk of developing ovarian cancer. Other risk reducing startegies are also available and are designed based on the patient’s needs.
“You’ve no doubt heard about that Oscar-winning actress Angelina Jolie found out through genetic testing that she is at high risk for breast and ovarian cancers because she has a faulty BRCA 1 gene. She ultimately decided to undergo a prophylactic bilateral mastectomy and chose to have her ovaries removed to reduce her risk of developing breast and ovarian cancers,” said Dr Al Sulaiman.
Dr. Reem added that patients are assessed on an individual basis and risk-reducing surgery may not always be possible, especially in the case of younger women who often express concerns related to fertility and body image. In these cases, other risk reducing strategies are offered and extensive follow-up care and examinations are recommended.
