Hereditary Gastrointestinal Cancer Risk Program

The Hereditary Gastrointestinal Cancer Risk Program available at Baylor University Medical Center at Dallas provides a valuable dimension to familial colon cancer risk assessment and includes a prevention plan with steps to reduce the likelihood of developing recurrent polyps and colorectal cancer.

Components of the program include:

• Education about the risk factors for cancer and generic mutations
• Genetic counseling
• Family tree construction and analysis
• Review of family history and personal history
• Genetic testing, if appropriate
• Recurrent polyp consultation and optimal regimens to reduce recurrences
• A written summary of risk
• Guidelines for continued monitoring
• Education about prevention research studies

Individuals who may benefit from genetic testing include:

• Persons with a personal or family history of colon cancer
• Persons who have had one or more adenomatous polyps removed and those who may be experiencing recurrent polyps
• Persons with Lynch Syndrome, a form of hereditary cancer caused by an inherited gene defect in the intracellular process that prevents errors during the duplication of DNA. People with a mutation in one of the genes are at markedly increased risk for cancer of the colon, endometrium, stomach, ovaries and other sites. Those individuals are also prone to tumors at an early age- in the 20s, or even earlier in some instances.
• Persons with familial polyposis (FAP), including attenuated FAP, Gardner's Syndrome, Peutz-Jeghers Syndrome, Juvenile Polyposis Syndrome, Banayan-Riley-Rubalcava Syndrome, Cowden's Disease, and other forms of multiple intestinal polyps
• Persons who have been tested for the APC gene (for FAP) or for a mutation in a DNA mismatch repair (MMR) gene.
• People who have been told by their surgeon or oncologist that there are abnormalities in their tumor DNA that suggest hereditary colon cancer
• Persons who need assistance in the interpretation of dysplasia on biopsies as a result of chronic inflammatory bowel disease or Barrett's esophagus.

What to expect:
Patients initially meet with a team of specialists lead by Dr. Richard Boland. Team members will obtain a complete family history and conduct a thorough screening and evaluation. The genetic counselor will provide extensive counseling. After discussing the factors that suggest one of the gene mutations linked to gastrointestinal cancer may be present, the patient can decide if he or she wishes to have a simple blood test to determine if, in fact, he or she has such a mutation.

The blood sample is sent to a national laboratory specializing in highly sophisticated genetic testing technology. In three to four weeks, the patient can return to his or her primary care physician to discuss the results. If indicated, the physician may choose to recommend treatment, which may include colonoscopy or series of colonoscopies to remove pre-malignant polyps.

The significance of the test results for other family members is also explained. Each participant in the program receives a detailed summary of risk, a plan of careful monitoring tailored to the individual's level of risk and a color copy of a three- generation family tree.

Participants at high-risk for developing cancer will receive information about several prevention and detection studies underway at Baylor University Medical Center at Dallas for which they may be eligible.

Fees:
Payment for the program is due at each appointment. Patients will be billed separately by the genetic testing laboratory for the genetic testing. Fees are usually covered by medical insurance.

For additional information, please call 1-800-4BAYLOR.