Can genome testing help manage my friend’s colon cancer?

Question

Hello doctor,

I read about something called cancer genome testing. My aunt’s breast cancer was treated based on a genetic profile, and it really helped her. I was wondering:

Is this something everyone with cancer can get?
Or only for advanced cases?
I have a friend who has been newly diagnosed with colon cancer, and his family is asking about testing options.
Does it actually change treatment or just give information?
Also, is it expensive?

I keep seeing advertisements about precision medicine and targeted therapy, but I am not sure what is real versus hype.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understood from your question that you were asking about the genetic test, why we do it, and what the benefits are. Regarding genetic testing in breast cancer, we usually perform it when there is a strong family history of cancer. There are two main types of tests. The first one is called Oncotype DX, which is done on the tumor cells themselves. This helps us determine whether the patient needs chemotherapy or not, and which type would be most effective. The second one is called the BRCA gene test, which we perform when there is a strong family history. It helps us choose the most suitable chemotherapy or targeted therapy for the patient. At the same time, it allows us to create a screening strategy for the family members.

Now, for colon cancer, like in your friend’s case, from the early stages, we usually perform immune genetic testing to determine whether the patient will respond to certain types of treatment or not. If there is a strong family history or if the patient is under 50 years old, we recommend that other family members undergo testing for mismatch repair (MMR) genes and microsatellite instability (MSI).

If the result is positive, we include the family in regular screening and preventive strategies, which often means active surveillance, checking them at frequent intervals.

As for the genetic tests in colon cancer, they are extremely important for guiding treatment. We usually test for BRAF (B-Raf proto-oncogene), KRAS (Kirsten rat sarcoma virus oncogene), microsatellite instability (MSI), and mismatch repair (MMR) genes. These help us decide which type of immunotherapy to use and whether the patient is likely to respond to it or not. We usually recommend that patients join clinical trials, since those are more affordable or sometimes completely free, especially for patients with a strong family history.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.