GenRISK Adult Genetics Program Recommendations

Our recommendations are tailored for each patient based on his or her health history, habits, preferences and family history. People with a genetic risk of getting a disease tend to develop it at a younger age. They may also be likely to develop other conditions as well. People at risk generally should have screenings at younger ages or more often, as well as looking at other ways to improve health and reduce risk factors. Some topics we discuss with our patients include:

Lifestyle changes

We all know that a healthy diet and regular exercise are good for health. Some lifestyle choices may, however, be influenced by your genetic risk for disease. For example, if you have inherited a risk of developing heart disease, the best diet for you may depend on your genetic risk factors. If you are insulin resistant, a low-fat, high-carbohydrate diet may not be wise. On the other hand, if you have increased homocysteine levels a high protein diet may not be best for you. Our genetic assessment can guide you in making changes in your eating and exercise habits that are specific to your genetic risks.

Chemoprevention

This approach uses drugs or vitamins to prevent a disease. It is known, for example, that birth control pills can reduce the chance of developing ovarian cancer. Aspirin may cut down the chance of developing heart disease or colon polyps. However, these same drugs may not be wise for all patients. For example, using birth control pills might be dangerous for a woman who has a personal or family history of deep vein thrombosis or pulmonary embolism. Aspirin might not be appropriate for people with uncontrolled high blood pressure or a history of gastritis or ulcer disease.

Tamoxifen is a drug that can be used both to treat breast cancer and to prevent future breast cancers. But tamoxifen has side effects and risks so it is not the right drug for every woman. Knowing your genetic risk for breast cancer can help in deciding whether to take this drug.

Hormone Replacement Therapy

The decision to use hormone replacement therapy (HRT) at menopause depends on your health history, family history, personal preferences and other factors. HRT has benefits as well as risks. It can prevent bone loss, improve many cardiovascular disease risk factors, and help improve symptoms of low estrogen. It can also raise the risk of breast and endometrial cancer and thrombosis (blood clots). By looking at a woman's genetic risks for cancers, heart disease, osteoporosis and thrombosis we can help her decide about use of HRT.

Screening Recommendations

When should you have your first mammogram? How often should you have a bone density scan? Should you undergo colonoscopy or sigmoidoscopy? Which test is most effective for discovering heart disease early? We help answer these questions in light of your personal genetic risk factors.

Surgery

Some people with a high risk of developing certain kinds of cancer may consider surgery to lower their chance of developing cancer. Women with a higher risk of ovarian cancer, for example, may want to think about having their ovaries removed. We can help you decide if a preventive surgery is right for you. We can also make referrals to other specialists if needed.

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