Kristine King, MD

Should You Consider Genetic Testing for Breast & Ovarian Cancer?

 

The recent news about Angelina Jolie’s decision to undergo a double mastectomy after hereditary cancer tests revealed an elevated cancer risk have many women (and some men) asking, “Should I have a cancer genetics evaluation?”

Hereditary testing involves a one hour appointment to gather your family history, evaluate a pedigree, and educate you about the risks and benefits of testing.

Kristine King, MD, an OB/GYN, board certified in Clinical Medical Genetics who practices at Valley Women’s Clinic, offers the following factors that may help you decide whether or not you should seek out genetic counseling:
• A cancer diagnosis before age 50
• More than one primary cancer in the same individual
• Multiple cancer diagnoses in paired organs (i.e. bilateral breast cancer)
• Rare cancers such as male breast cancer, pheochromocytoma (adrenal gland tumor), retinoblastoma (eye cancer)
• Families with specific cancer clusters (early onset breast and ovarian cancer, or colon and endometrial cancer)
• Three or more family members with the same cancer
• Family members with a known genetic mutation

Some primary care physicians will do genetic testing, but it may be to your advantage to seek out a genetics professional who will:
• Elicit and interpret a detailed, three-generation family history
• Determine which genetic testing is most appropriate (there are other genetic tests in place of, or in addition to the BRCA test that may be warranted)
• Discuss insurance coverage and potential genetic discrimination
• Interpret the genetic testing results
• Make cancer screening recommendations

It is important to note that not everyone needs genetic testing. Only 7 to 10 percent of breast cancer patients will have a genetic mutation that can be found. Current genetic testing will not find every cause of hereditary cancer, and people with negative genetic test results can still get cancer.

For more information, discuss this with your primary care physician or contact a certified genetics counselor. Dr. King can be reached at the Valley Women’s Clinic at 425.228.0722.

 

Posted in Breast Cancer, Genetic Testing, Gynecology, medical genetics, Ovarian Cancer | Tagged , , , , , , , , , | Leave a comment
Vandita Samavedi, MD

May is National Stroke Month: Are Young Women at Risk?

 

Although most strokes occur in people older than 50, about one in 5,000 women ages 15 to 49 suffers a stroke each year, according to the National Institute of Neurological Disorders and Stroke (NINDS). 

A stroke occurs when brain cells die because the brain is deprived of oxygen. The most common cause of stroke is a blockage in an artery, a blood vessel that brings oxygen-rich blood to the brain. This type of stroke is called an ischemic stroke. The blockage is nearly always because of a blood clot that has formed in the artery and becomes so big that it stops or greatly decreases the amount of blood that can flow past it. The blockage can also be caused by a dislodged fragment of a clot from elsewhere in the body that has become wedged in an artery too narrow for it pass through.

Another type of stroke occurs when a tear in the wall of an artery in the brain allows blood to flow out of the artery. The blood leakage deprives the brain of oxygen. This type of stroke is called a hemorrhagic stroke.

How a stroke affects a person depends on where in the brain it has occurred and how many brain cells have died.

Risks for stroke
In younger women, the risk factors for stroke are obesity, high blood pressure (hypertension), type 2 diabetes, and cardiovascular disease. Some research has shown that women who are obese or who have gained more than 44 pounds since they were 18 years old are about 2-1/2 times more likely to have an ischemic stroke than lean women who have not gained a lot of weight.

Smoking or using oral contraceptives also increases the risk for stroke. The stroke risk is increased even for women who use low-estrogen contraceptives. Women who smoke, are older than 35, and use oral contraceptives are at higher risk.

Healthy women ages 45 to 64 can cut their risk for ischemic stroke by exercising regularly, eating a healthy diet, drinking only moderate amounts of alcohol, not smoking, and controlling high blood pressure.

Other risk factors
In general, African American women are up to three times more likely that have a stroke than white women. For both African American and white women ages 15 to 49, however, having a particular gene boosts the risk for ischemic stroke. The gene, phosphodiesterase 4D, encourages both the buildup of plaque in arteries and the formation of blood clots. It also raises the risk for hemorrhagic stroke. If you smoke and have a certain variation of this gene, you are at especially high risk for stroke, the NINDS says.

Pregnancy can slightly increase the risk for ischemic stroke. It is more of a risk for women with high blood pressure linked to pregnancy, a condition called preeclampsia, and for women undergoing cesarean delivery. A woman with preeclampsia during pregnancy is also at risk in the days just after delivery.

Sickle-cell anemia

Younger women who use cocaine or methamphetamine are at greater risk for stroke.

Act F.A.S.T. if you see these signs of stroke:

 

Posted in High Blood Pressure, Obesity, Pregnancy, Preventive Health, Stroke, Women, Women's Health & Wellness | Tagged , , , , , , , , , , , , | Leave a comment