I feel like I have seen this full body MRI offered for a lot less. Maybe I’m thinking of a full body CT Scan? I think the concern I have the most is for pancreatic cancer, and I wonder what the best way is to figure out if you have that early, before it’s too late to treat.
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Since you asked. This is the company most hospitals use. We used it for Lynch Disease which runs in our family. But lots of hereditary cancers can be a form of Lynch.
I would personally go by family history instead of a wild goose chase and test for specific genes.
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Family history can be tough. If you have a very small family, where people rarely followed anything up and died of other things like stroke or dementia, you wouldn’t even know what to test for.
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CT scans involve radiation. The amount of radiation in comparison to background radiation is described at Understanding Radiation Risk from Imaging Tests | American Cancer Society
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I guess that would be a reason to get an MRI instead of a CT scan, if it was a good option.
I would go to a genetic counselor first. He/she would spend time going through your family history, obtaining a pedigree etc. From there…recommendations for specific testing would be discussed, more frequent screenings etc. You would discuss the pros and cons of any testing so that you (and only you) can make an informed decision, and once results come back you will be able to meet up and discuss what the results mean. There are many different variants, including those that might not be very clear to you. Do not underestimate the emotions that occur during the testing process, and do not overestimate your ability to analyze the science.
This person would also provide insight into the role of environment, as many families have shared environments and habits in addition to genes.
This is personalized medicine, rather than grasping at straws and testing for everything, trying to figure out if it is accurate etc.
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I guess. The company company I listed should give some guidance also.
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Or if you never knew half of your family, or were adopted (stating the obvious).
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But how would this help re pancreatic cancer? I am unaware of a genetic link. And, there appears to be no alternative test. And its rate is rising.
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There could be a genetic link, and certain genes are linked to several different cancers.
Also- the environment/habits could play a role, either alone or in combination with certain genes. Smoking, diet, red/processed meat etc.
And- if there is a higher risk there are screening tests available. Right now screening is not offered to everybody (like mammograms).
A GC can help sort all of this out, counsel on the pros and cons of testing, advocate for insurance coverage, and explain the results and genetic information.
I just think that when the public has access to these tests… it opens up a can of worms because they are not trained (maybe some are) to analyze the results (ie what happens if you get a variant of undetermined significance?) or determine what the next steps are. They also might not be emotionally prepared to view results.
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Please note that even with frequent screening the chances of catching an aggressive pancreatic cancer early enough to be meaningful are vanishingly small. We just can’t control everything.
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I agree 100%, but frequent screenings improve chances. I know somebody whose PC was caught at a stage 1 close to 5 years ago and she remains stable today.
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As far as I know, and I am fairly educated in health matters, though not a professional, there are no material, known, risk factors for pacreatic cancer. One’s only hope of survival is to catch it early, and before this test there was no way of doing so. Now, one has a chance.
I find the attitude that people won’t know how to interpret the results maddeningly paternalistic. I get it, not everyone is smart and educated, but I am, and the fact that someone suggests I shouldn’t have access to this test because it might cause someone anxiety, or they won’t understand it, is infuriating.
ETA another great use I see for this test is it’s use in those under 45 to screen for colon cancer. Rates in this group are skyrocketing, and insurance won’t cover colonoscopies. This test is better than what’s in use now – nothing.
Also – my brother in law had this test covered by his LIFE insurance company. Clearly they feel it is money well spent. Insurance companies aren’t exactly known for authorizing unproven or new treatments or tests, unless they see a clear benefit.
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BRCA mutations are risk factors for pancreatic cancer
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I wonder what percentage of pancreatic cancer cases are attributed to this genetic variant? (The article doesn’t say). Guessing, what, maybe 5% of all pancreatic cancer cases are due to this? Thus leaving 95% who might benefit from this test.
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This article references 10-20%, some articles reference less.
BRCA-Mutated Pancreatic Cancer: From Discovery to Novel Treatment Paradigms - PMC.
Regardless, I agree with you that plenty of people can interpret results of diagnostic tests. At the individual level, these various tests can save lives. That doesn’t necessarily mean various diagnostic tests are cost effective from a public health perspective because of rates of high false positives, or extra costs for things that end up being benign but need more tests to be checked out.
As someone else mentioned above, many people develop cancer cells over their lives, yet their body eliminates them and/or the cancer doesn’t become threatening. Catching these cancers super early and treating them could cause stress and extra healthcare $, but one would never know if that treatment was unnecessary or not. As always, appropriate healthcare is based on an individual’s needs in consultation with their healthcare team.
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Pancreatic Cancer Risk Factors | American Cancer Society lists some risk factors.
As seen in the colonoscopy thread, many people seem to think that colorectal cancer screening is (expensive) colonoscopy or nothing. But a yearly FIT is a relatively inexpensive but still effective form of screening that can also be used.
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There are known risk factors. That does not mean that these risk factors will impact everybody in the same way, but they are certainly worth researching.
And- while some people can emotionally handle test results of any kind that pop up on a portal…others cannot… and to suggest otherwise is naive. The same goes for interpretation- some can, others might not. This is not a black/white situation.
You could have a family history but the gene that is responsible has not been discovered yet. Or… maybe it has but you are not aware that the mutation you have could be responsible. There is also the way genes interact with the environment, etc.,There are many genes that could contribute to this cancer, as well as others.
All I am saying is that these tests could open up a can of worms for some. They might be great for others.
I agree that too much screening could present with problems- everybody has to decide what works for them.
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Just to be clear I am by no means suggesting that people can’t interpret their own findings nor is stress about results a reason not to have the screening. Nor am I about costs on an individual basis. My point is there is increasing evidence that “early” cancers are often - maybe more than often - cancers that would never become clinically significant. Great you caught your cancer at stage 1 and doing fine now but there is absolutely no evidence that that cancer would ever have caused any problems. Meanwhile late stage cancers often appear suddenly, essentially out of nowhere, and there was no way to catch them early or slow them down. There are some that argue there is no point in treating cancers until you have clinical symptoms. I’m not sure I’d go that far, but these are smart medical people who have really pored through the research. And there are very real risks to surgery, chemo and radiation - all increase the chance of death and disability - possibly - or probably - for a cancer that never would have become clinically significant. So I don’t think my argument is paternalistic, you can’t handle it, but that there are very real risks associated with too much screening. (And yes I have colonoscopies and mammograms though I don’t have the latter nearly as often as I’m supposed to under the guidelines).
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This is just one of many mutations. And you really cannot ignore the environment (not saying you are) - diet, smoking, toxins in water etc. and how all of these things interact with your genes.
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