People with a family history of thoracic cancers like mesothelioma should think about getting genetic counseling.
This is the recommendation of researchers from the United States and the United Kingdom. They explored what we know about how changes in a person’s genes passed down through their family can increase their chances of developing cancer.
The Power of Genetic Knowledge
Mesothelioma is a type of cancer that is caused by exposure to asbestos. It most often occurs in the lungs or in the abdominal cavity. With the best conventional treatments, people with this cancer typically have a median survival of a little over a year for mesothelioma in the lungs and about five years for mesothelioma in the abdomen.
There is a growing amount of research that shows that people with certain genes can be more likely to develop mesothelioma after asbestos exposure than others. These changes are called pathogenic germline variants (PGVs).
A mutation in a gene called BAP1 is linked with mesothelioma growth. People with this mutation may develop mesothelioma faster after being exposed to asbestos.
It is not currently standard practice to routinely test for PGVs in thoracic cancers like mesothelioma. But it may be important for people who have a family history of these cancers or other risk factors to receive genetic counseling from experts.
Mesothelioma and Family History
One obstacle to this practice is legal disputes. Many patients with mesothelioma are involved in lawsuits about their diagnosis due to exposure to asbestos. They are often worried that if a PGV is identified in their genes, it can be used against them in court as the cause of their cancer instead of asbestos exposure.
It is the responsibility of genetic counselor to discuss this concern with patients so they can make the best decision for themselves and their unique situation. This includes explaining the Genetic Information Non-Discrimination Act, a law that protects people in the United States from discrimination based on their genetic information.
Knowledge of their genetic makeup and PGVs like BAP1 can help patients and doctors in preventing cancer and improving cancer treatment to enhance patients’ quality and length of life.
Hathaway F, Martins R, Sorscher S, Bzura A, Dudbridge F, Fennell DA. Family Matters: Germline Testing in Thoracic Cancers. Am Soc Clin Oncol Educ Book. 2023;43:e389956. doi:10.1200/EDBK_389956. https://ascopubs.org/doi/10.1200/EDBK_389956