When it comes to cancer, one thing is clear: early detection is crucial. But to get a cancer diagnosis, you need to go to the doctor. And that’s something that isn’t happening as frequently now that COVID-19 is keeping more people home. In December 2020, about 35 percent of adults had delayed going to the doctor because of concerns about the pandemic.
One unintended consequence of all those postponed appointments? Cancer screenings are going down. In fact, it’s estimated that more than 22 million cancer screenings have been put off because of COVID-19. Specifically, screenings for breast cancer dropped 89 percent in April 2020 compared to a year earlier, and colorectal cancer screenings went down 84 percent. Concurrently, diagnoses for prostate cancer and breast cancer, among others, dropped between 48 and 49 percent from April 2019 to April 2020.
The other crucial cancer screening: Genetic tests
Certain gene mutations can impact your chances of getting certain cancers. They can be inherited from family members or develop later in life; in some instances, healthy genes can change or mutate later in life due to environmental factors like cigarette smoke, hormones, and diet.
Mutations in certain genes like BRCA1 or BRCA2 are associated with several types of cancer, including ovarian, breast, pancreatic, and prostate. Hereditary breast and ovarian cancer (HBOC) syndrome is associated with BRCA1/2 mutations in genes, and is associated with an increased risk of these types of cancer. Genetic testing may be appropriate for families with prostate cancer that also have HBOC. Hereditary prostate cancer can have a similar impact, explaining why a man is two to three times more likely to get prostate cancer if he has a father, brother, or son with the disease.
That’s where genetic testing can come in. Knowing if you’re genetically predisposed to prostate cancer or ovarian cancer can lead to earlier screenings to help catch the disease as quickly as possible. Genetic testing for inherited gene mutations can be done using a blood or saliva sample, which is then analyzed by a lab for gene mutations linked to higher cancer risks.
Genetic testing is often recommended for people with multiple close relatives who have had the same kind of cancer, a relative who had a cancer diagnosis at a young age, family members with certain cancers (e.g., breast, ovarian, colon, and endometrial), and other warning signs for the possibility of an inherited cancer. If you have a relative who has learned about an inherited gene mutation through genetic testing, you also might want to talk to a genetic counselor about being tested.
Post-diagnosis: Biomarker tests to help you take charge
While genetic testing can be useful to help determine cancer risk due to an inherited mutation, biomarker testing is used to look for other types of mutations, or markers, after a cancer diagnosis.
Biomarker testing can be done using a sample of tumor tissue, which is then analyzed for certain genetic markers that can be either inherited or acquired mutations, including ATM, CHEK1/2, and BRCA. This type of testing can help determine specific genetics of a tumor, which can then help inform targeted treatment options. This knowledge enables physicians and patients to partner and create a more personalized treatment plan.
For example, people with prostate or ovarian cancers can use biomarker testing to see if their cancer has homologous recombination repair (HRR) mutations, and people with ovarian cancer can use this type of testing to determine if their cancer has homologous recombination deficiency (HRD). Testing may help determine appropriate treatment options. This kind of informed decision-making is why talking about testing with your oncologist is such a crucial step when diagnosed with cancer.
Never delay regular screenings
All of this goes to show how important it is to keep up with cancer screenings and tests. If fewer men are getting screened for prostate cancer, then more men won’t get diagnosed until after their cancer has already metastasized. Once it reaches the metastatic stage, the goal of treatment is to extend life and provide the best quality of life for patients.
Simply put: catching a cancer earlier may make a difference. For prostate cancer, the screening may include a digital rectal exam (DRE) or a blood test that tests for prostate-specific antigen (PSA) levels. Screening tests for ovarian cancer may include a complete pelvic exam, transvaginal ultrasound (TVUS), or a blood test that measures levels of a protein called CA-125. What these screening tests have in common is the fact that a routine checkup can greatly help a doctor catch something that otherwise might have been missed. If you notice any worrying symptoms at all, your smartest move is to talk to your doctor. Those discussions can lead to physical exams and other tests that can help figure out what’s going on.
For more information on the differences between biomarker and genetic testing, check out the Common Testing Terminology Working Group whitepaper recommendations here.
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