Genetic Testing
Genetic testing is one of the scientific advancements in the field of medicine. Through genetic screening, it is possible to discover the possibility of a high risk of developing cancer or to determine the precise treatment for it.
Cancer is generally not inherited, but certain types, breast, ovarian, colorectal, and prostate cancers, can be significantly influenced by genetics and may run in families.
We all carry specific genes that protect against cancer, as these genes repair any DNA damage that naturally occurs when cells divide. Inheriting changes in these genes increases the risk of cancer, as mutated genes cannot repair damaged cells, which can accumulate and form tumors that contribute to cancer development.
What is genetic testing?
Genetic testing looks for specific genetic changes in a person’s genes. Genetic changes can have harmful, beneficial, or neutral (no effect) impacts on disease risk. Harmful changes in particular genes are known to be associated with an increased risk of cancer. These inherited changes contribute to about 5 to 10% of all cancer types. Warith International Cancer Institute (WICI) has established a hereditary cancer diagnostics clinic, making it the best institution for genetic cancer screening in Iraq.Is cancer a genetic disorder?
Genetic mutations or alterations can lead to changes in gene function and cause a cell to become cancerous. Genetic alterations that cause cancer can be inherited and result from changes in the genes that control how cells grow and multiply.Who should undergo genetic cancer screening?
• Individuals with a strong family history of cancer, where several relatives of the family have the same type of cancer.• Cases diagnosed with cancer where factors suggest that a genetic mutation may be the cause, such as a family history, being diagnosed at an unusually young age, or if the cancer type is uncommon, like male breast cancer.
• Individuals with multiple types of cancer.
• Cancer in a paired set of organs, such as the kidneys or both breasts.
• Many first-degree relatives (parents, siblings, or children) suffer the same type of cancer, for example, mother and daughter or sisters with breast or ovarian cancer, and family members with colon or endometrial cancer.
• Congenital defects associated with hereditary cancer syndromes, such as certain benign skin tumors.
A positive result for a genetic mutation does not confirm the presence of disease but indicates that the person carries a genetic mutation that increases the risk of developing it. In such cases, individuals should adopt a healthier lifestyle and commit to regular testing to monitor their health.
How is genetic testing conducted?
The test is performed at Warith International Cancer Laboratory on a small sample of body fluids or tissues, usually blood, but sometimes saliva, cheek cells, or skin cells.What do the results of a cancer genetic test mean?
Positive result:• A positive result in genetic testing for cancer confirms that the cancer was likely caused by an inherited genetic variant and helps guide treatment options.
• It indicates an increased risk for certain tumors in the future and directs future actions to reduce cancer risk or detect it early, including:
o Undergoing screenings at a younger age or more frequently searching for cancer signs.
o Reducing cancer risk by taking medications or undergoing surgery to remove at-risk tissues.
o Changing personal behaviors, such as quitting smoking, exercising more, and eating a healthy diet to lower the risk of certain cancers.
• It provides information that can help other family members make healthcare decisions, such as whether they should undergo genetic testing to see if they also have inherited the mutation.
Negative result:
A negative result occurs when the variant is not found. In such a case, the person does not inherit the variant in his family, so he does not have an inherited cancer susceptibility. A negative result does not mean there is no risk of cancer but rather that the risk is probably the same as the risk of cancer for the rest of the population.
Cancer Genetic Mapping Project in Iraq:
The genetic map facilitates the treatment journey by identifying the appropriate treatment for tumors rather than subjecting Iraqi patients to multiple treatments before finding the right one. This testing saves time and effort for both medical staff and patients. The genetic map allows for the study of tumor characteristics and identifies its causes to avoid them.The largest free campaign for genetic screening for cancerous tumors was launched within Warith International Cancer Institute (WICI). Supported by Imam Hussain Holy Shrine, the project began in November 2023 and focuses on mapping four types of cancer:
• Genetic screening for breast cancer (under 45 years old).
• Genetic screening for lung cancer (under 65 years old).
• Genetic screening for colorectal cancer (under 55 years old).
• Genetic screening for acute myeloid leukemia (AML) (ages 40 to 60).
What is genetic analysis for cancer?
• BRCA1 and BRCA2:BRCA1 and BRCA2 are examples of genes that increase the risk of cancer if they are altered. Having a mutated BRCA gene increases the chance of developing breast and ovarian cancer in women and the risk of breast and prostate cancer in men.
Approximately 30-50% of women with a BRCA1/2 gene mutation are at risk of developing breast and ovarian cancer by age 70. Typically, these genes protect against certain types of cancer, but their mutations can change how body cells function. Therefore, genetic testing is essential to detect these mutations, as some individuals inherit them, increasing their risk of familial or hereditary cancer.
What is the difference between BRCA1 and BRCA2?
Mutations in the two types of BRCA genes affect patient risks differently.
BRCA1 mutations are associated with an increased risk of:
• Breast cancer, including the aggressive form known as triple-negative breast cancer.
• Ovarian cancer.
• Pancreatic cancer.
• Prostate cancer.
BRCA2 mutations are associated with an increased risk of:
• Breast cancer.
• Ovarian cancer.
• Skin cancer.
• Pancreatic cancer.
• Prostate cancer.
• Next-generation sequencing (NGS):
Next-generation sequencing (NGS) is one of the most advanced techniques employed at Warith International Cancer Institute (WICI) and is the first of its kind in Iraq. It enables doctors to quickly identify multiple mutations in patients with tumors. This genetic testing technique provides comprehensive mutation identification using DNA extracted from small biopsy samples.
NGS has been used in the best oncology hospital in Iraq to design targeted treatments for each individual. The leading oncology institution in Iraq offers a wide range of services for identifying NGS-based tumor data and providing essential diagnostic and therapeutic information for hematological and solid tumors.
How much does genetic testing cost, and how long does it take?
The cost of genetic testing can range from less than $100 to over $2,000, depending on the nature and complexity of the test. Costs increase if multiple tests are necessary or if several family members need to perform the test. Warith International Cancer Institute offers genetic testing as part of its free initiatives for children and adults. Therefore, families in Iraq need not worry about the cost of BRCA testing. It may take a few days to weeks to receive test results from the date of sample collection.Importance of genetic testing:
There are benefits to genetic testing, regardless of whether a person receives a positive or negative result:• A negative test can provide peace of mind that the harmful gene variant has not been inherited.
• A positive test result gives the individual an opportunity to understand his risk of developing cancer and, in some cases, treating it.
• For those already diagnosed with cancer, genetic test results may help make decisions, guide their cancer treatment plan after its classification, and understand their risk of developing other cancers.
• Genetic testing offers family members a chance to learn about their cancer risks.
• It helps determine whether an individual has genes that could pass on cancer risk to his children.
No genetic test can definitively predict whether a person will develop cancer. However, it can indicate that he has a higher risk than most people.
Only some individuals with a genetic mutation will develop cancer; for example, a woman with a 45% to 65% chance of developing breast cancer may never get the disease, while another woman with a 25% chance might get the disease.
At Warith International Cancer Institute (WICI) in Iraq, genetic tests are highly accurate, as they are performed by medical professionals knowledgeable in cancer genetics to ensure the most precise test results, eliminating the need to travel abroad.
