Evaluation of hereditary syndromes that include pancreatic cancer

Size: px
Start display at page:

Download "Evaluation of hereditary syndromes that include pancreatic cancer"

Transcription

1 Evaluation of hereditary syndromes that include pancreatic cancer UPR CCC 04/12/13 Jeffrey N. Weitzel, M.D. Chief, Division of Clinical Cancer Genetics Cancer Screening & Prevention Program City of Hope Comprehensive Cancer Center and Beckman Research Institute

2 PANCREATIC CANCER Worldwide estimates: Incidence- 232,306 Deaths- 227,000 A deadly disease CA Cancer J Clin 2012

3 PANCREATIC CANCER Non-Genetic Risk Factors Cigarette Smoking Doubles Risk Causes 26% of pancreatic cancer Obesity Increases risk by ~70% Diabetes Longterm (>10yrs) 2-Fold increase (Everhart 1995) 1% of new-onset diabetics develop pancreatic cancer within 3 years (Chari 2005)

4 DDx: Start with Pathology Adenocarcinoma = >75% 5-year survival <5% Endocrine (AKA: islet cell) = ~ 1% Hormone-producing; control blood sugar levels Insulinoma, gastrinoma, VIPoma, glucagonoma, somatostatinoma, non-functional oma s Slower-growing better prognosis 5-year survival 50-70% if surgically resectable

5 DDx: Endocrine pancreatic tumor(s) MEN1 VHL NF1 TSC sporadic

6 Anterior Pituitary Parathyroid Adrenal cortex Pancreatic islet cells MEN 1 and MEN 2 MEN 1 MEN 2 Thyroid C-cells (MTC) Parathyroid Adrenal medulla (pheochromocytoma) Germline mutations in MEN1, chr 11 Germline mutations in RET, chr 10

7 Genetics of MEN 1: The Menin Gene Mutations in the MENIN (MEN1) gene on chromosome 11q13 Cloned in 1997 Tumor suppressor gene Involved in transcriptional regulation/cell growth and regulation > 400 distinct mutations identified throughout the gene; most are protein truncating

8 MEN 1 mutation - Epidemiology Two of the three main tumor types must be present (parathyroid, pancreatic, pituitary) Germline MEN1 mutations detected in 80-90% in families/cases with 2 or more major features >30% families with 1 major and 1 or more MEN1- associated tumors 10% de novo Penetrance: >50% by age 20 and 100% by age 60

9 MEN 1 Hyperparathyroidism (HPT) Generally the first manifestation Average age of diagnosis 14yrs, 80%-100% by age 40 Tumors usually multiglandular, hyperplastic Symptoms of HPT Fatigue, weakness Hypertension, nervousness Constipation, anorexia, nausia Polyuria, polydypsia, nocturia Kidney stones, bone disease

10 MEN 1- Gastro-Entero-Pancreatic Tumors Gastrinoma (50%) Major cause of morbidity and mortality Manifests as Zollinger-Ellison syndrome (peptic ulcer disease) Insulinoma (10%) Hypoglycemia VIPoma (2%) Watery diarrhea, hypokalemia, achlorhydria Glucagonoma (2%) Hyperglycemia, weight loss, anemia, skin rash Somatostatinoma, Pancreatic polypeptidoma, Enterochromaffin-like cell (ECL) Carcinoids

11 MEN 1 Screening Regimen Tumor Age (y) to start Biochemical tests annually Imaging tests, q 3 years Parathyroid adenoma 8 Calcium (esp Ca 2+ ), parathyroid hormone None Gastrinoma 20 Gastrin None Insulinoma 5 Glucose, insulin None Other enteropancreatic tumors 20 Chromogranin-A Somatostatin receptor scintigraphy, CT or MRI Anterior pituitary tumors 5 Prolactin MRI Thymus or bronchial carcinoid 20 None CT

12 von Hippel-Lindau Risk for benign cystic pancreatic lesions Also a risk for islet cell tumors (5-7%) Generally found in individuals with otherwise normal pancreas Malignant potential (<10%) Better prognosis than sporadic malignancies Main tumors: RCC, pheo, hemangioblastoma Annual abdominal ultrasound beginning at age 16, possible baseline MRI/CT, biochemical screening

13

14 Familial Pancreatic Adenocarcinoma Associated with several hereditary syndromes/genes: Hereditary pancreatitis (PRSS1- cationic trypsinogen gene) Hereditary breast-ovarian cancer syndrome (BRCA2) FAMMM sydrome (p16/cdkn2a) Peutz-Jeghers syndrome (STK11/serine-threonine kinase) Lynch Syndrome (HNPCC) (MLH1, MSH2, MSH6 and PMS2) FAP (APC) PALB2 ATM

15 Pancreatitis

16 Cystic Fibrosis Risk to homozygotes maybe as high as 30% due to pancreatitis Risk to heterozygotes Sharer et al studied 134 patients with chronic pancreatitis 13.4% were CFTR mutation carriers (including T5 alleles) Pezzilli et al studied 46 patients with chronic pancreatitis 19.6% were CFTR mutation carriers (including T5 alleles)

17 Hereditary Pancreatitis PRSS1 gene Penetrance of 80% 40% risk for pancreatic cancer by age 70 Risk increased by paternal-line transmission, possibly as high as 70% Smoking increases risk Begin screening 10 years after pancreatitis diagnosis

18 Hereditary Pancreatitis not subtle EUROPAC study: 112 families, 14 countries PRSS1 mutations in >80% of affected families Median onset of symptoms at 12 years over 70% symptomatic by age 20 years Median of 1.88 attacks per year 70/75 patients (93%) required hospital treatment pancreatitis

19 BRCA1- and BRCA2-Associated Cancers: Lifetime Risk Breast cancer 50%-85% (often early age at onset) Second primary breast cancer 40%-60% Ovarian cancer 15%-45% Absolute risk likely to be higher than 10% - Prostate cancer Absolute risk 10% or lower - Male breast cancer - Fallopian tube cancer - Pancreatic cancer ASCO

20 Population Relative Cancer Risks and 95% CI by Mutation status and Cancer Site Risch et al. J Natl Cancer Inst 2006;98: First degree relatives of patients with BRCA1 (n=534); BRCA2 (n=446)

21 Age specific cancer risks in Dutch BRCA2 mutation carriers* For all presented cancer sites, p for difference is < *Among 1,811 at 50% carrier probability Most striking risks are for earlier onset for pancreas, pharynx and prostate van Asperen CJ et al: Cancer risks in BRCA2 families: estimates for sites other than breast and ovary. J Med Genet 42:711-9, 2005

22 Estimated cumulative risks for pancreas and prostate cancer in BRCA2 mutation carriers by sex and age van Asperen CJ et al: Cancer risks in BRCA2 families: estimates for sites other than breast and ovary. J Med Genet 42:711-9, 2005

23 BRCA2 Mutations, Relative Risks (RR), and Lifetime Risk of Pancreatic Cancer in Jewish Patients and Controls PAC (n = 145) Controls (n = 5,318) Mutation No. (%) No. (%) RR (95% CI) LRP RR LRC BRCA2 6 (4.1) (2.1 to 10.8) 1.3% % 6174delT Abbreviations: LRP, lifetime risk of pancreatic adenocarcinoma in the general population LRC, lifetime risk of pancreatic adenocarcinoma in the BRCA2 heterozygotes Ferrone et al: BRCA Germline Mutations in Jewish Patients with Pancreatic Adenocarcinoma. JCO 27: , 2009

24 BRCA and Prostate Cancer BRCA1 and BRCA2 mutations increase prostate cancer risk - BRCA1: relative risk BRCA2: relative risk 4-7 BRCA2 may result in early onset prostate cancer BRCA1 and BRCA2 are unlikely to account for a high percentage of familial prostate cancer BRCA2 may account for 2% of early onset PC and 5% of familial prostate cancer HOXB13 and CHEK2 mutations may also play a role in prostate cancer susceptibility

25 Familial Atypical Multiple Mole Melanoma (FAMMM) p16: cyclin dependent kinase (CDKN2A) at 9p21 Somatic mutations in 75-85% of pancreatic cancer Pancreatic cancer only present in some CDKN2A families Risk by age 75 is ~17% (10-40 fold increase) Phenotypically expressed FAMMM in 12% of families with familial pancreatic cancer Individuals with CDKN2A mutations should be considered for pancreatic cancer screening

26 Melanoma and Pancreatic cancer 2 fold increase in risk in individuals diagnosed with melanoma <50 y Reports of pancreatic cancer in families lacking CDKN2A mutations, but uncommon

27 Peutz-Jeghers Syndrome Serine threonine kinase 11 (STK11) gene at 19p13 Literature review found the risk for pancreatic cancer to be 132 times the general population (Giardiello et al. 2000) Risk by age 65 of 11-36% EUS every 1-2 years beginning at age 30

28 HNPCC MLH1 and MSH2 mutations reported in kindreds with pancreatic cancer Reported more frequently in Korean, Taiwanese, and Finnish families, less frequently in Dutch families Tumors are often MSI high Often of Medullary histology Not all kindreds meeting Amsterdam criteria for HNPCC have been found to have germ line mutation despite MSI high and absence of MLH1 expression Risk of pancreatic cancer up to 4%, but not well defined

29 Familial Adenomatous Polyposis APC gene at 5q21-22 RR 4.5 ( CI) ~2% lifetime risk of pancreatic cancer Consider EUS after age 20 Giardiello (1993) Gut 34:1394

30 Pancreatoblastomas Reported in individuals with APC mutations and Beckwith-Wiedemann Syndrome <1% of all pancreatic tumors Often occur in children Potentially similar mechanism to hepatoblastoma

31 PALB2 (partner and localizer of BRCA2) Cancer Risks (Casadei et al. 2011): Breast: 2.3-fold by 55 yo; 3.4-fold by 85 yo Male Breast CA: 4-fold Pancreas CA: 6-fold Prevalence in BrCa: 0-2% of unselected BrCa s (ethnicity-based 3.4% (33/972) non-aj FBC; 0/172 AJ FBC Prevalence in FPC: 3-4% (Jones 2009; Slater 2010)

32 Hereditary Pancreatic cancer risk Cancer Discovery 2: 41 6, 2011 WGS on 16 subjects in 6 families, followed by WES on 22 subjects from 10 families; 2.4% (4/166) of familial pancreatic cancer probands carried deleterious ATM mutations

33 Progression Model

34 Pancreatic Intraepithelial Neoplasia Klapman J, Malafa MP: Early detection of pancreatic cancer: why, who, and how to screen. Cancer Control 15:280-7, 2008

35 Screening for pancreatic cancer Three common precursor neoplastic lesions: Intraductal papillary mucinous neoplasms (IPMN) Mucinous cystic neoplasm (MCN) Pancreatic intraepithelial neoplasm (PanIN) IPMN- CT, papillary or rarely flat epith neoplasm arise from main duct or main branch ducts >1cm can be visualized by multidetector MRI, US, or EUS Branch ducts are most common in high risk individuals

36 Screening for pancreatic cancer PanIN- papillary or flat noninvasive epith neoplasms arise in smaller pancreatic ducts usually <5mm low grade PanIN is not always distinguishable from IPMNs < 1cm

37 Screening for pancreatic cancer Imaging: Multidetector CT High accuracy but may still miss EARLY stage disease Concern for repeated exposure to radation if used for surveillance MRI/MRCP No published data on accuracy High costs; not tolerable by those with claustrophobia or metal implants Ultrasound (US) Endoscopic ultrasound (EUS)* Gastrointest Endoscopy Clin N Am 2008 (18):

38 Screening for pancreatic cancer EUS Combines endoscopy and high frequency ultrasonography ± FNA Limited by potential adverse events, cost and operator dependence Pilot study in 36 patients- one time screening with EUS- diagnostic yield 5.3% 2 pancreatic neoplasms; one CT neg ductal adenoca in woman from a kindred with 6 affected individuals, one benign IPMN adenoma in pt with PJS Gastrointest Endoscopy Clin N Am 2008 (18):

39 Endoscopic Ultrasound Klapman J, Malafa MP: Early detection of pancreatic cancer: why, who, and how to screen. Cancer Control 15:280-7, 2008

40 Endoscopic ultrasound images of pancreatic lesions Klapman J, Malafa MP: Early detection of pancreatic cancer: why, who, and how to screen. Cancer Control 15:280-7, 2008

41 Screening for pancreatic cancer Goal of Screening: Detect and treat early pancreatic neoplasia in high risk individuals. Should be offered only to those individuals who are willing and able to undergo treatment of pancreatic neoplasms detected by screening No consensus EUS or MRCP two to four times a year for pts with pancreatic lesions 1 to 3 year interval for high risk individuals who do not have pancreatic lesions. Gastrointest Endoscopy Clin N Am 2008 (18):

42 BRCA2 and Pancreatic Cancer - does informative testing make a difference?

43 CASE-continued Given Ashkenazi Jewish ancestry, tested patient for founder BRCA gene mutations: NEGATIVE How would we screen her? her children? and her brother s children? Blood/DNA had been banked for deceased brother BRCA2 6174delT POSITIVE Patient s mother s test was negative

44 Abnormal Screen Total pancreatectomy Partial pancreatectomy is not recommended due to mutifocal and widespread nature of dysplasia If opt not to have surgery, follow-up EUS and CT scan at 3-6 months to assess any changes

45 Pancreatectomy Risk of mortality is 3% Brittle diabetes Exocrine insufficiency requiring pancreatic enzyme replacement High rate of ulceration, lifelong acidsuppressive therapy Bleeding, infection, and poor wound healing

46 Pancreatectomy Cost effective when compared to cost of carcinoma Cost ~$37,000 Cost of diabetes care ~$11,000 Surgical approaches Partial pancreatectomy with frozen section analysis intraoperatively Laparoscopic distal pancreatectomy then complete pancreatectomy if dysplasia is found Pancreatic rests in the bowel are present in ~10% and should be removed

47 Recommendations: Genetic Testing Need to know pathology/phenotype first May be pursued if family history is suggestive of syndrome Low yield for p16 absent melanoma (only pancreatic cancer family history) BRCA2/PALB2 testing may be considered in families with adenocarcinoma of the pancreas, especially with breast cancer Hx Multigene panels may help illuminate prevalence and phenotype of rare genes

48 Recommendations: Screening Careful evaluation of family history Some families may be at risks as high as 70% Evaluation of personal history Smoking is a large risk factor Assessment of psychosocial concerns and anxiety Screening is costly and is most advantageous under research protocols

Genetics of Pancreatic Cancer. October 6, If you experience technical difficulty during the presentation:

Genetics of Pancreatic Cancer. October 6, If you experience technical difficulty during the presentation: Genetics of Pancreatic Cancer October 6, 2016 If you experience technical difficulty during the presentation: Contact WebEx Technical Support directly at: US Toll Free: 1-866-229-3239 Toll Only: 1-408-435-7088

More information

Surveillance of Individuals At High Risk For Developing Pancreatic Cancer

Surveillance of Individuals At High Risk For Developing Pancreatic Cancer Surveillance of Individuals At High Risk For Developing Pancreatic Cancer Marco Bruno Erasmus Medical Center, Rotterdam Pancreatic Cancer Facts & figures One of the most fatal malignancies Overall 5-year

More information

Hereditary Aspects of Pancreatic Cancer

Hereditary Aspects of Pancreatic Cancer Pancreatic Cancer Seminar San Francisco, CA Hereditary Aspects of Pancreatic Cancer Genetic Risk Assessment and Counseling for Familial Pancreatic Cancer February 3, 2016 Amie Blanco, MS, CGC Gordon and

More information

Family history of pancreatic cancer

Family history of pancreatic cancer Family history of pancreatic cancer _ This fact sheet is for people who want to find out about the hereditary risk of pancreatic cancer. You can speak to our specialist nurses on our Support Line about

More information

Risk Factors and Early Detection Efforts for Pancreatic Cancer

Risk Factors and Early Detection Efforts for Pancreatic Cancer HEADER SLIDE Risk Factors and Early Detection Efforts for Pancreatic Cancer by Jennifer B. Permuth, PhD, MS Assistant Member Departments of Cancer Epidemiology and Gastrointestinal Oncology Moffitt Cancer

More information

Genetic testing and pancreatic disease

Genetic testing and pancreatic disease Genetic testing and pancreatic disease February 2 d, 2018 Yale Pancreas Symposium 2018: Multidisciplinary Management of Pancreatic Cancer Xavier Llor, M.D., PhD. Associate Professor of Medicine Co-Director,

More information

Clinical Cancer Genetics

Clinical Cancer Genetics Clinical Cancer Genetics Lisen Axell, MS, CGC University of Colorado Cancer Center Individuals with cancer Making surgical decisions (lump vs. mast) Making treatment decisions (XRT) Concerns for additional

More information

CentoCancer STRIVE FOR THE MOST COMPLETE INFORMATION

CentoCancer STRIVE FOR THE MOST COMPLETE INFORMATION CentoCancer STRIVE FOR THE MOST COMPLETE INFORMATION CentoCancer our most comprehensive oncogenetics panel for hereditary mutations Hereditary pathogenic variants confer an increased risk of developing

More information

Unusual Pancreatic Neoplasms RTC 2/11/2011

Unusual Pancreatic Neoplasms RTC 2/11/2011 Unusual Pancreatic Neoplasms RTC 2/11/2011 Objectives Intraductal Papillary Mucinous Neoplasm (IPMN) Mucinous Cystic Neoplasm (MCN) Islet Cell Tumors Insulinoma Glucagonoma VIPoma Somatostatinoma Gastrinoma

More information

HEREDITY & CANCER: Breast cancer as a model

HEREDITY & CANCER: Breast cancer as a model HEREDITY & CANCER: Breast cancer as a model Pierre O. Chappuis, MD Divisions of Oncology and Medical Genetics University Hospitals of Geneva, Switzerland Genetics, Cancer and Heredity Cancers are genetic

More information

PANCREATIC CANCER RISK PERCEPTION AND WORRY IN FAMILIAL HIGH- RISK PATIENTS UNDERGOING ENDOSCOPIC ULTRASOUND FOR SURVEILLANCE.

PANCREATIC CANCER RISK PERCEPTION AND WORRY IN FAMILIAL HIGH- RISK PATIENTS UNDERGOING ENDOSCOPIC ULTRASOUND FOR SURVEILLANCE. PANCREATIC CANCER RISK PERCEPTION AND WORRY IN FAMILIAL HIGH- RISK PATIENTS UNDERGOING ENDOSCOPIC ULTRASOUND FOR SURVEILLANCE by Erica Lynn Silver BS, Cell and Molecular Biology; California State University

More information

Familial and Hereditary Colon Cancer

Familial and Hereditary Colon Cancer Familial and Hereditary Colon Cancer Aasma Shaukat, MD, MPH, FACG, FASGE, FACP GI Section Chief, Minneapolis VAMC Associate Professor, Division of Gastroenterology, Department of Medicine, University of

More information

PANCREAS DUCTAL ADENOCARCINOMA PDAC

PANCREAS DUCTAL ADENOCARCINOMA PDAC CONTENTS PANCREAS DUCTAL ADENOCARCINOMA PDAC I. What is the pancreas? II. III. IV. What is pancreas cancer? What is the epidemiology of Pancreatic Ductal Adenocarcinoma (PDAC)? What are the risk factors

More information

Primary Care Approach to Genetic Cancer Syndromes

Primary Care Approach to Genetic Cancer Syndromes Primary Care Approach to Genetic Cancer Syndromes Jason M. Goldman, MD, FACP FAU School of Medicine Syndromes Hereditary Breast and Ovarian Cancer (HBOC) Hereditary Nonpolyposis Colorectal Cancer (HNPCC)

More information

Hepatobiliary and Pancreatic Malignancies

Hepatobiliary and Pancreatic Malignancies Hepatobiliary and Pancreatic Malignancies Gareth Eeson MD MSc FRCSC Surgical Oncologist and General Surgeon Kelowna General Hospital Interior Health Consultant, Surgical Oncology BC Cancer Agency Centre

More information

Genetic Risk Assessment for Cancer

Genetic Risk Assessment for Cancer Genetic Risk Assessment for Cancer Jennifer Siettmann, MS CGC Certified Genetic Counselor Banner MD Anderson Cancer Center Objectives Describe the role of genetic counseling and genetic testing in patient

More information

5/1/2010. Genetic testing in patients with endocrine tumors. Genetic testing in Patients with Endocrine Tumors

5/1/2010. Genetic testing in patients with endocrine tumors. Genetic testing in Patients with Endocrine Tumors Genetic testing in patients with endocrine tumors Why? Jessica E. Gosnell MD Assistant Prof of Surgery April 30, 2010 Genetic testing in Patients with Tumors Indications & Interpretation Germline mutations

More information

Familial and Hereditary Colon Cancer

Familial and Hereditary Colon Cancer Familial and Hereditary Colon Cancer Aasma Shaukat, MD, MPH, FACG, FASGE, FACP GI Section Chief, Minneapolis VAMC Associate Professor, Division of Gastroenterology, Department of Medicine, University of

More information

Neuro-endocrine and pancreatic non-adenocarcinomas. Marc Engelbrecht, AMC, Amsterdam

Neuro-endocrine and pancreatic non-adenocarcinomas. Marc Engelbrecht, AMC, Amsterdam Neuro-endocrine and pancreatic non-adenocarcinomas Marc Engelbrecht, AMC, Amsterdam Pancreatic Tumors q Epithelial Exocrine q Mesenchymal Ductal Adenocarcinoma (85-95%) Metastasis Lymfoma Acinar Cell Carcinoma

More information

Combatting Pancreatic Cancer: Keys to Early Recognition and Diagnosis

Combatting Pancreatic Cancer: Keys to Early Recognition and Diagnosis Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/combatting-pancreatic-cancer-keys-earlyrecognition-and-diagnosis/7286/

More information

Assessment and Management of Genetic Predisposition to Breast Cancer. Dr Munaza Ahmed Consultant Clinical Geneticist 2/7/18

Assessment and Management of Genetic Predisposition to Breast Cancer. Dr Munaza Ahmed Consultant Clinical Geneticist 2/7/18 Assessment and Management of Genetic Predisposition to Breast Cancer Dr Munaza Ahmed Consultant Clinical Geneticist 2/7/18 Overview The role of the Cancer Genetics team NICE guidelines for Familial Breast

More information

Hereditary Cancer Update Strengthening Linkages Workshop April 22, 2017

Hereditary Cancer Update Strengthening Linkages Workshop April 22, 2017 Hereditary Cancer Update Strengthening Linkages Workshop April 22, 2017 Renée Perrier, MD MSc FRCPC Clinical Assistant Professor University of Calgary, Department of Medical Genetics Medical Director,

More information

Expert Interview: Inherited Susceptibility to Cancer with Dr. Nicoleta Voian

Expert Interview: Inherited Susceptibility to Cancer with Dr. Nicoleta Voian Expert Interview: Inherited Susceptibility to Cancer with Dr. Nicoleta Voian ANNOUNCER OPEN: Welcome to CME on ReachMD. This segment, entitled Inherited Susceptibility to Cancer: What Do Primary Care Providers

More information

The Pancreas. Basic Anatomy. Endocrine pancreas. Exocrine pancreas. Pancreas vasculature. Islets of Langerhans. Acinar cells Ductal System

The Pancreas. Basic Anatomy. Endocrine pancreas. Exocrine pancreas. Pancreas vasculature. Islets of Langerhans. Acinar cells Ductal System SGNA: Back to Basics Rogelio G. Silva, MD Assistant Clinical Professor of Medicine University of Illinois at Chicago Department of Medicine Division of Gastroenterology Advocate Christ Medical Center GI

More information

GI EMERGENCIES Acute Abdominal Pain

GI EMERGENCIES Acute Abdominal Pain GI EMERGENCIES Acute Abdominal Pain Marcia Cruz-Correa, MD, PhD, AGAF. FASGE Associate Professor of Medicine, Biochemistry, Surgery Director Translational Research University of Puerto Rico Comprehensive

More information

Assessing Your Patient s Breast Cancer Risk: Is Genetic Testing Necessary?

Assessing Your Patient s Breast Cancer Risk: Is Genetic Testing Necessary? May 16, 2016 Assessing Your Patient s Breast Cancer Risk: Is Genetic Testing Necessary? Presenter: Emily Kuchinsky, MS, CGC 1 Experiences with Genetic Testing Adverse Events in Cancer Genetic Testing:

More information

Management of Pancreatic Islet Cell Tumors

Management of Pancreatic Islet Cell Tumors Management of Pancreatic Islet Cell Tumors Ravi Dhanisetty, MD November 5, 2009 Morbidity and Mortality Conference Case Presentation 42 yr female with chronic abdominal pain. PMHx: Uterine fibroids Medications:

More information

7th Annual Symposium on Gastrointestinal Cancers " St. Louis, Mo, 9/20/08

7th Annual Symposium on Gastrointestinal Cancers  St. Louis, Mo, 9/20/08 Molecular markers to aid in early diagnosis of pancreatic cancer Michael Goggins, MD Professor of Pathology, Medicine and Oncology Johns Hopkins Medical Institutions, Baltimore, MD 7th Annual Symposium

More information

Genetic Risk Assessment for Cancer

Genetic Risk Assessment for Cancer Genetic Risk Assessment for Cancer Jennifer Siettmann, MS CGC Certified Genetic Counselor/Cancer Risk Counselor Banner Good Samaritan Cancer Screening & Prevention Program Objectives Describe the role

More information

Intraductal Papillary Mucinous Neoplasms: We Still Have a Way to Go! Francesco M. Serafini, MD, FACS

Intraductal Papillary Mucinous Neoplasms: We Still Have a Way to Go! Francesco M. Serafini, MD, FACS Intraductal Papillary Mucinous Neoplasms: We Still Have a Way to Go! Francesco M. Serafini, MD, FACS Brooklyn VAMC September 21 st GI Grand Rounds - What is it? - Clinical entity that has emerged from

More information

Neoplasias Quisticas del Páncreas

Neoplasias Quisticas del Páncreas SEAP -Aproximación Práctica a la Patología Gastrointestinal- Madrid, 26 de mayo, 2006 Neoplasias Quisticas del Páncreas Gregory Y. Lauwers, M.D. Director, Service Massachusetts General Hospital Harvard

More information

Myriad Financial Assistance Program (MFAP)

Myriad Financial Assistance Program (MFAP) Myriad Financial Assistance Program (MFAP) MEDICAL CRITERIA Hereditary Cancer Products The Myriad Financial Assistance Program offers aid to patients who meet specific financial and medical requirements.

More information

Are you at risk of Hereditary Cancer? Your Guide to the Answers

Are you at risk of Hereditary Cancer? Your Guide to the Answers Are you at risk of Hereditary Cancer? Your Guide to the Answers What is Hereditary Cancer? The genes we are born with may contribute to our risk of developing certain types of cancer, including breast,

More information

Identification of patients suggestive of hereditary breast and ovarian cancer syndrome that warrants further professional evaluation.

Identification of patients suggestive of hereditary breast and ovarian cancer syndrome that warrants further professional evaluation. Allina Breast Program Committee Consensus Guidelines These guidelines apply to clinical interventions that have well-documented outcomes, but whose outcomes are not clearly desirable to all patients Identification

More information

Hereditary Gastric Cancer

Hereditary Gastric Cancer Hereditary Gastric Cancer Dr Bastiaan de Boer Consultant Pathologist Department of Anatomical Pathology PathWest Laboratory Medicine, QE II Medical Centre Clinical Associate Professor School of Pathology

More information

Hereditary Cancer Products

Hereditary Cancer Products Hereditary Products Integrated BRACAnalysis (BRCA1 and BRCA2 sequencing and large rearrangement testing (BART)), covered when: PERSONAL HISTORY of Breast (must meet at least 1) Diagnosed

More information

Radiology Pathology Conference

Radiology Pathology Conference Radiology Pathology Conference Nadia F. Yusaf, M.D. PGY-3 1/29/2010 Presentation material is for education purposes only. All rights reserved. 2010 URMC Radiology Page 1 of 90 Case 1 60 year- old man presents

More information

Pancreatic Cancer. BIOLOGY: Not well defined (genetic and enviromental factors) CLINICAL PRESENTATION: Abd pain, jaundice, weight loss.

Pancreatic Cancer. BIOLOGY: Not well defined (genetic and enviromental factors) CLINICAL PRESENTATION: Abd pain, jaundice, weight loss. EloreMed Editor: Le Wang, MD, PhD Date of Update: 2/6/2018 UpToDate: Liposomal irinotecan (Onivyde) plus FU/LV is now approved for gemcitabine-refractory metastatic pancreatic cancer and recommended by

More information

Neuroendocrine Tumors

Neuroendocrine Tumors Neuroendocrine Tumors Neuroendocrine tumors arise from cells that release a hormone in response to a signal from the nervous system. Neuro refers to the nervous system. Endocrine refers to the hormones.

More information

Hereditary Breast and Ovarian Cancer Rebecca Sutphen, MD, FACMG

Hereditary Breast and Ovarian Cancer Rebecca Sutphen, MD, FACMG Hereditary Breast and Ovarian Cancer 2015 Rebecca Sutphen, MD, FACMG Among a consecutive series of 11,159 women requesting BRCA testing over one year, 3874 responded to a mailed survey. Most respondents

More information

Cancer Genomics 101. BCCCP 2015 Annual Meeting

Cancer Genomics 101. BCCCP 2015 Annual Meeting Cancer Genomics 101 BCCCP 2015 Annual Meeting Objectives Identify red flags in a person s personal and family medical history that indicate a potential inherited susceptibility to cancer Develop a systematic

More information

Information for You and Your Family

Information for You and Your Family Information for You and Your Family What is Prevention? Cancer prevention is action taken to lower the chance of getting cancer. In 2017, more than 1.6 million people will be diagnosed with cancer in the

More information

Genetic Testing of Inherited Cancer Predisposition Genetic Testing - Oncology

Genetic Testing of Inherited Cancer Predisposition Genetic Testing - Oncology Genetic Testing of Inherited Cancer Predisposition Genetic Testing - Oncology Policy Number: Original Effective Date: MM.02.010 05/01/2010 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration

More information

The Genetics of Breast and Ovarian Cancer Prof. Piri L. Welcsh

The Genetics of Breast and Ovarian Cancer Prof. Piri L. Welcsh The Genetics of Breast Piri L. Welcsh, PhD Research Assistant Professor University of Washington School of Medicine Division of Medical Genetics 1 Genetics of cancer All cancers arise from genetic and

More information

ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes

ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes Sapna Syngal, MD, MPH, FACG, 1,2,3 Randall E. Brand, MD, FACG, 4 James M. Church, MD, FACG, 5,6,7

More information

Surveillance in patients with chronic pancreatitis or hereditary risks

Surveillance in patients with chronic pancreatitis or hereditary risks European Digestive Cancer Days 2017 26 th September Prague Surveillance in patients with chronic pancreatitis or hereditary risks J. Rosendahl Universitätsklinik für Innere Medizin I Universitätsklinikum

More information

Pancreatic Lesions. Valerie Jefford Pediatric Surgery Rounds June 6, 2003

Pancreatic Lesions. Valerie Jefford Pediatric Surgery Rounds June 6, 2003 Pancreatic Lesions Valerie Jefford Pediatric Surgery Rounds June 6, 2003 Embryology 4 th week 2 buds of endodermal origin from caudal foregut Dorsal and ventral bud Ventral migrates dorsally with CBD (below/behind

More information

6/8/17. Genetics 101. Professor, College of Medicine. President & Chief Medical Officer. Hereditary Breast and Ovarian Cancer 2017

6/8/17. Genetics 101. Professor, College of Medicine. President & Chief Medical Officer. Hereditary Breast and Ovarian Cancer 2017 Genetics 101 Hereditary Breast and Ovarian Cancer 2017 Rebecca Sutphen, MD, FACMG Professor, College of Medicine President & Chief Medical Officer INVASIVE CANCER GENETICALLY ALTERED CELL HYPERPLASIA DYSPLASIA

More information

Risk of Colorectal Cancer (CRC) Hereditary Syndromes in GI Cancer GENETIC MALPRACTICE

Risk of Colorectal Cancer (CRC) Hereditary Syndromes in GI Cancer GENETIC MALPRACTICE Identifying the Patient at Risk for an Inherited Syndrome Sapna Syngal, MD, MPH, FACG Director, Gastroenterology Director, Familial GI Program Dana-Farber/Brigham and Women s Cancer Center Associate Professor

More information

Outline. Intraductal Papillary Mucinous Neoplasm (IPMN) Guideline Review 4/6/2017. Case Example Background Classification Histology Guidelines

Outline. Intraductal Papillary Mucinous Neoplasm (IPMN) Guideline Review 4/6/2017. Case Example Background Classification Histology Guidelines Intraductal Papillary Mucinous Neoplasm (IPMN) Guideline Review The Nurse Practitioner Association New York State Capital Region Teaching Day Matthew Warndorf MD Case Example Background Classification

More information

WHAT IS A GENE? CHROMOSOME DNA PROTEIN. A gene is made up of DNA. It carries instructions to make proteins.

WHAT IS A GENE? CHROMOSOME DNA PROTEIN. A gene is made up of DNA. It carries instructions to make proteins. WHAT IS A GENE? CHROMOSOME E GEN DNA A gene is made up of DNA. It carries instructions to make proteins. The proteins have specific jobs that help your body work normally. PROTEIN 1 WHAT HAPPENS WHEN THERE

More information

BRCA and Pancreatic Cancer

BRCA and Pancreatic Cancer BRCA and Pancreatic Cancer Mokenge (Mo) P. Malafa, MD Chair, Department of GI Oncology Program Leader, GI Tumor Program Head, Pancreatic Tumor Section Moffitt Cancer Center Tampa, Florida Objectives What

More information

Hereditary Cancer Update: What do GPOs need to know?

Hereditary Cancer Update: What do GPOs need to know? Hereditary Cancer Update: What do GPOs need to know? Mary McCullum, RN, MSN, CON(C) Nurse Educator, Hereditary Cancer Program BC Cancer Agency October 1, 2016 Conflict of Interest Disclosure Nothing to

More information

Colonic Polyp. Najmeh Aletaha. MD

Colonic Polyp. Najmeh Aletaha. MD Colonic Polyp Najmeh Aletaha. MD 1 Polyps & classification 2 Colorectal cancer risk factors 3 Pathogenesis 4 Surveillance polyp of the colon refers to a protuberance into the lumen above the surrounding

More information

GYNplus: A Genetic Test for Hereditary Ovarian and/or Uterine Cancer

GYNplus: A Genetic Test for Hereditary Ovarian and/or Uterine Cancer GYNplus: A Genetic Test for Hereditary Ovarian and/or Uterine Cancer Causes of Hereditary Ovarian and Uterine Cancer uterine cancer ovarian cancer Sporadic 75-90% Sporadic 70-80% Hereditary, 5% Lynch syndrome

More information

Genetic Testing for BRCA1 and BRCA2 Genes

Genetic Testing for BRCA1 and BRCA2 Genes Genetic Testing for BRCA1 and BRCA2 Genes MP9478 Covered Service: Prior Authorization Required: Additional Information: Yes when meets criteria below Yes as shown below Pre and post-test genetic counseling

More information

Célia DeLozier-Blanchet

Célia DeLozier-Blanchet The Genetics Consultation in OB-GYN : Hereditary cancers Célia DeLozier-Blanchet Division of Medical Genetics, Geneva University Hospital It is probable that all cancers are genetic! genetic vs. hereditary

More information

COLON CANCER GENETICS (FOR SURGEONS) Mark W. Arnold MD Chief, Division of Colon and Rectal Surgery Professor of Surgery The Ohio State University

COLON CANCER GENETICS (FOR SURGEONS) Mark W. Arnold MD Chief, Division of Colon and Rectal Surgery Professor of Surgery The Ohio State University COLON CANCER GENETICS (FOR SURGEONS) Mark W. Arnold MD Chief, Division of Colon and Rectal Surgery Professor of Surgery The Ohio State University 1. I am a surgeon; of course I have nothing to disclose.

More information

Hereditary Cancer Syndromes

Hereditary Cancer Syndromes Hereditary Cancer Syndromes Nicoleta Voian, MD, MPH Director Clinical Genetics Service Roswell Park Cancer Institute Nicoleta.Voian@Roswellpark.org February 28, 2017 Common Genetics Terms Gene: A hereditary

More information

Appendix 4: WHO Classification of Tumours of the pancreas 17

Appendix 4: WHO Classification of Tumours of the pancreas 17 S3.01 The WHO histological tumour type must be recorded. CS3.01a The histological type of the tumour should be recorded based on the current WHO classification 17 (refer to Appendices 4-7). Appendix 4:

More information

CANCER GENETICS PROVIDER SURVEY

CANCER GENETICS PROVIDER SURVEY Dear Participant, Previously you agreed to participate in an evaluation of an education program we developed for primary care providers on the topic of cancer genetics. This is an IRB-approved, CDCfunded

More information

Pancreas Quizzes c. Both A and B a. Directly into the blood stream (not using ducts)

Pancreas Quizzes c. Both A and B a. Directly into the blood stream (not using ducts) Pancreas Quizzes Quiz 1 1. The pancreas produces hormones. Which type of hormone producing organ is the pancreas? a. Endocrine b. Exocrine c. Both A and B d. Neither A or B 2. Endocrine indicates hormones

More information

WHAT IS A GENE? CHROMOSOME DNA PROTEIN. A gene is made up of DNA. It carries instructions to make proteins.

WHAT IS A GENE? CHROMOSOME DNA PROTEIN. A gene is made up of DNA. It carries instructions to make proteins. WHAT IS A GENE? CHROMOSOME GENE DNA A gene is made up of DNA. It carries instructions to make proteins. The proteins have specific jobs that help your body work normally. PROTEIN 1 WHAT HAPPENS WHEN THERE

More information

Management A Guideline Based Approach to the Incidental Pancreatic Cysts. Common Cystic Pancreatic Neoplasms.

Management A Guideline Based Approach to the Incidental Pancreatic Cysts. Common Cystic Pancreatic Neoplasms. Management 2016 A Guideline Based Approach to the Incidental Pancreatic Cysts ISMRM 2016 Masoom Haider, MD, FRCP(C) Professor of Radiology, University of Toronto Clinician Scientist, Ontario Institute

More information

Cancer Survivorship Symposium Cancer and Heredity January 16, Jeanne P. Homer, MS Licensed Certified Genetic Counselor

Cancer Survivorship Symposium Cancer and Heredity January 16, Jeanne P. Homer, MS Licensed Certified Genetic Counselor Cancer Survivorship Symposium Cancer and Heredity January 16, 2017 Jeanne P. Homer, MS Licensed Certified Genetic Counselor Outline Cancer and Heredity Hereditary Cancer Risk Assessment & Genetic testing

More information

Hereditary Cancer Risk Assessment for Gynecological Cancers. FarrNezhatMD.com

Hereditary Cancer Risk Assessment for Gynecological Cancers. FarrNezhatMD.com Hereditary Cancer Risk Assessment for Gynecological Cancers FarrNezhatMD.com Image credit: PLOS blogs 5-10% hereditary 10-20% 70-80% sporadic Genetic Changes and Cancer Cancer begins with a genetic

More information

Management of BRCA Positive Breast Cancer. Archana Ganaraj, MD February 17, 2018 UPDATE ON WOMEN S HEALTH

Management of BRCA Positive Breast Cancer. Archana Ganaraj, MD February 17, 2018 UPDATE ON WOMEN S HEALTH Management of BRCA Positive Breast Cancer Archana Ganaraj, MD February 17, 2018 UPDATE ON WOMEN S HEALTH The number of American women who have lost their lives to breast cancer outstrips the total number

More information

Chronic pancreatitis mimicking intraductal papillary mucinous neoplasm of the pancreas; Report of tow cases

Chronic pancreatitis mimicking intraductal papillary mucinous neoplasm of the pancreas; Report of tow cases Jichi Medical University Journal Chronic pancreatitis mimicking intraductal papillary mucinous neoplasm of the pancreas; Report of tow cases Noritoshi Mizuta, Hiroshi Noda, Nao Kakizawa, Nobuyuki Toyama,

More information

Genetic Testing for Hereditary Cancer Susceptibility Syndromes

Genetic Testing for Hereditary Cancer Susceptibility Syndromes Medical Coverage Policy Genetic Testing for Hereditary Cancer Susceptibility Syndromes Table of Contents Effective Date... 1/15/2018 Next Review Date... 7/15/2018 Coverage Policy Number... 0518 Related

More information

Familial Adenomatous Polyposis

Familial Adenomatous Polyposis Familial Adenomatous Polyposis 1 in 10,000 incidence 100 s to 1000 s of colonic adenomas by teens Cancer risk: colon, gastric, duodenum (periampulla), small bowel, pancreas, papillary thyroid, childhood

More information

Tumor markers. Chromogranin A. Analyte Information

Tumor markers. Chromogranin A. Analyte Information Tumor markers Chromogranin A Analyte Information -1-2018-04-22 Chromogranin A Introduction Chromogranin A (CgA) is a 439-amino acid protein with a molecular weight of 48 to 60 kda, depending on glycosylation

More information

GENETIC MANAGEMENT OF A FAMILY HISTORY OF BREAST AND / OR OVARIAN CANCER. Dr Abhijit Dixit. Family Health Clinical Genetics

GENETIC MANAGEMENT OF A FAMILY HISTORY OF BREAST AND / OR OVARIAN CANCER. Dr Abhijit Dixit. Family Health Clinical Genetics GENETIC MANAGEMENT OF A FAMILY HISTORY OF BREAST AND / OR OVARIAN CANCER Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review

More information

Be Ready Pack Learn more about how Myriad myrisk is revolutionizing hereditary cancer testing.

Be Ready Pack Learn more about how Myriad myrisk is revolutionizing hereditary cancer testing. Be Ready Pack Learn more about how Myriad myrisk is revolutionizing hereditary cancer testing. Hereditary cancer and you Approximately 5% to 10% of all cancers develop because a person inherited a genetic

More information

Genetic Testing for BRCA1 and BRCA2 Genes

Genetic Testing for BRCA1 and BRCA2 Genes Genetic Testing f BRCA1 and BRCA2 Genes MP9478 Covered Service: Pri Authization Required: Additional Infmation: Yes when meets criteria below Yes--as shown below Pre and post-test genetic counseling is

More information

Germline Genetic Testing for Breast Cancer Risk

Germline Genetic Testing for Breast Cancer Risk Kathmandu, Bir Hospital visit, August 2018 Germline Genetic Testing for Breast Cancer Risk Evidence-based Genetic Screening Rodney J. Scott Demography in New South Wales (total population ~ 7,000,000)

More information

Diagnostic Challenges in Multiple Endocrine Neoplasia Type 1 (MEN1) : Usefulness of Genetic Analysis

Diagnostic Challenges in Multiple Endocrine Neoplasia Type 1 (MEN1) : Usefulness of Genetic Analysis Diagnostic Challenges in Multiple Endocrine Neoplasia Type 1 (MEN1) : Usefulness of Genetic Analysis Professor R. V. Thakker, FRS May Professor of Medicine University of Oxford, U.K. Meet The Experts 49

More information

Poblacions amb alt risc de càncer de pàncrees. Quin seguiment hem de fer?

Poblacions amb alt risc de càncer de pàncrees. Quin seguiment hem de fer? Poblacions amb alt risc de càncer de pàncrees. Quin seguiment hem de fer? T. Macarulla Hospital Vall d Hebrón Actualització en patologia pancreàtica Societat catalana de pàncrees-scpanc 4 Octubre 2016

More information

Pancreas Cancer Genomics

Pancreas Cancer Genomics Pancreas Cancer Genomics Steven Gallinger MD, MSc, FRCS HPB Surgical Oncology Program University Health Network Samuel Lunenfeld Research Institute Mount Sinai Hospital University of Toronto Fate of the

More information

GYNplus. genetic testing for hereditary ovarian and/or uterine cancer

GYNplus. genetic testing for hereditary ovarian and/or uterine cancer GYNplus genetic testing for hereditary ovarian and/or uterine cancer What Are the Causes of Hereditary Ovarian and Uterine Cancer? uterine cancer ovarian cancer sporadic 70-80% hereditary 5% Lynch syndrome

More information

Anatomy of the biliary tract

Anatomy of the biliary tract Harvard-MIT Division of Health Sciences and Technology HST.121: Gastroenterology, Fall 2005 Instructors: Dr. Jonathan Glickman Anatomy of the biliary tract Figure removed due to copyright reasons. Biliary

More information

Imaging and Management of Pancreatic Endocrine Tumors in MEN 1

Imaging and Management of Pancreatic Endocrine Tumors in MEN 1 October 20, 2008 Imaging and Management of Pancreatic Endocrine Tumors in MEN 1 Marie Elaine Stevens Georgetown University School of Medicine, Year IV Dr. Agenda Discuss Our Patient s Presentation Review

More information

GeneHealth BreastGene_New qxp_Layout 1 21/02/ :42 Page 3 BreastGene GeneHealth UK

GeneHealth BreastGene_New qxp_Layout 1 21/02/ :42 Page 3 BreastGene GeneHealth UK GeneHealth BreastGene_New 8.2.17.qxp_Layout 1 21/02/2017 16:42 Page 3 BreastGene GeneHealth UK BreastGene What is hereditary breast cancer? Breast cancer is the most common cancer in the UK. Unfortunately

More information

Policy and Procedure. Department: Utilization Management. SNP, CHP, MetroPlus Gold, Goldcare I&II, Market Plus, Essential, HARP

Policy and Procedure. Department: Utilization Management. SNP, CHP, MetroPlus Gold, Goldcare I&II, Market Plus, Essential, HARP Retired Date: Page 1 of 9 1. POLICY DESCRIPTION: BRCA 1&2 Genetic Testing 2. RESPONSIBLE PARTIES: Medical Management Administration, Utilization Management, Integrated Care Management, Pharmacy, Claim

More information

Pancreatic intraepithelial

Pancreatic intraepithelial Pancreatic intraepithelial neoplasia (PanIN) Markéta Hermanová St. Anne s University Hospital Brno Faculty of Medicine, Masaryk University Precursor lesions of invasive pancreatic cancer Pancreatic intraepithelial

More information

Predictive and Diagnostic Testing for Cancer in Women. Aparna Rajadhyaksha MD

Predictive and Diagnostic Testing for Cancer in Women. Aparna Rajadhyaksha MD Predictive and Diagnostic Testing for Cancer in Women Aparna Rajadhyaksha MD Hereditary Cancer s in Women BRCA1 &2 Other Breast Cancer Genes Li Fraumeni PTEN CHEK2 BRCA1&2 t BRCA1 is part of a complex

More information

WELCOME. Taking Care of Your Health. April 30, 8 am to noon

WELCOME. Taking Care of Your Health. April 30, 8 am to noon WELCOME Taking Care of Your Health April 30, 8 am to noon Cancer: Know Your Risk Emily Kuchinsky, MS, CGC, Certified Genetic Counselor Sporadic Cancer Lifetime Probability- Women Family Cluster Risk factors

More information

GHUK BowelGene_2017.qxp_Layout 1 22/02/ :22 Page 3 BowelGene

GHUK BowelGene_2017.qxp_Layout 1 22/02/ :22 Page 3 BowelGene GHUK BowelGene_2017.qxp_Layout 1 22/02/2017 10:22 Page 3 BowelGene BowelGene What is hereditary bowel cancer? Bowel cancer (also known as colorectal cancer) is the fourth most common cancer in the UK.

More information

Type 2 gastric neuroendocrine tumor: report of one case

Type 2 gastric neuroendocrine tumor: report of one case Case Report Type 2 gastric neuroendocrine tumor: report of one case Yuanliang Li, Xin Su, Huangying Tan Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China Correspondence

More information

Multigene Panel Testing for Hereditary Cancer Risk

Multigene Panel Testing for Hereditary Cancer Risk Multigene Panel Testing for Hereditary Cancer Risk Dana Zakalik, M.D. Director, Nancy and James Grosfeld Cancer Genetics Center Professor, OUWB Medical School MCC Annual Meeting November 4, 2015 Outline

More information

Citation American Journal of Surgery, 196(5)

Citation American Journal of Surgery, 196(5) NAOSITE: Nagasaki University's Ac Title Author(s) Multifocal branch-duct pancreatic i neoplasms Tajima, Yoshitsugu; Kuroki, Tamotsu Amane; Adachi, Tomohiko; Mishima, T Kanematsu, Takashi Citation American

More information

A Patient s Guide to Hereditary Cancer. Is Hereditary Cancer Testing Right for You?

A Patient s Guide to Hereditary Cancer. Is Hereditary Cancer Testing Right for You? A Patient s Guide to Hereditary Cancer Is Hereditary Cancer Testing Right for You? What is Hereditary Cancer? Most cancers occur in people who do not have a strong family history of that cancer. This is

More information

Genetic Panel Testing and Implications for Cancer Care

Genetic Panel Testing and Implications for Cancer Care Genetic Panel Testing and Implications for Cancer Care Dana Zakalik, M.D. Nancy and James Grosfeld Cancer Genetics Center Professor, OUWB Medical School MCC Board of Directors Meeting September 28, 2016

More information

What All of Us Should Know About Cancer and Genetics

What All of Us Should Know About Cancer and Genetics What All of Us Should Know About Cancer and Genetics Beth A. Pletcher, MD, FAAP, FACMG Associate Professor of Pediatrics UMDNJ- New Jersey Medical School Disclosures I have no relevant financial relationships

More information

Endocrine Tumors of the Gastrointestinal System. F. V. Nowak Ohio University March 22, 2005

Endocrine Tumors of the Gastrointestinal System. F. V. Nowak Ohio University March 22, 2005 Endocrine Tumors of the Gastrointestinal System F. V. Nowak Ohio University March 22, 2005 Gastroenteropancreatic Endocrine System Clear cells of endodermal origin found in the pancreas, stomach, small

More information

HEREDITARY CANCER SYNDROMES: IDENTIFYING THOSE AT RISK

HEREDITARY CANCER SYNDROMES: IDENTIFYING THOSE AT RISK HEREDITARY CANCER SYNDROMES: IDENTIFYING THOSE AT RISK OCTOBER 20, 2017 JESSICA CARY, MS, RN, CGC cary@newecs.org GENETIC COUNSELOR OBJECTIVES 1) Taking a Cancer Family History 2) Identify patients and/or

More information

Dr Marion Harris (Medical Oncologist)

Dr Marion Harris (Medical Oncologist) Dr Marion Harris (Medical Oncologist) 1. Cancer genetic testing and surveillance for familial breast and colorectal cancer What does an FCC do? Collect, assess and VERIFY a FHx of cancer Questionnaire

More information

Hereditary Colorectal Cancer Syndromes Miguel A. Rodriguez-Bigas, MD

Hereditary Colorectal Cancer Syndromes Miguel A. Rodriguez-Bigas, MD Hereditary Colorectal Cancer Syndromes Miguel A. Rodriguez-Bigas, MD Living Beyond Cancer A-Z January 12,2019 Hereditary CRC Syndromes Objectives are to discuss the : Most common Hereditary CRC syndromes

More information

Intro to Gallbladder & Pancreas Pathology

Intro to Gallbladder & Pancreas Pathology Cholecystitis acute chronic Gallbladder tumors Adenomyoma (benign) Adenocarcinoma Pancreatitis acute chronic Pancreatic tumors Intro to Gallbladder & Pancreas Pathology Helen Remotti M.D. Gallstones (Cholelithiasis)

More information

GENETICS OF COLORECTAL CANCER: HEREDITARY ASPECTS By. Magnitude of the Problem. Magnitude of the Problem. Cardinal Features of Lynch Syndrome

GENETICS OF COLORECTAL CANCER: HEREDITARY ASPECTS By. Magnitude of the Problem. Magnitude of the Problem. Cardinal Features of Lynch Syndrome GENETICS OF COLORECTAL CANCER: HEREDITARY ASPECTS By HENRY T. LYNCH, M.D. 1 Could this be hereditary Colon Cancer 4 Creighton University School of Medicine Omaha, Nebraska Magnitude of the Problem Annual

More information