Genetic Counseling

Most cancers occur randomly. But a family history of pancreatitis or pancreatic cancer can increase your risk for pancreatic cancer and other cancers.

Our board-certified and licensed genetic counselors help you understand these risks. Doctors can then provide proactive monitoring and treatment for you and your loved ones.

Genetic Counseling at UCLA

Inheriting non-working copies of certain genes increases your risk of developing pancreatic cancer and other cancer types. Roughly 5 to 10 percent of pancreatic cancers are hereditary, where the risk is passed in specific versions of genes, unique to a family, from parent to child.

While your genetic makeup does not say for certain whether you will develop cancer, knowing your risks helps physicians provide targeted monitoring and earlier treatment. At UCLA, our genetic counselors can help you understand these genetic risks. We provide:

• Genetic risk assessment: You and your genetic counselor review your personal and family history to identify potential risks. Before your first meeting, you will need to complete a questionnaire about your personal and family history of cancer. You may wish to get information from family members on their cancer history, which allows for a personalized risk assessment. Many types of genetic tests exist, and our genetic counselors help determine the genetic tests that are the best fit for you and your family. 
• Genetic testing: If appropriate, we can order genetic testing during your genetic risk assessment appointment when you first meet with your genetic counselor. After we get the results, your genetic counselor will explain them to you, including whether you need special monitoring or follow-up for different cancer types.
• Medical referrals: Medical guidelines exist to help physicians monitor patients with certain genetic risks. Your genetic counselor may provide referrals to specialists based on your unique history and genetic testing results. Our genetic counselors work closely with other UCLA experts. This helps us streamline your medical care and gives you access to high-caliber monitoring, prevention and treatment at UCLA.

Understanding Your Risk for Pancreatic Cancer

Even though most cancers occur by chance, the following risk factors can increase your risk for developing pancreatic cancer:

• Smoking
• Alcohol abuse
• Obesity
• Family history

Hereditary Cancer Syndromes

In some cases, increased cancer risk is due to a specific genetic syndrome in the family, such as hereditary pancreatitis (inflammation of the pancreas). Several hereditary cancer syndromes increase your risk for pancreatic cancer, however most are primarily associated with other cancer types.

Hereditary cancer syndromes that increase pancreatic cancer risk include (from highest to lowest risk):

• Multiple endocrine neoplasia type 1 (MEN1): This rare disorder causes tumors in the intestinal tract, such as the stomach and duodenum, as well as tumors of the endocrine glands. The duodenum is the first part of the small intestine, while endocrine glands secrete hormones into the bloodstream. Patients with MEN1 have a 40 to 70 percent risk of developing a type of pancreatic cancer called pancreatic neuroendocrine tumor (PNET).
• Hereditary pancreatitis: This inherited disorder causes repeat episodes of pancreas inflammation (pancreatitis). Patients with hereditary pancreatitis have a 40 percent lifetime risk of developing pancreatic cancer.
• Peutz-Jeghers syndrome (PJS): Patients with PJS have a 36 percent risk of developing pancreatic cancer. They have increased risk for polyps, or growths, in the stomach and intestines. Patients with PJS are also at increased risk for breast cancer, cancers of the female reproductive organs, colon cancer and other cancers.
• Familial atypical multiple-mole melanoma (FAMMM) syndrome: Patients with FAMMM syndrome have multiple moles of various colors and sizes, with features different from common moles that many people have. These patients also have a family history of 1 or more relatives with malignant melanoma (skin cancer) and/or pancreatic cancer. Having FAMMM carries a 17 percent risk of developing pancreatic cancer.
• Lynch syndrome: Also called hereditary nonpolyposis colorectal cancer (HNPCC), this inherited disorder increases the risk of several cancers, including colon cancer and uterine cancer. Lynch syndrome also increases a patient’s risk of developing pancreatic cancer by up to 9 percent.
• Hereditary breast and ovarian cancer (HBOC) syndrome: HBOC is caused by mutations in the BRCA1 or BRCA2 genes and greatly increases a woman’s lifetime risk for breast and ovarian cancer. Men and women with mutations in BRCA1 or BRCA2 have a 4 to 8 percent risk of developing pancreatic cancer.
• Familial adenomatous polyposis (FAP): Patients with FAP develop growths in the colon that become cancerous over time. FAP also carries a 1 to 2 percent risk of developing pancreatic cancer.

Calculating Your Family Risk

In most instances where pancreatic cancer affects two or more immediate family members, the cause is not a specific hereditary cancer syndrome. Physicians call this familial pancreatic cancer (FPC). This cluster of cases of pancreatic cancer in a family may be due to shared environmental factors, unknown genes or a combination of genes and environment.

Pancreatic cancer risk in FPC families depends on the number of your immediate relatives (defined as a parent, sibling or child) with pancreatic cancer:

• None: 1 to 2 percent
• 1 immediate relative: 4 to 6 percent
• 2 immediate relatives: 4 to 7 percent
• 3 or more immediate relatives: 17 to 32 percent

Who Should Receive Genetic Counseling?

Many patients wonder if genetic counseling is right for them. Genetic counseling and testing may be beneficial for you if you have:

• A personal diagnosis of pancreatic cancer at a young age or a personal history of other cancers as described above
• A family history of pancreatic cancer or other cancers as described above
• One or more relatives diagnosed with a hereditary cancer syndrome, such as multiple endocrine neoplasia type 1, hereditary pancreatitis or Peutz-Jeghers syndrome
• A confirmed diagnosis of a hereditary cancer syndrome, and you wish to discuss your risks, options for management and risks to your family members

Insurance almost always covers the cost of a genetic counseling consultation and risk assessment, as well as genetic testing if your personal and family history meets certain criteria. Our genetic counselors can help you understand your risk of an inherited cancer predisposition and whether your insurance covers the cost of genetic testing.

The cost of genetic testing has dropped in recent years. We will discuss your testing options and costs with you in detail.

Contact Us

For more information or to make an appointment with a cancer genetic counselor:

• Phone: (310) 825-5287
• Email: cancergenetics@mednet.ucla.edu

Clinic is held in the Bowyer Oncology Center:
200 UCLA Medical Plaza, Suite 120
Los Angeles, CA  90095