Illustration by Katrin Rodegast
A blood test that can detect 50 types of cancer brings hope for discovering disease early. But genetic testing for cancer won’t replace routine screenings anytime soon—and the medical community is still learning about the implications of the technology.
St. Elizabeth Healthcare now offers the test for patients over age 50 who are thought to be cancer free but may be at risk. We asked Jaime Grund, director of St. Elizabeth Healthcare’s Precision Medicine & Breast Centers and a licensed genetic counselor, what we should know about when to pursue this promising new tool.
What exactly is this test?
It’s a new application of the genetic testing that’s been used in prenatal care for more than a decade, Grund says. It looks at DNA circulating in the blood stream. Cancer cells have different markers from typical cells, so the test could flag potential disease before symptoms appear. But positive tests aren’t conclusive. If you have positive result, there’s about a four out of 10 chance you do have cancer and a six out of 10 chance that you don’t. “It means we need to take a closer look.” That means following up with CT scans or other screening procedures.
Is genetic testing the future for cancer detection?
“My gut says it’s the way we’re going to head. But we haven’t made that leap,” Grund says. “It’s meant to go hand-in-hand [with] or supplement more traditional tests. It does not replace a colonoscopy or mammogram.” Grund is particularly excited about the possibility to detect cancers that don’t have good screening options. “Let’s say someone has a family history that predisposes them to pancreatic cancer or ovarian cancer. This can be powerful.”
Why isn’t St. Elizabeth offering this test to everyone?
“This is new and it does come with a lot of emotional baggage,” Grund says. “We require extensive pre-test counseling. Patients consider questions such as What does this mean for you if it comes back positive? As this scales up, we can’t keep up that method of introduction. But at this point we’re breaking new ground. We want to make sure we support the patients not only medically but emotionally as well.” If a patient receives positive results, they are immediately enrolled in St. Elizabeth’s Cancer Prevention Clinic.
Are there other concerns about widespread testing?
Financial considerations are one factor. “If you’ve been screened as high risk, this warrants extra work ups,” Grund explains. “Would your insurance pay for this work up based on this new test? There’s a lot to think about.” The test alone costs about $1,000 and insurance companies are not covering it yet.
What’s your biggest concern?
“Patients can think it’s a golden ticket. They think they can have a genetic test and know if they’re going to have cancer. It’s important that patients understand genetics is a powerful tool, and it can guide us in their care. But it’s certainly not the answer to all things medical.”
Jaime Grund, Director, St. Elizabeth Healthcare’s Precision Medicine & Breast Centers
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