Genomic Testing is my choice for the health topic. I believe it is the earliest form of detection and therefore the best method for the prevention for breast and colon cancer. The presence of MSKCC alerted me to the possibility of cancer being an issue in or around Middletown. Further research indicated that caner is a significant risk when observing the “Interactive Map: Cancer Across New Jersey” (New Jersey Department of Health, njspotlight.com). Breast cancer was the most prevalent. there was an 8% increase in cancer deaths from 2004 to 2008 just in Monmouth county (O’Dea, 2012) where Middletown is found. As I was assessing the clubs and associations section in Middletown there was a support group called Breast Intentions that helps those going through the rigors of treatment. All these indications led me to believe that the prevention of cancer through genomic testing would be a good topic. I also have a general interest in the genome and believe the epigenome is relevant to the practice of acupuncture.
One of my patients had two aunts who had died from cancer, one uterine the other ovarian. The aunt who died from ovarian had three daughters. All three daughters developed breast cancer. One had stage four. She underwent a double mastectomy and chemotherapy. I am glad to report she is doing well now. Another daughter developed breast cancer, the tumors were malignant. She underwent a double mastectomy, no chemo and is clear for now. The third daughter had benign growth in the breast but chose to voluntarily receive a mastectomy and hysterectomy to prevent malignancy. the patient lost her mother at young age to an aneurysm. She didn’t get a chance discuss family history and her paternal grandmother died of colon cancer. I believe that having genomic testing would benefit this patient and all people with relevant family histories. Should there be any evidence of gene mutation they could take precautionary measures to avoid future problems.
There is increasing recognition of the benefits to society that can result from the promotion of health and the prevention of disease, disability, and premature death (Shi p. 44). What better way to prevent disease than to find it early through genomic testing and implement lifestyle changes that prevent its genetic expression?
According to healthy people 2020 their Goal is to Improve health and prevent harm through valid and useful genomic tools in clinical and public health practices. In 2005 34.6 of women who had a family history received genomic testing the target is 38.1 (Genomics: National Snapshot, healthypeople.gov).
Resouces for genomic testing under the Affordable Care Act mandate that insurance companies are required to pay for both genetic counseling and BRCA testing for women who meet certain criteria. For these patients, insurance companies must cover the entire cost of genetic counseling and BRCA testing with no out-of-pocket costs to the individual (Paying for Genetic Services, facingourrisk.org). If a patient and their primary care physician (PCP) feel that it’s necessary then the PCP may order the test. Both MSKCC (Genetic Testing & Counseling at Memorial Sloan Kettering, mskcc.org) and Riverview (Hereditary Cancer Risk Program, riverviewmedicalcenter.com) offer the service.
U.S. Preventive Services Task Force (USPSTF) states that Women with certain high-risk family health history patterns for breast, ovarian, tubal, or peritoneal cancer could benefit from receiving genetic counseling to learn about genetic testing for BRCA1/2. For women who have BRCA1/2 mutations, several interventions may reduce their risk of cancer, including surgery, medications, and earlier, more frequent, or intensive screening. The strength of evidence varies across interventions, and evidence is strongest for the benefit of surgical interventions, which potentially reduce breast cancer risk by 85% or more and ovarian cancer risk by 69% or more (Final Recommendation Statement BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing, uspreventiveservicestaskforce.org).
About the author
Michael D. Beys L. Ac., D.A.C.M. is a Doctor of Acupuncture and Herbal Medicine. His training consisted of over 3000 hours in the study of acupuncture and herbal medicine and has over 20 years of clinical experience. He was supervising acupuncturist at RUMC’s substance abuse Detox Center, South Beach Psychiatric Rehab facility and treating acupuncture physician at Sunrise Detox.
He is also fluent in Greek, and Spanish, and proficient in Mandarin, Arabic, and Italian. Currently his practice focuses on fertility and women’s health, pain management, and substance abuse mental health.
O’Dea, C. (2012, July 27). In http://www.njspotlight.com/stories/12/0726/1344/. Retrieved from NJ Department of Health.
Shi, L., & Singh, D. A. (2017). Essentials Of The U.S. Health Care System (4th ed., p. 44). Burlington, MA: Joans & Bartlet Learning.
Genomics: National Snapshot. (n.d.). In https://www.healthypeople.gov/2020/topics-objectives/topic/genomics/national-snapshot. Retrieved November 7, 2017.
(n.d.). In http://www.facingourrisk.org/understanding-brca-and-hboc/information/finding-health_care/paying_for_testing/basics/insurance_coverage_for_testing.php. Retrieved November 7, 2017.
Hereditary Cancer Risk Program
(n.d.). In http://www.riverviewmedicalcenter.com/RMC/services/cancercenter/Hereditary-Cancer-Risk-Program.cfm. Retrieved November 7, 2017.
Genetic Testing & Counseling at Memorial Sloan Kettering. (n.d.). In https://www.mskcc.org/cancer-care/risk-assessment-screening/hereditary-genetics/genetic-counseling. Retrieved November 7, 2017.
Final Recommendation Statement BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing. (n.d.). In https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing. Retrieved November 7, 2017.