Integrate genetic testing into local routine oncology care
Identification of BRCA mutation in ovarian cancer is vital because it allows better risk management and there is evidence that carriers may benefit from new treatment modalities, said Professor Woo Yin Ling, consultant gynaecological oncologist at the University of Malaya.
Locally, 12 percent of ovarian cancer patients are carriers of a germline BRCA1 or BRCA2 mutations. Genetic counselling plays a crucial role in cancer genetics; interpretation of the results of genetic testing is unique to every individual and her situation, she explained. Unfortunately, there are several barriers to overcome, such as lack of population-based data on genetic mutation in Asians, lack of access to BRCA testing, lack of awareness among healthcare professionals, complex interpretation of genetic test results and psychosocial barriers.
Together with Cancer Research Malaysia, Woo and other healthcare professionals are conducting the MaGiC (MAinstreaming GenetIc Counselling for genetic testing of BRCA1 and BRCA2 in ovarian cancer patients in Malaysia) trial as part of an effort to make genetic counselling mainstream in the country. The study aims to establish a local population-based cohort of ovarian cancer patients to determine the prevalence of mutations, feasibility of mainstreaming BRCA1 and BRCA2 testing for ovarian cancer and psychosocial impact of genetic testing.
Preliminary findings showed the identification of 20 new BRCA carriers from different states in Malaysia. Previously, identified BRCA carriers were mostly from Klang Valley. With the identification of carriers outside of Klang Valley, risk management protocols were then set up in those hospitals and training is provided for clinicians to form multidisciplinary teams for risk management, said Woo. Another preliminary finding is that majority of patients felt counselling done by their doctors were valuable; indicating the importance of physician-led genetic counselling.