tag:blogger.com,1999:blog-6173393362223742012.post6911635363329029025..comments2023-08-24T08:30:25.608-07:00Comments on Gene Sherpas: Personalized Medicine and You: Senator Kennedy's Cancer Family HistorySteve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-6173393362223742012.post-40945813167104541942008-05-28T02:19:00.000-07:002008-05-28T02:19:00.000-07:00Is there any effective strategy for preventing tum...Is there any effective strategy for preventing tumors in Li-Fraumeni positive individuals?<br>If oncologists don't know all the syndromes (ok, maybe Lynch, FAP, ecc are more common) wouldn't a good idea be to have a clinical genetist in every oncology group? Don't know how it works in the US.Albertohttp://www.blogger.com/profile/01808102177363398719noreply@blogger.comtag:blogger.com,1999:blog-6173393362223742012.post-58409454329076579452008-05-28T06:59:00.000-07:002008-05-28T06:59:00.000-07:00From Gene ClinicsNo surveillance measures, with th...From Gene Clinics<br><br>No surveillance measures, with the possible exception of breast cancer monitoring, have been shown to be effective in reducing morbidity or mortality among individuals with LFS or LFL. Routine mammograms and clinical breast exams are effective in women over age 40 years, but have not been proven to be beneficial for younger women with LFS or LFL. <br><br>Surveillance strategies have been suggested for individuals at risk for LFS or LFL [Varley, Evans et al 1997; NCCN 1999]. <br><br>For at-risk children, on an annual basis: <br><br>Complete physical examination <br><br>Urinalysis <br><br>Complete blood count <br><br>Abdominal ultrasound examination <br><br>Additional organ-targeted surveillance based on family history (e.g., imaging studies of the head if a relative has had a childhood brain tumor) <br><br>For at-risk adults: <br><br>Complete physical examination every 12 months <br><br>Dermatologic examination every 12 months <br><br>Urinalysis and complete blood count every 12 months <br><br>Women only: clinical breast examination every six months <br><br>Women only: annual mammograms and annual breast MRI examination starting at age 20-25 years. Controversy exists regarding the use of routine mammograms in women with LFS, because of possible radiation sensitivity associated with TP53 mutations [Varley, Evans et al 1997; Eng et al 2001]. <br><br>Additional organ-targeted surveillance based on family history (e.g., colonoscopies at regular intervals if a relative has had colorectal cancer) <br><br>Full-body MRI examination or PET scan has been suggested. However, no evidence supporting the benefit of such testing exists; in fact, it is possible that such testing leads to unnecessary biopsies or other follow-up tests. <br><br>Perhaps most importantly, at-risk individuals and their physicians are urged to pay greater attention to lingering symptoms and illnesses, particularly headaches, bone pain, or abdominal discomfort, and to schedule diagnostic tests promptly. <br><br>As for putting counselors or geneticists in Oncologists offices.....Way too many Oncs, way too few counselors. But it could be a start.<br><br>-SteveSteve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.com