SURVEY OF CANCER GENETICS - GENETIC TESTING IMPLICATIONS

The identification of an increasing variety of ''cancer genes,'' there by signifying the cancer destiny of patients from hereditary cancer fa milies, offer numerous opportunities for cancer surveillance and manag ement, including prophylactic surgery in selected circumstances. This new science and technology has emerged at a rapid pace, making it diff icult for many physicians to grasp its full impact. This article revie ws the genetics and molecular genetics of cancer and updates its genet ic counseling implications. Several hereditary cancer syndromes are re viewed as cancer genetic models, including multiple endocrine neoplasi a types 2A and 2B, neurofibromatosis, familial pancreatic carcinoma, f amilial atypical multiple mole melanoma syndrome, and von Hippel-Linda u disease. Special attention is given to the distinctive pathology fea tures that may appear in certain hereditary cancer syndromes, with her editary nonpolyposis colorectal carcinoma discussed as a prototypic mo del. Genetic testing issues including variable positions relevant to w hether and/or when to test and whom to test, as well as the position o f the American Society of Clinical Oncology, are also discussed. (C) 1 997 American Cancer Society.