Winnipeg Free Press - PRINT EDITION

Genetic testing has pluses -- and minuses

  • Print

It's been said that "all would be well if there were no 'buts.' " Unfortunately, in genetics there are many "buts" and unwary traps for unsuspecting medical consumers. So if you have the choice to receive genetic testing, be sure you know these pros and cons.

There's no doubt genetic testing is a huge benefit under certain conditions. For instance, when this subject is discussed, most people think positively about genetic screening to diagnose a child destined to be born with Down syndrome.

Genetic testing is also of great value for the parent with a dominant gene for Huntington's chorea, a severe nervous affliction. In this case, there's a 50 per cent chance a child will inherit this condition.

It would also be madness to bury your head in the sand when there is a genetic family history of colon cancer. By being aware that a faulty gene is present, regular colonoscopies can save lives by detecting polyps long before they become malignant. So, on the surface, it appears that finding these problems is a good thing. It's like the Holiday Inn TV ad that promises "No surprises."

But what about the "buts?" A report in the Canadian Medical Association Journal points out the other side of the coin. Dr. James Evans, professor of genetics at the University of North Carolina in Chapel Hill, says, "We rarely in medicine do unalloyed good. Some of the tools we employ are blunt, so you had better have great information before you employ them."

For instance, screening can detect types of breast cancer that will become invasive in some women but not in others. The trouble is there's no way of knowing which group a patient will fall into. It reminds me of what a Jewish friend who owned a department store once said to me: "My problem is that half of my advertising is worthless. But I don't know what half."

So the downside is that many women will be subjected to surgery or radiation because it is not known who needs to be treated. It's the price some women pay for having this genetic test. Some will be over-diagnosed and some over-treated.

Then suppose you are a 25-year-old woman who discovers she has a gene that will cause breast cancer. Currently, it's impossible for the gene to pinpoint the date. So should she have both breasts removed when this cancer might not appear until she is 80?

Screening also leads to incidental findings, the spotting of genetic markers that were not intended to be part of the goal. For example, the test may spot a generic defect for which there is no known treatment. How many people would want to know they are destined to develop Alzheimer's disease before there is a cure for it?

To ask these questions is like asking, "How many angels can dance on the head of a pin?" At the moment, there are no ultimate answers.

Things get even more complicated when dealing with chronic disorders such as heart disease, diabetes and osteoporosis. In these cases, more than one gene might be involved, and it's still unknown how much depends on genetics and how much on environment and lifestyle.

Today, more people are ill due to faulty lifestyle than faulty genes. For instance, the gene for Type 2 diabetes may not trigger this disease if there's no weight gain. And if a gene is discovered for osteoporosis, it's possible that brittle bones could be averted by ensuring an adequate dietary intake of calcium, vitamin D and vitamin K2.

So don't jump to the hasty conclusion that coronary attacks of several relatives were caused by a generic abnormality. You may be right if they had all behaved themselves. But you had better check first to see if they were all overweight, smoked two packs of cigarettes a day and were couch potatoes for years.

You might discover that Pogo was right: "We have discovered the enemy, and the enemy is us." All too often today, we are the architects of our own misfortune, not our genes.

See the website www.docgiff.com For comments, email info@docgiff.com

Republished from the Winnipeg Free Press print edition July 6, 2012 A21

Fact Check

Fact Check

Have you found an error, or know of something we’ve missed in one of our stories?
Please use the form below and let us know.

* Required
  • Please post the headline of the story or the title of the video with the error.

  • Please post exactly what was wrong with the story.

  • Please indicate your source for the correct information.

  • Yes

    No

  • This will only be used to contact you if we have a question about your submission, it will not be used to identify you or be published.

  • Cancel

Having problems with the form?

Contact Us Directly
  • Print

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

Have Your Say

New to commenting? Check out our Frequently Asked Questions.

Have Your Say

Comments are open to Winnipeg Free Press print or e-edition subscribers only. why?

Have Your Say

Comments are open to Winnipeg Free Press Subscribers only. why?

The Winnipeg Free Press does not necessarily endorse any of the views posted. By submitting your comment, you agree to our Terms and Conditions. These terms were revised effective April 16, 2010.

letters

Make text: Larger | Smaller

LATEST VIDEO

Spring fashion trends

View more like this

Photo Store Gallery

  • Young goslings jostle for position to take a drink from a puddle in Brookside Cemetery Thursday morning- Day 23– June 14, 2012   (JOE BRYKSA / WINNIPEG FREE PRESS)
  • MIKE APORIUS/WINNIPEG FREE PRESS STANDUP - pretty sunflower in field off HWY 206 near Bird's Hill Park Thursday August 09/2007

View More Gallery Photos

Poll

Now that the snow is mostly gone, what are your plans?

View Results

Ads by Google