Monitoring Cancer Treatment Effectiveness
Genetic and genomic discoveries are also leading to new ways to monitor the effectiveness of cancer treatment. One example is the response to anticancer treatments of children who have acute lymphoblastic leukemia (ALL). Although the cure rates for ALL have increased greatly since the 1960s, individual variation in treatment response has been observed among affected children. Yang and colleagues recently conducted a study to identify genetic factors that may affect treatment response in ALL. The research involved testing in two groups of affected children small genetic variations called single nucleotide polymorphisms (SNPs) for their association with minimal residual disease (MRD) after initial chemotherapy. Many SNPs were associated with MRD in both groups of patients, and some were associated with hematologic relapse. A significant number of the SNPs studied also were associated with early response to treatment and with relapse risk. The researchers concluded that inherited genetic variation of the individual patient affects the effectiveness of anticancer therapy.
Family History of Breast and Ovarian Cancer: Role of the Oncology Nurse in Family History Collection and Assessment
Patient Overview. You are an oncology nurse practicing in a high-risk breast cancer outpatient clinic. The first patient of the day is a 41-year-old Caucasian woman who has been referred to your clinic because of her family history of breast and ovarian cancer.
Risk Assessment. In your role as an oncology nurse, you review and document her family history (See Figure 1). You learn that her sister, age 45, has a history of right invasive breast cancer diagnosed when she was 40; her mother was diagnosed with ovarian cancer at age 36 and died at age 40 from this disease; a maternal aunt was diagnosed with bilateral invasive breast cancer at age 42 and died at the age of 47 of metastatic disease; a maternal uncle, now age 65, has a history of prostate cancer diagnosed at age 50; the maternal grandmother died from cancer at age 55.
Your patient does not know the type of cancer her grandmother had or when she was diagnosed with the cancer. She has two sons, 15 and 18 years of age. When you inquire about her ethnic background, she tells you that her parents are both of Ashkenazi Jewish descent. The patient tells you that she is “really worried about my risk for breast and ovarian cancer,” and wants to know “What can I do about this?”