00:00My name is Dr. Neha Kumar. I am the program head of Gyneal Oncology Department in Amrita Hospital, Paridabad.
00:11My name is Dr. Neha Kumar. I am the program head of Gyneal Oncology Department in Amrita Hospital, Paridabad.
00:22Look, this is something that we are starting to know. This is not the first thing.
00:31About one fourth of our population, 25-30% of people, for instance, if we talk about ovarian cancer,
00:40which is the third most common cancer in Indian women,
00:43so 25-30% of patients, we have found that there are some genetic genes,
00:51which are mutations due to this cancer.
00:55So, this is such a thing, because genetic tests were very expensive,
00:59they were validated, that's why we didn't have this knowledge before.
01:04But now, every ovarian cancer patient, especially high grade cancer,
01:11we have recommended genetic testing for each patient.
01:15This genetic testing is important, because, as you said,
01:1925-30% of people can get this genetic mutation.
01:24Besides, if someone has a genetic mutation,
01:28they can also check the same mutation for their family members,
01:32so that we can advise protective measures for those family members.
01:37For instance, there is a syndrome, which we call hereditary breast and ovarian cancer syndrome.
01:43This is because of genes' mutation, which means BRCA1 and BRCA2.
01:48It increases breast cancer and ovary cancer incidence.
01:52So, this is the testing that if someone has a high-grade cancer patient,
01:58we have to say that if someone has a genetic cancer or hereditary cancer,
02:09then it cannot detect the first cancer.
02:13So, every patient, irrespective of family history,
02:16we do genetic test advice.
02:18There are two reasons for this.
02:20One is that you can check the same mutation for your family members,
02:23so that if someone has a genetic mutation,
02:24they can also check the same mutation as well.
02:26For instance, if we talk about hereditary breast and ovarian cancer syndrome,
02:30so in such cases, when family is completed,
02:34we recommend the patient who has a mutation,
02:38and if there is no cancer,
02:39then as a protective measure,
02:41we recommend them that they have tubes and ovaries.
02:44And one is that the breast removal of these two is to remove the breast.
02:48Or if they don't want to remove the breast,
02:51then we then do breast screening.
02:54The ovaries of cancer is not happening,
02:56so that overies are not going to be able to remove the tubes and ovaries.
02:59And one another is that genetic testing is that
03:03some targeted therapies,
03:05which after the chemotherapy of patients,
03:07we have patients who have a pediatric cancer and have a genetic mutation.
03:12So, when chemotherapy is finished and treatment is finished,
03:16we can give some targeted drugs in which we have 5 perimeters.
03:20And we have found that the survival is improved.
03:24So, this is a problem.
03:26And definitely, if someone has any history in the family,
03:31one of the patients, one of the first-degree or second-degree relatives
03:34that we have to promote cancer,
03:36then we have to understand the genetic risk and hereditary risk.
03:42Then, they will tell us which test is necessary and they can test it.
03:47So, this test can be reduced?
03:51It can be reduced.
03:54For instance, if breast and ovary cancer syndrome has come to you,
04:01if you have a breast cancer, you can reduce the risk of 95% of the breast cancer.
04:05Similarly, breast cancer is reduced.
04:08If you have breast cancer, you can reduce the incidence of breast cancer.
04:10There are some cancers that have been linked syndrome.
04:13If we talk about it,
04:16in the case of the Lynch syndrome,
04:17there are uterus cancer and the eye cancer.
04:20These are removed cancers.
04:21So, it may be possible that a female has no family history or family history,
04:27but the index case,
04:29the first case,
04:30that is the only patient.
04:31So, this is definitely the case.
04:34So, this is the case.
04:35This is the case.
04:35So, today, the uterus cancer,
04:37we are all testing,
04:40to see that there is no genetic cause or hereditary cause.
04:46What is your name?
04:48Hello.
04:49My name is Dr. Shweta Raasthan.
04:51I am a senior consultant in the Breast Oncology Department.
04:57There is a research that has been told
04:59that someone has been diagnosed with cancer.
05:03So, who has been diagnosed with cancer?
05:08So, who has been diagnosed with cancer?
05:10What is your question?
05:12So,
05:13as you may have studied,
05:16that hereditary breast and ovarian cancer
05:20incidence in India has been found
05:22as compared to the western population.
05:26The data that shows that
05:295-10% of hereditary breast
05:33or ovarian cancer is the risk of cancer.
05:36But, if we talk about India,
05:37if we talk about India,
05:38the different series has been told
05:41that this incident has been told
05:43that this incident has been told
05:45that this incident has been told.
05:45There was a study in AIMS
05:46that has been told
05:46that there was 30% of the incident.
05:49Our study,
05:51which has been published recently,
05:52has also been told
05:53that this incident has been told
05:54that 28% of the incident has been told.
05:57That is, 28%.
05:58This is the reason
06:00that there are many reasons.
06:03Firstly,
06:04if we compare it to the US,
06:06there are 80% of genetic tests
06:10are tested.
06:12Whereas,
06:12in India,
06:13there are only 2% of people
06:15or 2% of people
06:16are tested.
06:18So,
06:19we test the patients
06:20who have a cancer history
06:23that are taken
06:23without the test
06:25from the people
06:27who have been told.
06:27Therefore,
06:28we call this
06:30the patient
06:30that has come to us
06:31and the willing
06:32that is the test
06:33that is able to do.
06:35Not that
06:36all patients
06:38are tested
06:39in the US.
06:39this test is a preventive measure
06:41which is not
06:42the case of cancer.
06:44But yes,
06:45it can happen
06:45in the family
06:46or mother,
06:48sister,
06:48grandparents
06:49have cancer.
06:52Whereas,
06:52in India,
06:53there is no margin
06:56on this test.
06:58It is not available
06:59for the test.
07:00The other cost
07:01is very much.
07:03So,
07:04the Indian studies
07:06have all
07:07the aims
07:08of our recent study
07:10from Chandigarh
07:11and all
07:12the incidents
07:12have been told
07:13that
07:14there is a selection bias
07:15and
07:16all patients
07:17need to be
07:17ideally
07:18testing.
07:19So,
07:20we will know
07:20how the actual
07:21incidence is
07:24in India.
07:25If there is a test
07:26for someone
07:27who has cancer,
07:29then
07:29is there a test
07:30for them?
07:33So,
07:34I will talk first
07:34about breast cancer.
07:36If we have tested
07:39for some patients,
07:40for example,
07:41their mother
07:42had breast cancer
07:43or her sister
07:45had breast cancer.
07:47If there is no cancer,
07:50then the test
07:51is indicated.
07:53If there is no cancer,
07:54positive eye,
07:55like the most commonly
07:56genes,
07:57BRCA gene,
07:58BRCA1,
07:59BRCA2,
08:00there are also
08:01many genes
08:02that have breast cancer
08:03seen.
08:05If there is a gene
08:07positive eye,
08:08then we call
08:09risk-reducing surgeries
08:19mastectomy
08:19as a risk reduction
08:21treatment
08:23who can also
08:24reach the patients.
08:24If there is a
08:24they will tell
08:25the patients
08:25that we are
08:26to have complete
08:27with that.
08:29If there is a
08:31risk-reducing mastectomy
08:32a young patient
08:33who has not married,
08:35or they are not
08:35divorced,
08:36then we have
08:38surveillance
08:38for them.
08:39It means that every 6 months we test the breast, like ultrasound, mammogram, or MRI breast,
08:45which we know that we will get to catch breast cancer as soon as possible.
08:53So if patients want to do surgery, then we advise them to do surgery.
08:58If they are not ready for surgery because of various factors,
09:02then we do imaging surveillance.
09:04And we can use imaging surveillance until 70 to 80 years of age.
09:14So usually we see genetic testing positive young patients
09:19who have breast cancer can get more than young patients.
09:22But ideally now we have to do genetic testing in every breast cancer patient.
09:28Otherwise, now there are indications of breast cancer, genetic testing,
09:32who have less than 50 years of age, or triple negative breast cancer.
09:36And we have seen in families that have breast cancer and ovarian cancer.
09:40So we need to do genetic testing.
09:42But in the past two years, the ASCO guidelines,
09:45the American guidelines,
09:47they have to say that no patient who has breast cancer,
09:51we need to do genetic testing.
09:53So we need to do genetic testing.
09:54And if the genetic test is positive,
09:57if the genetic test is positive,
09:58then the ASCO guidelines are associated with children,
10:00even the mother and mother,
10:01they need to do genetic testing.
10:03So we need to know the actual incidence of genetic testing.
10:07So we need to know the actual incidence of genetic testing.
10:08blamene,
10:08they è elective!
10:081
10:0800
10:0900
