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Vikstroms Team Up for Online Chat

Posted: March 20, 2019

Understanding the underlying causes of cancer and the latest in treatment and genetic testing was the focus of the latest #OurDocTalk on the NorthBay Facebook page — despite a worldwide outage on the social media platform.

Oncologist Brian Vikstrom, M.D., and wife Karen Vikstrom, NorthBay’s genetic counselor, teamed up for the half-hour discussion on March 13. Because of the Facebook outage that day, the chat was recorded and posted on Facebook and YouTube later in the evening.

Karen Vikstrom explained that what happens with cancer involves gene mutations. Most are “random or sporatic” cancers but as many as 10 percent of cancers are hereditary, meaning the mutations were handed down in one’s family.

“It can be from either your mom or dad,” she explained. “And cancer occurs when the genes that control cell growth can no longer do their job because there are errors in the genes and that is the beginning of cancer.”

Treatment options have expanded in recent years, noted Dr. Vikstrom. “There are a lot of different treatments out there now. ... Beginning in the late 1980s a whole new class of drugs (biologics) came in and these include antibody drugs like Rituxin or Herceptin, which can be used to actually fight cancer cells,” he said. “We have since developed small molecular targets and a lot of these targets are pills that often have fewer side effects than the chemotherapy options we have, and some of these are used to treat people with incurable cancers and some are used to treat people with curable cancers.”#OurDocTalk

Interestingly, he said, advances in genetics are helping scientists develop drugs that can target specific mutations and fight cancer. “So a lot of our understanding of what causes cancer is growing hand in hand with treatment options that are being developed,” he said.

Karen noted that advances in genetics have found that one gene can cause different kinds of cancers — in different genders, for example. “A good example is breast cancer. The most common hereditary breast cancer is caused by the BRAC1 and BRAC2 genes. Well, BRAC2 can cause breast cancer in a woman and prostate cancer in a man,” she said. “A lot of people are surprised, especially men with prostate cancer are surprised, to learn they have a breast cancer gene that is actually the cause of their prostate cancer.”

Karen also explained the process involved in her work as a genetic counselor, including developing a detailed family history for a patient, which can indicate “red flags” that would lead to genetic testing.

“Red flags are if they are young, have a rare cancer, have both been diagnosed with cancer and have a family history of it,” she explained. Testing unaffected family members is also important “because we want to identify people who have that genetic background risk because then we start screening them very carefully. We have options for surveillance and screening but if they don’t know they are at risk, they may not get the screening.”

Carrying a certain gene mutation does not necessarily mean a person will develop cancer, she added. “You can carry these genes all your life and not get cancer. All we know is that you have inherited a risk and, depending on the gene, there are guidelines in place to manage the risk.”

The video of the chat is available on the NorthBay Facebook page (Facebook.com/NorthBayHealthcare) and on the NorthBay YouTube channel.