Wednesday 9th November 2016
The younger you are when you are diagnosed with cancer, the more likely it is that it is due to it being inherited genetically. As cancer is fundamentally a genetic disease, powerful new technologies in genomics are offering to us for the first time an insight into the genetic basis for early onset cancer.
Genomics: Improving Survival and Survivorship for Young People with Cancer
Director of The Kinghorn Cancer Centre and Head of the Cancer Division, The Garvan Institute, Sydney
Cancer in young people doesn't occur by random chance, nor does it occur because of environmental exposures. It is to a major degree the expression of genetic patterns we inherit. The younger the age at cancer onset, the more likely this is the case. As cancer is fundamentally a genetic disease, powerful new technologies in genomics are offering to us for the first time an insight into the genetic basis for early onset cancer.
This has particular importance for young people affected by cancer. Fortunately, the cure rate for the young is now higher than for any other age group—85% or so of young people diagnosed with cancer will go on to survive more than 5 years. More than 1/300 members of our community will be a survivor of cancer in childhood or young adulthood. This raises the important question of what happens to survivors—something about which we know surprisingly little. Data on survivors of childhood cancer suggests that a very substantial fraction have long-term health problems, including early mortality from second malignancies and chronic health conditions related to treatment. It is very likely that similar outcomes apply to survivors of young adult cancer.
Genetics has much to teach us about who is likely to get into trouble, and what sort of problems they may face. More importantly, this information can be used to understand cancer risk better, which in turn can be used to detect it earlier, or prevent it altogether, through family planning and prenatal diagnosis. It can even be used to change the treatment of cancers. These opportunities constitute the essence of precision medicine—targeting interventions on the basis of individualised assessment. The strong genetic basis for cancer in the young means that this group may particularly benefit from introduction of genomics into their care.
Genomics have the potential to improve both survival and survivorship for young people with cancer. New tools are required to achieve this, however, because clinical research into young onset cancer has been notoriously difficult. During the Global Congress, I will talk about the implementation of a precision medicine program in New South Wales that is designed to facilitate access for young adults to biomarker-driven therapies, and to whole genome sequencing to understand the genetic basis for their cancer.
David will be speaking more on how genomics are improving survival and survivorship for young people with cancer during our International Conference and Global AYA Cancer Congress taking place December 5-7 at the Assembly Rooms in Edinburgh, UK.