Inheriting the cancer gene
A woman has just been diagnosed with breast cancer. Her doctor tells her that while cancer is a multifactorial disease, she carries the breast cancer susceptibility gene, BRCA1. One of her two identical twin 19-year-old daughters is afraid that she also may have inherited the gene (Chapter 4, Learning Objective 2, 3, 8).
What considerations would you give her daughter who is worried about inheriting the cancer gene?
What ethical issues are raised when one identical twin wants to know her genetic susceptibility to a disease and other does not?
As a first step, it may be beneficial for the daughter to understand more about genetic predisposition for breast cancer. She should learn about her mother’s diagnosis and what factors are known to increase risk in general populations (age, family history etc.), as well as how genetics can play a role. Particularly in this case when there has been an identified mutation in one identical twin’s DNA which increases risk of developing certain cancers; she needs to understand what BRCA1 is and its significance. Knowledge on these topics can help her reach informed decisions regarding any testing or preventative measures she wishes take going forward.
There are numerous emotional considerations as well when discussing genetic testing with someone who may have inherited a predisposition for disease from one parent/guardian. Fear of inheriting the same condition can bring up stress related to fears over mortality or disability if they were to develop similar symptoms in later life – all perfectly normal reactions given this potentially life-altering situation. The need for validation from those around them is common too; people often look for reassurance from loved ones that their concerns are valid so providing support & understanding can be just as calming as factual information in such circumstances (Meyer et al.). Thus it may benefit both mother & daughter if they share feelings openly before jumping into investigating testing options further together; allowing space & time for processing emotions without judgement would create an environment where both parties feel safe expressing themselves without fear of being judged – though such openness will obviously depend on personal preference/style & cultural background too).
When speaking with her twin sister too, addressing issues surrounding medical confidentiality must form part of any conversation as both siblings have different approaches towards privacy – one wanting detailed knowledge & another not so much - . If possible having an impartial third party involved like a counsellor or physician could help bring clarity on sensitive matters like these whilst avoiding feelings resentment between sisters should arise through differences opinion towards sharing information between each other (Berglund et al.). It’s important therefore that each person feels comfortable enough make decisions regarding their own health independently rather than feeling pressured by others into undertaking tests which conflict with desired outcomes (Frydman et al.) Respectful communication between siblings must be encouraged regardless if they choose test or not so everyone can maintain peaceful relationship outside of healthcare setting even though different choices have been made within it..
Throughout process proper guidance should also be available throughout process so whichever path chosen by either twin access appropriate care correctly managed throughout journey forwards - whether evidence based counselling focussed helping manage anxiety associated hereditary diseases wanted tested 4not - realising sometimes 1st step taken seeking out additional info may involve ‘doing nothing’ at present moment time until feels ready confront potential implications following results come back(if any).. Ultimately point matter most here safety wellbeing young women affected maintained whatever decision makers decide take next because right speak openly responsibly about familial burden illnesses remains priority here no matter responses generated afterwards.