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Dr. Andrew Rynne

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Is it useful to have genetic test when having history of distal bile duct cancer?

Answered by
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Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3607 Questions

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Posted on Tue, 20 Oct 2015 in Digestion and Bowels
Question: I had Distal Bile Duct Cancer in 1997 that was removed using a pylori-saving Whipple procedure. I had adjuvant radiation and chemotherapy in Apr-May 1998. I was healthy up to and since the surgery. I have never taken any medications related to this and my eating habits have not changed.

At 67 years old I remain at 160-165 lbs as I did during my 20's. I have 2 questions:
1) Do I have anything to gain by having a genetic test?
2) I have 2 adult children (male & female). Would they have anything to gain by my having a genetic test? Could it provide useful information for their future health?

I have uploaded the pathology report to my profile.

Thank you.
doctor
Answered by Dr. Mukund Savaskar 1 hour later
Brief Answer:
Prognostic Value of Genetic Test in Transfer of Ca pancreas to my children

Detailed Answer:
Brief Ans- Prognostic Value of Genetic Test in Transfer of Ca pancreas to my children

Hi,Welcome with your query to HCM.
After studying details of your query, based on the facts of your query-
My replies are as follows-
1) Do I have anything to gain by having a genetic test?-Yes.As the tests for the genetic mutations being transferred to your children from you,would ALERT you to need for -EARLY DETECTION of CA Pancreas in your children by -
a-CEA (Carcino-embryonic Carcinogen detection at early stage of development of probable cancer would increase the chances of their survival by early treatment,than to detect them at a later stage as in your case)testing /
b- endoscopic USG to detect Pancreatic Cancer in your genetically predisposed children.
It would telly if your children are in 10 % of children who get genetic transmission of the DNA mutational gene transfers,who are predisposed to develop Ca pancreas in having parents like you.

2-a)Would they have anything to gain by YOUR having a genetic test?
Yes they would gain from your and your children's Genetic testing for detecting Pancreatic Cancer -DNA mutational changes being transferred to your children.
Cancer Markers of Pancreas only tell when the Cancer is there in the body and is usually done when patient comes in later stages like you,when more destructive surgery is needed.

2-b-) Could it provide useful information for their future health?
Yes,as told above the if they fall in 10 % as detected by these Genetic tests,as these tests could provide useful information in advance and would help you to plan tests for early detection of CA Pancreas by CAE marker and Endoscopic USG to detect at the early stage of Cancer pancreas.
And also would help to plan precautions to be taken to avoid the life style which would lead to CA Pancreas in either of your male and female child.

On review of your query,I did not find your updates on the pathology reports for my study.

Hope this reply would resolve your worry regarding the AdenoCarcinoma Pancreas from which you came out uneventfully and successfully.

Await for your further details and updates on your pathology report profiles.

Good Day!!

     
Dr.Savaskar, XXXXXXX Surgical Specialist
M.S.Genl-CVTS



Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mukund Savaskar 1 hour later
Hi. Is there a specific type of genetic test I should get? Are there renown labs in North America/Europe/Asia that you would use for yourself or your family? Thanks.
doctor
Answered by Dr. Mukund Savaskar 2 hours later
Brief Answer:
Prognostic Value of Genetic Test in Transfer of Ca pancreas to my children

Detailed Answer:
Brief-Ans-Prognostic Value of Genetic Test in Transfer of Ca pancreas to my children

Hi,Dear,Thanks for the updates from you.
It appears that you have understood the importance of the Genetic testing in your case.
I studied the last updates and reviewed it with the earlier query.
Till now I have given answers to 2 of your queries.
If you continue to ask 3 rd and 4 th query as asked by the last query,I would suggest you to recharge for it.Would you mind recharging for more queries(3 for the next session-pathology report +2 more queries of the last updates)

In the meanwhile I would remind you for updating your pathology report profile(the 5th review and assessment to reply your query) ,which you can send for the next sessions study.

Await for your pathology report profile and needful recharge for the next 2 queries.

Good Day!!

Dr.SavasKar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS




Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mukund Savaskar 3 hours later
I'm sorry I don't understand what you mean by "If you continue to ask 3 rd and 4 th query as asked by the last query,I would suggest you to recharge for it.Would you mind recharging for more queries(3 for the next session-pathology report +2 more queries of the last updates)"

I have uploaded my profile and just checked to see if it worked and it downloaded just fine.

My question is can I just take any genetic test offered by my physician or on the internet or is there a specific genetic test I should be asking for? Thanks.

Cheers, XXXXX
doctor
Answered by Dr. Mukund Savaskar 8 hours later
Brief Answer:
Prognostic Value of Genetic Test in Transfer of Ca pancreas to Your childrn

Detailed Answer:
Prognostic Value of Genetic Test in Transfer of Ca pancreas to Your childrn

Hi,Thanks for the updates.I am not seeing your pathology report profile.Still I would try to suggest to you on the genetic testing without your pathology report profile,as asked by you.
Answers for your 2 questions are as follows-
a- can I just take any genetic test offered by my physician ?A specific Genetic test to find out the Genetic suseptibility -is required.There after your also need to be investigated for it and then you need to take precautionary protocol after study from the Genetic Counsellars/doctors/nurses of the Genetic Center.Its a very specific and special work up.
Genetic Test for You-
In My opinion you will need to have Genetic testing for-
CDKN2A gene.
You could get it done in the following Center for This Test-
GENESIS Center for Medical Genetics, Laboratory of Molecular Genetics - Poznan,Poland.
Hope this would help you to resolve your queries asked.
Would love to reply any other query in this regard in future course.
Will appreciate your writing of excellent review feedback comments,to help the needy patients like you,at HCM services.
Keep Me updated for further help,if need be.

Good Day!!

Dr.SavasKar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS



Above answer was peer-reviewed by : Dr. Yogesh D
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