Ask the Doctor: Valentina Dalili-Shoaie, M.D.

Q: I’m concerned about my risk for cancer. Can anything be done to mitigate my risk?

A: First, Hoag wants to stress that it is important to address any health concerns, including concerns about cancer. Treatment is most effective when cancer is caught early. If you are concerned about cancer, please speak with your physician.

When it comes to cancer, a few principles must be understood. The first is that cancer can be due to familial or hereditary risk factors, sporadic in nature, or due to lifestyle and environmental exposures. It is hard to pinpoint why one person develops cancer versus another, but what we do know is that close to 1 in 3 people will develop cancer during their lifetime. Therefore, it is important to arm yourself with knowledge and understand your personal risk.

For cancer prevention, there is a tiered strategy that is readily available. The first tier applies to general prevention measures, addressing common cancers such as breast, colon, and prostate, typically assessed at an annual physical examination.

Research has shown that certain risk factors may increase a person’s risk for cancer, such as age, family history and lifestyle behaviors. While the former two are fixed risk factors, lifestyle habits and behaviors are modifiable.

Approximately 5-10% of all cancers are inherited. This feeds into the next tier of cancer prevention which relies on understanding your family history. At Hoag, we look at a number of factors when determining if a person is at higher risk for hereditary cancer syndromes, including how many relatives have been diagnosed with cancer, the ages at the time of diagnosis, and the types of cancer involved. Hoag offers genetic testing based on this counseling and evaluation. What may appear on the outset as a random smattering of cancers may in fact be a common pattern for genetic susceptibility. For instance, breast and ovarian cancer are readily identifiable as two types of cancer that coexist within a family, and yet, pancreatic cancer, prostate cancer, melanoma, and male breast cancer are well documented cancers occurring within such said families that can be missed. Therefore, speaking with a geneticist or genetic counselor will allow for a thorough evaluation of family history and help with risk stratification.

Following this assessment, and if a high-risk status is identified, Hoag offers a variety of surveillance and screening programs, utilizing imaging, blood work and even nutrition and exercise programs to closely monitor your health and aide in prevention.

Valentina Dalili-Shoaie, M.D., specializes in genetics.