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Weighing the Risks of Preventive Surgery For Women with BRCA Gene Mutations

Weighing the Risks of Preventive Surgery For Women with BRCA Gene Mutations | Cancer - Advances, Knowledge, Integrative & Holistic Treatments | Scoop.it
For women with the BRCA gene mutation considering risk-reducing surgery to remove the ovaries and fallopian tubes, it is a struggle to balance conflicting information about whether to include a hysterectomy.
Graham Player Ph.D.'s insight:

How much does having a BRCA1 or BRCA2 gene mutation increase a woman’s risk of breast and ovarian cancer? The National Cancer Institute (http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA ) answers this question as follows:

“A woman’s lifetime risk of developing breast and/or ovarian cancer is greatly increased if she inherits a harmful mutation in BRCA1 or BRCA2.”

“Breast cancer: About 12 percent of women in the general population will develop breast cancer sometime during their lives. By contrast, according to the most recent estimates, 55 to 65 percent of women who inherit a harmful BRCA1 mutation and around 45 percent of women who inherit a harmful BRCA2 mutation will develop breast cancer by age 70 years.”

“Ovarian cancer: About 1.4 percent of women in the general population will develop ovarian cancer sometime during their lives. By contrast, according to the most recent estimates, 39 percent of women who inherit a harmful BRCA1 mutation and 11 to 17 percent of women who inherit a harmful BRCA2 mutation will develop ovarian cancer by age 70 years.”

So women with BRCA gene mutations may face a difficult decision in terms of whether or not to opt for preventive surgery. Even amongst gynecologists and oncologists there are often strong opinions for or against preventive surgery.

This article may provide some clarification of the present level of understanding.

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Supreme Court Ruling Makes BRCA Genetic Testing Widely Available

Supreme Court Ruling Makes BRCA Genetic Testing Widely Available | Cancer - Advances, Knowledge, Integrative & Holistic Treatments | Scoop.it
Mary-Claire King, who discovered the BRCA1 cancer-related gene, says she is delighted by the US Supreme Court ruling that makes it illegal to patent it
Graham Player Ph.D.'s insight:

The BRCA1 (breast cancer type 1) gene was discovered by Dr. Mary-Claire King in 1990. Her breakthrough discovery paved the way for major changes in the study of many other common diseases.

BRCA1 is expressed in the cells of breast and other tissue, where it helps repair damaged DNA, or destroy cells if DNA cannot be repaired. If BRCA1 itself is damaged, damaged DNA is not repaired properly and this increases risks for cancers.

Not long after Dr. King discovered the BRCA1 gene, a company called Myriad Genetics was granted a patent on BRCA1 in the U.S. in 1997. In the following year, 1998, Myriad Genetics was granted a patent on BRCA2 which was also discovered by Dr. King. These patents were quite obviously for financial gain only and resulted in Myriad Genetics immediately insisting that it was the only entity that could test for this gene, and anybody else who performed such tests would be shut down. This meant that Myriad Genetics had been legally granted a monopoly for testing the BRCA1/2 genes for mutations, and as you can imagine they levied very high charges for such tests.

Since the patent was granted for BRCA1/2 genes legal battles have been initiated to fight against then fact that a company has was granted a patent on something that occurs in nature. Common sense certainly does not prevail if genes occurring in nature can be patented and monopolized. So after due legal process, just last week, a US Supreme Court ruling made it illegal to be granted a patent on the BRCA gene.

It is nice to know that common sense has prevailed, and that we can look forward to freedom of choice on the availability of genetic testing without any organization imposing financial burden on patients for needing to have such tests.

I recommend you read the interview with Dr. King in which she describes her role in the discovery and delight at the recent Supreme Court ruling.

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Should Human Cancer Genes Be Owned and Controlled by Legal Monopolies?

Should Human Cancer Genes Be Owned and Controlled by Legal Monopolies? | Cancer - Advances, Knowledge, Integrative & Holistic Treatments | Scoop.it
Gayle Sulik says the reason the BRCA1 gene mutation test for breast cancer risk is so expensive is that a company owns the gene and sets the price.
Graham Player Ph.D.'s insight:

The BRCA1 and BRCA2 human genes were patented by Myriad Genetics back in 1998. Therefore as the “owner” of those genes it is the only company that can legally conduct tests for mutations of them. Myriad Genetics has created a test for mutations of those genes trademarked “BRACAnalysis”. So if anybody wants to test for mutations of BRCA1 and BRCA2 it can only be done using that trademarked test. No freedom of choice, no competitive pricing, and in reality it is a gene that is part of you.

This situation makes me wonder what the world is coming to when companies can patent the products of nature. It is also happening with our food supply.

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Who Owns Your Genes? Maybe Not You!

Who Owns Your Genes? Maybe Not You! | Cancer - Advances, Knowledge, Integrative & Holistic Treatments | Scoop.it
This ongoing debate on gene patents boils down to one simple question: Should anyone, in this case Myriad Genetics, be allowed to patent human genes? For me this case is personal.
Graham Player Ph.D.'s insight:

On April 15, 2013, the U.S. Supreme Court will hear oral arguments in a landmark case challenging Myriad Genetics' intended patents on the breast cancer genes BRCA1 and BRCA2.

If Myriad Genetics is granted a patent, it will mean that you don't "own" your own genes, the cellular chemicals that define who you are and what diseases you might be at risk for.

Quoted from Nancy Stordahl’s article here are some reasons why Myriad's monopoly on the "breast cancer genes" is a bad idea:

Myriad retains exclusive rights to all testing and research on BRCA1 and BRCA2 genes. This means that sharing of data and analysis is blocked, undermining further collaborative scientific research efforts.

Myriad can keep testing costs high indefinitely (and they have).

Second opinions are impossible.

The patents mean continued limited access/information/treatment for underserved populations.

This monopoly creates a barrier standing in the way of further breast and ovarian cancer research.

The idea that human genes can be patented is flawed, sets a dangerous precedent and is just plain wrong.

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Why Are Genetic Testing Companies Doing Genetic Tests for BRCA Genes Being Sued

Why Are Genetic Testing Companies Doing Genetic Tests for BRCA Genes Being Sued | Cancer - Advances, Knowledge, Integrative & Holistic Treatments | Scoop.it
Why is the firm that lost a Supreme Court case still suing competitors who offer breast cancer tests?
Graham Player Ph.D.'s insight:

Despite the recent Supreme Court ruling against patenting human genes, Myriad Genetics is still suing companies for offering tests for the BRCA genes, which are linked to breast cancer.

If these lawsuits succeed, they could transform last month’s Supreme Court ruling into little more than a symbolic gesture. It seems that Myriad Genetics are suggesting that their patent covers the processes for diagnosing breast cancer.

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Court Ruling Against Gene Patents

Court Ruling Against Gene Patents | Cancer - Advances, Knowledge, Integrative & Holistic Treatments | Scoop.it
Companies and a university are moving to offer cheaper and broader genetic testing for breast cancer risk to a growing group of women, following a U.S.
Graham Player Ph.D.'s insight:

Good news that the U.S. Supreme Court ruled against Myriad Genetics Inc. having a monopoly over DNA.

This means that expanded testing on the BRCA1 and BRCA2 genes can now progress. It is nonsense that a company such as Myriad Genetics can actually hold a patent on human genes, which they have had since the late 1990’s. Such patent ownership means other organizations are reluctant to do further testing, and ultimately such preclusion effects cancer patients.

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IVF Treatment Removes Cancerous Genes in Embryos

IVF Treatment Removes Cancerous Genes in Embryos | Cancer - Advances, Knowledge, Integrative & Holistic Treatments | Scoop.it
Genes that predispose fertile Australian women to breast and ovarian cancers are increasingly being treated by the In-vitro-fertilisation (IVF) technique which removes the cancerous genes from the embryos.
Graham Player Ph.D.'s insight:

Mutation in the BRCA 1 and BRCA 2 genes increases the chances of breast cancer in women by 60-80 per cent. A controversial procedure is now available to remove these genes in the embryos so that the mutation is not passed on to the off-springs.

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