Keeping watch for cancer

Luana Locke surrounds herself with photographs of her children at her office in Toronto.

Credits: (VERONICA HENRI, Toronto Sun)


Luana Locke who was diagnosed with breast cancer when she was eight months pregnant and is thrilled with a new surveillance approach for the early detection of malignant tumours.

A Hospital for Sick Children study, called the Toronto Protocol, shows people who are genetically at risk for cancer can benefit from a new surveillance protocol that detects tumours early and improves survival rates.

“It is really exciting,” said Locke, who has her children under surveillance since cancer runs in her family. “It helps inform people and give them a voice. This study validates our decision to have our children tested.

“This approach gives people who have a predisposition to cancer a tool to be able to do something proactive for themselves. It gives us hope,” she added.

The study uses genetic testing for at-risk people and monitors genetic mutations that could lead to tumours.

Quick detection allows oncologists to remove tumours when they’re small and in some cases eliminate the need for cancer therapy.

“This surveillance protocol was implemented for families with Li-Fraumeni syndrome because of their high lifetime risk of developing cancer,” said Dr. David Malkin, principal investigator for the study and a senior staff oncologist at Sick Kids. 

“However, the concept of a comprehensive surveillance protocol may be applicable to some of the more common cancer susceptibility disorders.”

People with Li-Fraumeni syndrome have a mutation of certain tumour suppressor genes which increases their risk of cancer.

“This important study illustrates the power of genetics to identify children and young adults at high risk of developing cancer so that they can be carefully monitored,” said Dr. Christine Williams, director of research at the Canadian Cancer Society Research Institute, which co-funded the study. 

“Then, if they do develop cancer, it will be detected early and their chance of surviving and thriving is much better.”

Some people have been critical of the study.

“Previously, genetic testing in children has been controversial and considered unjustified,” says Malkin, who is also senior scientist at Sick Kids. “

“The argument was what’s the benefit in knowing that your child is at risk of cancer if there’s nothing you can do to prevent it. From other cancer scenarios, we know that early detection may translate into improved survival outcomes and in the cases of at-risk patients, genetic screening and frequent monitoring may enable early detection and thus survival.”

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