Starting this month, doctors at Asante Rogue Regional Medical Center will be able to read your genes to predict whether certain cancers loom in your future.
This poses a philosophical question playing out in the medical field as genetic testing becomes more advanced, making it possible to foresee a wide range of future illnesses.
Do you really want to know whether you are destined for cancer — or any other serious disease? Perhaps it's better to live your life in blissful ignorance.
For Heidi Hartley, 33, the answer was simple. She wanted to know whether the aggressive breast cancer that has stricken her mother has been passed down a generation.
She and her sister underwent genetic testing, and the results were mixed. Hartley's sister's gene test came back negative. Hartley received the tough news that her genes showed the cancer mutation and that she could very well find herself enduring grueling chemotherapy treatments like her mother.
"I was prepared for the positive test because of my mother," Hartley said. "It was still hard for me because I have three children. In fact, I was pregnant when I got the test."
Hartley, who is a technical support specialist in Klamath Falls, faced a slew of tough decisions following her positive test.
She could have doctors closely monitor her health in the coming years. This would include numerous visits to the doctor to check for cancer. The goal would be to detect the cancer early enough to remove it before it progressed to a potentially deadly stage.
The other option was to have preventative surgery to remove her breasts. This strategy made news recently when actress Angelina Jolie had a preventative double mastectomy after her genetic cancer test came back positive.
Hartley decided to be proactive in her fight with cancer.
"I am going to have a double mastectomy and a hysterectomy," Hartley said. "I have to meet with doctors to plan out the next few years of my life and decide at what dates and times these things are going to occur."
Hartley had her test done in Klamath Falls and will follow up on those results with Dr. Jone Sampson, a clinical geneticist specializing in cancer genetics.
Sampson works out of Oregon Health and Sciences University in Portland and will journey to RRMC two times a month to oversee the genetic testing program here.
The hospital plans to conduct the tests twice a month, which would include testing for about eight patients.
Sue Kilbourne, clinical oncology manager at RRMC, said the hospital will begin genetic testing for cancer on Sept. 16.
"This is not something that serves only a morbid curiosity about your future," Kilbourne said. "We believe this is going to help a lot of people. We all know that when you catch cancer in its early stage that outcomes are better."
Genetic testing is not new to the medical field, thought its scope is expanding. Patients have shown interest in having their genes read, even though the results might be unpleasant.
"People want to know if they have the mutation because they want to help their children and future generations," Sampson said. "It helps them explain why they have cancer in their family and what they can do about it."
The focus will be on heredity cancers such as ovarian and breast cancer, Sampson said.
"We might see the list grow in the future, but for right now we are concerned with those more common cancers," Sampson said.
The test is relatively painless. Hartley gulped a cup of mouthwash and swished it around before spitting it into a tube. The DNA from the mouthwash was then tested for the cancer mutation. The test can also be done through blood draw and mouth swabs.
Doctors are looking for the presence of BRCA1 and BRCA2 mutations in the gene strain. These mutations account for about 20 to 25 percent of all hereditary breast cancers, according to the National Cancer Institute.
So how critical is it for women to know if they have either of these mutations in their genes? The National Cancer Institute reports that about 12 percent of women in the general population will develop breast cancer sometime during their lives.
Recent estimates show that between 55 and 65 percent of women who inherit a BRCA1 mutation and around 45 percent who carry the BRCA2 mutation will develop breast cancer by age 70.
If a test comes back positive, Sampson asks the patient to fill out a detailed family medical history form. The patient can then contact other family members and inform them of the mutation to see whether they want to have genetic testing done.
"We provide the patient with options and allow them to make the choices they feel would be best for them," Sampson said. "They can also change their minds, too."
Hartley's insurance covered her test and will cover the preventative operations. Kilbourne said many insurance companies will cover the testing, which could cost several thousand dollars.
In the end, Hartley believes knowledge is the key to seeing her children grow up.
"I'm glad I am being proactive before I get cancer," she said. "Even though my sister came back negative, she is still fighting it with me. So is my mother. We are going to keep fighting cancer together."
Reach reporter Chris Conrad at 541-776-4471 or firstname.lastname@example.org.