Familial Cancer Takes Center Stage at Lombardi’s Fisher Center

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Very few cancers have a single, known genetic cause, and yet families can often trace a disease through many generations. Researchers at Georgetown’s Jess and Mildred Fisher Center for Familial Cancer Research, part of Lombardi Comprehensive Cancer Center, seek to understand the basis of a genetic predisposition to cancer.

The Center was established in 2007 with a $5 million gift from the Robert M. Fisher Memorial Foundation to substantially expand the familial cancer clinical and research programs at the Lombardi, allowing faculty to conduct more research on genetic predisposition to cancer, provide increased clinical trial opportunities, and provide resources for physicians to evaluate and treat more patients.

“The Fisher Center at Lombardi will be a pioneer in understanding, treating, and preventing hereditary cancer. Through prevention, screening, and early-detection trials, our ultimate goal is to prevent high-risk patients from ever developing cancer,” says Claudine Isaacs, MD, who co-directs the center with Marc Schwartz, PhD.

At present, most patients seen for genetic counseling are concerned about familial risks for breast and/or ovarian cancer. The Fisher Center has expanded research and clinical programs in a number of hereditary cancers to also include colorectal, prostate, melanoma, and renal cell cancer. This expansion allows Lombardi to conduct direct clinical research to enhance the medical, behavioral, and psychosocial outcomes of high-risk individuals.

In its first year of operation, the Fisher Center provided two pilot grants to support early-stage research on familial cancer to Bassem Haddad, MD, and Vanessa Sheppard, PhD. While each is studying a related aspect of familial breast cancers, the projects are indicative of the range of research supported by the Fisher Center. Haddad’s study focuses on the role of a single gene in familial breast tumors, while Sheppard’s examines potential barriers to genetic testing among African American women.

Another major component of the Center is its genetic counseling and testing program. Genetic counseling is a comprehensive process of risk assessment, management, and support for individuals and families concerned about their risk of developing cancer.

“In the last 15 years we’ve learned a tremendous amount about how genetic testing may help some individuals make informed decisions about managing their risk,” explains Lombardi’s Senior Genetic Counselor, Beth N. Peshkin, MS, CGC.

While a family history of cancer typically increases an individual’s risk, this does not mean that he or she necessarily has a strong hereditary predisposition to cancer. Genetic testing determines whether a patient has a known genetic predisposition to cancer, such as the BRCA1 and BRCA2 gene mutations that increase risk of breast and ovarian cancer.

In addition to better defining genetic risks, researchers at the Fisher Center are working to understand who benefits most from genetic testing, how to counsel patients and their families before and after testing takes place, and what interventions are most effective in reducing cancer development in high risk patients. Through clinical and research programs supported by the Fisher Center, patients can take advantage of many options that are available for patients who wish to learn more information about cancer risk and optimal ways of cancer screening and risk reduction.

At the same time, the Fisher Center is dedicated to education about genetic risk and familial cancer – for the public as well as health professionals. The Center offers educational programs for healthcare providers, clinical researchers, as well as the public, and offers specialized training for genetic counselors in the form of internships and fellowships.

The three components of the Center – research, patient care, and education – enable the faculty to carry forward the model of comprehensive service and translational science that forms the foundation of all Lombardi activities.

By Allison Whitney, excerpted from Lombardi Comprehensive Cancer Center’s 2007 Annual Report.

Photo by Lisa Helfert