This video describes what the MSK-IMPACT test is. It will also help you decide if you want to take part in research we’re doing (IRB 12-245) to learn why some people get cancer.
As part of your care at Memorial Sloan Kettering, your doctor would like you to have a test called MSK-IMPACT. This video describes what the MSK-IMPACT test is. It will also help you decide if you want to take part in research we’re doing to learn why some people get cancer.
In the past, cancer has been treated based on where it started. For example, a lung cancer was not usually treated the same way as a colon cancer. Now, we know that sometimes we need to understand not only where the cancer came from, but also what the genes look like inside the cancer. Researchers here at Memorial Sloan Kettering developed the MSK-IMPACT test to look at those genes.
When we’re born, every cell in our body has the same set of genes. Genes come in pairs: 1 copy from our father and 1 from our mother. Genes are made of DNA. They contain spelled-out instructions to build the proteins that make our bodies work. Sometimes, the genes are damaged, which changes the spelling. This is called a mutation.
Mutations can change the way a gene works. They can cause a cell to grow in an abnormal way and become cancer. We want to learn more about the mutations in the genes in your cancer. By learning this, your doctor may be able to make better decisions about treatment.
The MSK-IMPACT test shows us the types of mutations in your cancer. MSK-IMPACT starts with 2 samples from your body. 1 is a sample of your cancer that was removed during an earlier surgery or biopsy. The other is a sample of your normal cells. That sample usually is taken from a tube of blood. The DNA in the sample of your cancer cells will be compared with the DNA in the sample of your normal cells. If there are mutations in the DNA of your cancer cells, the spelling of the genes in your cancer cells will be different from the spelling in your normal cells. These mutations in the cancer were not inherited from your parents. They cannot be shared with your children or other family members. Your MSK-IMPACT report will list the mutations in your cancer, which your doctor may use to decide the best way to treat your cancer.
MSK-IMPACT can also look at the genes in the sample of your normal cells. If we do this, we may find a mutation in the DNA that you were born with. Mutations in your normal DNA might increase the risk for cancer or other diseases or help your doctors plan treatment. Different mutations in different genes can increase the risk for different kinds of cancer. For example, mutations in genes called BRCA1 or BRCA2 increase the risks of breast, ovarian, pancreatic, and prostate cancers. Mutations in a different gene called TP53 gene can increase the risk of other kinds of cancer, such as blood cancers and sarcomas. The MSK-IMPACT test can also find mutations in other genes that increase the risk of different kinds of cancer.
Your doctor would like to use the MSK-IMPACT test to look at some of the genes in your normal cells in order to find out if you and your family may be at a higher risk for cancers or certain other genetic diseases. If you agree to let us look for mutations in your normal cells, we will contact you when your results are ready to tell you what we found. This may take several weeks. We will also tell your doctor and include the results in your medical record. If you have a myMSK account, your results will appear in the medical information section. If family or friends have access to your myMSK account, they will also be able to see your results.
We may contact you before the results are ready to get information about your family history of cancer. This will help us better understand what your test results mean.
If we find an important mutation in your normal DNA, we will ask you to schedule an appointment with one of our genetic specialists. They will explain what the mutation means and tell you how you can best protect your health and the health of your family. In some cases, your doctors may be able to use the information to plan treatments for your cancer.
Close family members share many of the same genes. If you have a mutation, your brothers, sisters, parents, and children may or may not share it. If they do share it, they may be at risk for the same kind of cancer that you have, or for other types of cancer. If we find a mutation in your normal DNA that can increase the risk of cancer, your family members can be tested to see if they share it. If they do share it, we will help them design a special plan to help protect them from cancer.
We also offer MSK-IMPACT testing to children being treated for cancer. If we find a mutation in the DNA of the child’s normal cells, that mutation usually comes from one of the child’s parents. That parent, other family members on that side of the family, and the child’s brothers and sisters may be at higher risk for the diseases caused by that mutation.
Some people worry that looking for mutations in their normal DNA will cause them or their family to be treated differently by other people or even cause them to lose their health insurance. There are some laws, such as the Genetic Information Nondiscrimination Act, that provide some protection against this, but we cannot guarantee that no one will ever use genetic information against you. Your genetic test results are protected in the same way as the rest of your medical record. We will not give out your results without your permission.
The MSK-IMPACT test does not look for mutations in every gene that could increase your or your family’s risk of cancer or other diseases. You and your family could still be at an increased risk for cancer or another disease, even if your test is negative.
If your personal or family history suggests that you have inherited a risk for cancer or another disease, your doctor can refer you to Memorial Sloan Kettering’s clinical genetics service, whether you have the MSK-IMPACT test or not.
Your healthcare provider will now go over the consent form with you. If you would like, you can meet with the genetic counselor before you decide whether to agree to test genes in your normal sample or not. You can have the genes in your cancer tested while you're thinking about whether to look at the genes in your normal sample. Please let your doctor know if you would like a referral to speak with a genetic counselor.