Oncology Central

World Cancer Day: Mainstreaming cancer genetics

To mark World Cancer Day, Oncology Central spoke with Nazneen Rahman (The Institute of Cancer Research, London, UK). Rahman leads research directed at identifying, characterizing and clinically implementing genes that predispose to cancer and developing foundational resources for genetic medicine. She is currently Head of the Division of Genetics and Epidemiology at The Institute of Cancer Research and Head of the Cancer Genetics Clinical Unit at The Royal Marsden NHS Foundation Trust. She was awarded a CBE in the Queen’s 2016 Birthday Honours in recognition of her contribution to medicine.

Can you tell us about your career to date and your work at the Institute of Cancer Research?

I first trained as doctor specializing in Medical Genetics. I am now Head of the Cancer Genetics Unit at the Royal Marsden NHS Foundation trust. Nearly 20 years ago I did a PhD at The Institute of Cancer Research with Sir Mike Stratton, who is now Director of the Wellcome Trust Sanger Institute. It was just at the time he was discovering the BRCA2 gene. I instantly became captivated by genetics and I spent the first decade of my career discovering genes that predispose to human disease, particularly in breast and ovarian cancer. More recently I have been leading two innovative translational research programmes. The Mainstreaming cancer genetics (MCG) programme is undertaking the technological, scientific and translational work required to make cancer predisposition gene testing part of routine cancer care. The Transforming Genetic Medicine Initiative (TGMI) is building the knowledge base, tools and processes required to deliver the promise of genetic medicine.

What would you say has been your greatest achievement of your career to date?

I don’t think there is one single achievement that is more important than others. I have dedicated my career to discovering genetic causes of disease and using that knowledge to improve the lives of cancer patients and their families. It’s a 20 year body of work. And it’s made difference, in science and medicine. I feel happy and privileged to have had that opportunity.

You are currently leading the MCG programme, the aim of which is to make genetic testing available to more patients as part of their routine cancer care.Could you tell us more about this programme?

The MCG Program has pioneered a new “oncogenetic” pathway for testing the BRCA1 and BRCA2 genes which brings gene testing to patients through their existing oncology appointments.

Previously, patients could only have a gene test after referral to genetics departments, which adds significant time and cost to the testing process. In the mainstreaming pathway members of the cancer team can order gene tests for eligible patients directly, though the flexibility to refer to genetics for testing is retained. Any patient found to have a gene mutation is automatically also seen by a geneticist. Those with normal results can be referred for further discussions, but generally this not required.

This model offers more streamlined, flexible, patient-centred and efficient testing for cancer patients. It is much faster and cheaper than the traditional model and the patient and clinician feedback has been overwhelmingly positive. It’s a win-win for everyone.

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