You Have a 50/50 Chance of Passing a Cancer Gene to Your Child. What Would You Do?
Genetic testing can catch markers of disease before they’re transmitted to future generations — presenting some would-be parents with a difficult choice.
Caitlin Michelle is four months’ pregnant, and although she doesn’t know the sex of her baby yet, she says she thinks about it every day. Michelle is positive for BRCA, the so-called breast cancer gene, and there is a 50% chance she’ll pass it on — a serious risk if she gives birth to a girl.
“If I have a daughter,” she says, “I will probably think about it every day of her life.”
Michelle, a 32-year-old public health practitioner in Illinois, only learned she was BRCA-positive last year. The news upended her life plans to eventually have more children once she and her partner finished their doctoral programs and completed a cross-country move. Carriers of the BRCA variant often choose to have a preventative mastectomy and oophorectomy (removal of the ovaries) to decrease their chances of developing breast and ovarian cancers. The latter procedure eliminates the possibility of becoming pregnant. With BRCA, says Michelle, “our timeline for more kids suddenly moved up.”
Most adults with BRCA inherited the gene from a parent who didn’t know they had it. Widespread testing for cancer-risk genes, like BRCA and Lynch, and other genetic variations that increase the risk of Alzheimer’s and other cognitive conditions, autoimmune issues, and heart problems have only become available in the last two decades. Previously, a person might have been aware of their family’s tendency for certain conditions, but there was no way of knowing if they’d inherit them and certainly no way to prevent them from being passed to future generations. But with advances in personal genetics, people increasingly have the option to peek behind the curtain and take action to prevent these conditions from being passed on.
Deciding whether to take precautions to avoid passing on a genetic illness to future children is a personal decision but also one that has rippling consequences.