Greater Peoria Metro Area, IL

Working with the community... for a healthier community.

New Genetics Program Boosts Patient Care Outcomes


By Sara Browning

Illinois CancerCare, PC is raising the
bar for patients at an increased risk for developing hereditary cancer
through a genetics program designed to provide comprehensive,
compassionate care in the diagnosis, treatment, and prevention of cancer
family syndromes.

Providing state-of-the-art treatments for
patients with cancer and blood diseases has been made easier for
physicians at Illinois CancerCare, PC with the introduction of a
genetics program for patients at risk of developing cancer family
syndromes. Such syndromes cause individuals to have an increased risk of
developing one or more types of cancer due to their genetic makeup.

Founded in 1977 by Dr. Stephen Cullinan in Peoria, Illinois
CancerCare, presently one of the largest private oncology practices in
the nation, has continuously provided research and treatment for genetic
diseases and syndromes.

“At Illinois CancerCare there has
always been a program for genetic testing with each physician within
their practice,” says Dr. James Knost, MD, Medical Director for the
Genetics Program. “The difference with this program is that we felt a
designated clinic with a physician in charge of it would help us to
better handle cancer genetics in our community.”

Genetic Testing for HBOC
When it comes to diagnosing and treating various cancer family
syndromes, genetic testing at Illinois CancerCare has saved the lives of
countless patients and has also aided physicians in cancer prevention,
alerting them to “red flags” that may signal the potential for the onset
of various cancer family syndromes.

Genetic testing begins with
an initial patient consultation. “We generally talk to patients about
their general health and background,” says Dr. Knost. “Then we assess
the family history of parents, siblings, and relatives in order to fill
in a family tree and look for patterns in genetic makeup. Genetic
testing may change the workup and management of the patient.”

The genetics program will assist patients in the fight against
Hereditary Breast and Ovarian Cancer (HBOC) Syndrome, Lynch Syndrome,
and other genetic cancers. “The genetic basis of HBOC is an inherited
mutation in either the BRCA1 or BRCA2 genes. Normally, the proteins
produced by these genes prevent cells from becoming cancerous by aiding
in the repair of mutations on other genes through a process called
double-strained DNA repair. An inherited mutation in either of these
genes increases the probability of cancer.”

Dr. Knost highly
recommends BRACAnalysis® genetic testing to his patients to aid in the
diagnosis, treatment, and prevention of HBOC. “Undergoing BRACAnalysis®
testing enables family members who carry either BRCA1 or BRCA2 to take
preventative measures. For example, women at risk can have mammograms
once a year and MRIs once a year. In males, BRCA2 puts them at increased
risk for breast and prostate cancer. Males are screened for prostate
cancer beginning at age forty.”

Combating Lynch Syndrome
Genetic testing has also proven beneficial in the diagnosis,
treatment and prevention of Lynch Syndrome, a cancer family syndrome
also known as Hereditary Nonpolyposis Colorectal Cancer (HNPCC). Lynch
Syndrome results from a genetic mutation in one of the mismatch repair
(MMR) genes. Under normal circumstances, MMR genes produce proteins that
identify and correct base-pairing mismatches that can occur during DNA

Germline mutations in MLH1, MSH2, MSH6, and
PMS-2 account for the majority of detected mutations in families with
Lynch Syndrome. Says Dr. Knost: “When these genes become mutated, the
genetic mistakes that occur can predispose patients to colon cancer
before the age of fifty.”

Genetic testing for Lynch Syndrome is a
critical step in changing hereditary cancer outcomes. Warning signs in a
person’s personal and family history may indicate a person’s increased
risk for Lynch Syndrome and help identify family members for testing.

If genetic testing uncovers a patient at risk for Lynch Syndrome,
cancer may be managed through increased surveillance, primarily a
colonoscopy every one or two years beginning between the age of twenty
and twenty-five. Family members diagnosed with endometrial or ovarian
cancer might consider discussing screening options with a gynecologic
oncologist. Hereditary Pancreatic cancer, Hereditary Melanoma Syndrome
and Adenomatous Polyposis Syndrome are also common cancer family

Dr. Knost says Illinois CancerCare’s new genetics
program has increased the number of hereditary cancer syndromes
physicians can define. This is due to new technology, such as advances
in DNA sequencing.

Says Dr. Knost: “Next generation sequencing
allows the entire genome to be read for less than one thousand dollars.
The original ‘genome projects’ took seven years and cost three billion

First-Hand Experience
Illinois CancerCare patient Liz Pisano has experienced firsthand the
benefits of the new genetics program. Diagnosed with colon cancer in
January 2007 and then a brain tumor in May of that same year, Liz and
her physician, Dr. Knost, put together a genetic makeup that uncovered a
specific gene mutation in her family’s history.

testing helped Dr. Knost to discover that I inherited one mutated gene
from my dad and one mutated gene from my mom,” says Liz. “When both of
these genes are inherited together, they cause cancer.”

According to Liz, inheriting both genes is “extremely rare.” In terms
of her family history, Liz says: “My genetic case brought a lot to life.
My grandfather had leukemia, and my grandmother was believed to have
passed away from ovarian cancer. My older brother passed away from colon
cancer at twenty-one years of age.”

Liz’s mother suffered from
breast cancer but recovered following surgery. “My mom has a rare blood
disorder,” says Liz. “They did some blood work on me and sent it to the
lab along with my mom’s and my younger brother’s blood work to find out
if there were any similar mutations.”

Genetic blood tests
revealed pre-cancerous cells in both Liz’s and her mother’s uterus. She
and her mother underwent a hysterectomy. “Knowing that I had to have the
hysterectomy was a huge benefit of my genetic testing,” says Liz.

Liz’s brain tumor warranted a slim chance for survival. “People with
my type of brain tumor rarely survive five years after diagnosis. I know
genetic testing really played a role in saving my life.”

Knost says the new genetics program is “long overdue” in Central
Illinois. “The Illinois Cancer Foundation in conjunction with Illinois
CancerCare will screen patients that have HBOC and Lynch Syndromes and
other cancer family syndromes. If we identify mismatched repair
abnormalities, we can perform additional testing to define these
families in our community. The Foundation provides grant support to
cover the cost of the genetics software, and will also provide financial
resources to aid family members with financial hardship, should they
desire to have testing. In 2014, we would like to expand this to
surrounding communities as our way of helping patients and families
prevent cancer in the future.”   

Dr. James Knost, MD, graduated
from Louisiana State University in Baton Rouge, Louisiana, and attended
Louisiana State Medical Center in New Orleans, Louisiana. He completed
his internship and residency in internal medicine at Vanderbilt
University Hospital in Nashville, Tennessee and completed a medical
oncology fellowship at Vanderbilt. He is Board-certified in Internal
Medicine and Medical Oncology.

For more information on Illinois CancerCare, PC, visit For information on the benefits of its genetics program, visit Illinois CancerCare is located at 8940 Wood Sage Road, Peoria, IL 61615.