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Understanding how genes affect cancer risk and treatment

MUSC Hollings Cancer Center

March 1, 2022

Josh Birch


Understanding how genes affect cancer risk and treatment


Knowledge is power – that’s a message Libby Malphrus, a genetic counselor at MUSC Hollings Cancer Center, tells her patients. Malphrus has seen demand for Hollings’ genetic counseling program increase by over 400% in the past two years. Hollings’ program is supported by two full-time genetic counselors, along with a growing support team, in order to meet the demand more fully as more patients become eligible for testing. “We are seeing that patients really understand the role that genetics can play in cancer risks and prevention,” Malphrus said. “If a patient is found to be at higher risk for breast cancer, that patient may need to start her mammogram at the age of 25 or 30, instead of 40. Our goal is to catch cancers as soon as possible and even try to prevent them in the first place.” Malphrus knows firsthand the importance of knowledge when it comes to personal cancer risks and a cancer diagnosis. At the age of just 33, she underwent a radical hysterectomy after being diagnosed with invasive cervical cancer.


“At the time, my mom had just been diagnosed with ovarian cancer,” Malphrus said. “I was due for my annual screening the next month, and I almost skipped it. I’m so incredibly thankful that I didn’t skip that screening.” Malphrus is a fierce advocate for men and women to receive annual screenings to know their risk factors and be better able to detect cancer earlier with proactive screenings to keep advanced cancers from developing. She knows screenings could be the difference between life and death, which is why she is quick to educate patients about the role genetics can play when it comes to cancer development and cancer risk.


Genetic mutations only account for between 5% and 10% of all cancers. That is why Malphrus said it is also important for patients to make positive lifestyle choices. Previous research indicates that around 42% of cancer cases in the U.S. are linked to excess weight, poor diet and lack of physical exercise. Alcohol and tobacco use also are linked to an increased risk of cancer. For patients with cell mutations, genetic testing remains a very important resource. Malphrus said she is excited to see eligibility for these services expand to include cascade testing so that more patients can receive potentially lifesaving information. Cascade testing refers to the genetic counseling and testing provided to blood relatives of individuals who have been identified with specific genetic mutations. “This is an exciting service. If a doctor has a patient who tests positive for a genetic mutation that makes that patient at a higher risk of cancer, then that patient’s family members could also be eligible to be tested.”