Dr Rajiv Sarin
Dr Rajiv Sarin

‘The cost of genetic testing for cancer has to come down’

Rajiv Sarin, head of genetic testing at Tata Memorial Hospital, on the new frontiers of treating hereditary breast and ovarian cancers

Dr Rajiv Sarin is the director of the Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai. He leads the Cancer Genetics Unit here and is a professor of Radiation Oncology at the Tata Memorial Centre. In this interview, Sarin talks about the need for women to go for genetic testing. Edited excerpts:

Have you seen a substantial rise in the number of patients who are undergoing genetic testing for gender-related cancers?

About 5% of all breast cancers, 20% of all ovarian cancers and 5% of all endometrial cancers are hereditary or genetic type. Previously many of these cancers were not suspected to be of the genetic type since it was not appreciated that even in the absence of strong family history of cancer they could be of he genetic type if the cancer occurred at much younger age.

Over the last few years, I have witnessed increased awareness among the public, cancer patients and the doctors about hereditary cancers. This increase in awareness has been the greatest benefit for breast and ovarian cancer patients partly as a result of the Angelina Jolie story and partly as a result of the new drugs for ovarian and breast cancers which work better in those with a BRCA mutation. At the Tata Memorial Hospital, we now register 1,200 families with hereditary cancer every year, and a third of these families have breast, ovarian or uterine cancers.

What is the next frontier in this field in India and at the Tata Memorial Hospital?

We are not waiting for a breakthrough discovery, but on how to effectively implement what is already known. Prevention of hereditary cancer and its associated suffering or death requires timely, culturally sensitive and individualised genetic counselling; affordable and appropriate genetic testing; and access to medical expertise for lifelong screening of cancer and risk-reducing surgery. The Cancer Genetics Clinic started in 2013 at the Tata Memorial Hospital has served 6,500 families so far, trained 15 genetic counsellors and a few medical doctors.

How much do these tests cost?

There are several good private labs in the country that provide high quality and reliable genetic testing, but the cost, ranging from 5,000 to 40,000 is unaffordable for many families. No government hospital currently provides genetic testing for cancer. Tata Memorial and its Advanced Centre for Treatment Research and Education in Cancer (ACTREC) has provided free testing under a research funded by the Indian Council for Medical Research to a few thousand families so far. The country urgently needs many more counsellors and oncologists or geneticists with expertise in handling hereditary cancer in families. And the cost of genetic testing has to come down.

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