Sweeping Up after the Kardashians: What We Wish had been Covered in Their Genetic Testing Episode

“Keeping Up With The Kardashians: Fear of the Unknown” featured genetic testing for hereditary cancer genes. While some of the footage may have hit the cutting room floor, here are 5 essential things that shouldn’t have:

1.     Pre-Test Genetic Counseling

KUWTH: The Kardashian family members pursued genetic testing while getting hair and make-up done for a photo shot. 

Sweep: Genetic testing for hereditary cancer risk is an important decision and should have been the main event, not a light issue to be mashed in between mousse and mascara.

KUWTK: A representative from the genetics testing company came to the photo shoot to draw blood with little explanation of what testing is available, pros/cons of testing or why they may/may not be good candidates for this testing.

Sweep: A review of your personal and family history by a certified genetics expert should be performed before testing to determine if genetic testing is warranted and if so, which testing is best for you.

2.     Test the Right Family Member

KUWTK: While a family history of breast and colon cancer was mentioned in MJ (Kim and Khloe’s grandmother), and while Khloe mentioned a "BRCA gene" it seemed murky whether MJ actually had genetic testing.

Sweep: In any family, the most accurate approach to genetic testing is to first offer genetic counseling and testing to a relative who has been diagnosed with cancer, if possible. Testing an affected family member provides the most information about the genetic nature of cancer in the family. If MJ was truly found to carry a BRCA (or other gene) mutation, then MJ’s children, including Kris, could be offered genetic counseling and testing next.  If Kris were positive, then her children would be offered testing.  However, testing multiple generations at one time, as was done in this episode, is rarely the most accurate scientific approach. 

3.     Right to Choose

KUWTK: Several family members were pressured to have genetic testing. Khloe repeatedly stated that she did not want the information.

Sweep: Genetic testing is a personal decision and is not right for everyone and no one should be pressured into testing. The process of genetic counseling helps an individual decide if genetic testing is right for her/him. 

4.     Get the Facts Right

KUWTK: Khloe agreed to have testing “for her grandmother,” and representatives from the testing lab came to her home to facilitate the blood draw. In the explanation of what Khloe is being tested for, it is mentioned that BRCA genes are associated with male/female breast cancer and ovarian cancer as well as – kidney, colon, melanoma, lung and brain tumors. Khloe responds with:  ‘so either way we are XXcked and dying of cancer’. Someone responded: ‘yes.’

Sweep: The most significant risks associated with a mutation in BRCA1 or BRCA2 are for female breast and ovarian cancer. BRCA mutations are also associated with modest increases in melanoma, pancreatic, male breast cancer and prostate cancer. Men and women who learn they carry a BRCA mutation are offered specialized options for screening and risk reduction. The options can dramatically reduce their risk of ever developing cancer and be life-saving. Many people who carry BRCA mutations live long, healthy lives. 

5.     Get Post-Test Genetic Counseling

KUWTK:  Kris, Kim and Khloe received their genetic testing results from a plastic surgeon who was a ‘family friend.’ Khloe asks if these results can change and is told “no.”

Sweep:  The family should have received their test results from a genetic counselor, who would have explained that ‘negative’ test results can be difficult to interpret. While it is true that your genetic makeup doesn’t change, advances in technology do, and testing options are constantly evolving.

 

Final Sweep: This week’s episode of KUWTK highlighted that KEEPING UP WITH GENETICS is hard to do, even with unlimited resources. It has been documented that, in patients who do not receive genetic counseling, there is a high rate of result misinterpretation and errors. For full, accurate, up-to-date information, make sure to seek out genetic counseling from a certified professional before and after genetic testing. 

Image by Faye Harris, via Flickr