Archives for October 2014

The ribbon is a symbol of awareness and support.  It was originally used in the early mid-1900s in a United States military marching song.  The song “Tie a Yellow Ribbon”, inspired the wife of a hostage held in Iran from 1979-1981 to use the yellow ribbon to show support for hostages and to remind others of their service to their country.  Later, during the Gulf War, the symbol evolved into a reminder of all men and women serving the country abroad.

A decade later, AIDS activists turned the yellow ribbon red.  From then on every charitable health cause had one.  It became so popular that the New York Times called 1992 “The Year of the Ribbon.”  The meaning behind the ribbon depends on its color or colors.   Many causes often share each color.

Ribbon colors representing cancer:

Clear, Pearl or White : Lung                                                 

Blue :  Mouth

Orange : Leukemia                                                                       

Yellow : Bone                                                                        

Lime  : Non-Hodgkin’s Lymphoma                                

Purple : Testicular                                                                     

Periwinkle : Stomach and Esophageal                         

Pink and Blue : Male Breast                                                

Gray : Brain                                                                         

Black : Melanoma                                                           

Pink : Breast                                                              

Green : Kidney                                                                         

Teal : Ovarian                                                                      

Teal and White : Cervical                                                    

Violet : Hodgkin’s Lymphoma                                                                      

Burgundy : Multiple Myeloma                                                                

Red and Orange : Myeloproliferative Disorders           

Burgundy and Ivory : Head and Neck                                            

BRCA1 and BRCA2 are the big bads of breast cancer genes. They’re not terribly uncommon, they make it about even odds (or worse) that a cancer will develop, and they often cause a more aggressive form of the disease.

But having normal BRCA genes isn’t a guarantee of normal cancer risk.

PALB2 mutations, we’ve learned recently, change the way BRCA gene products function. And it appears that PALB2 gene mutations raise the risk of breast and ovarian cancer to the same level as a woman with a BRCA mutation – multiplying the risk five or ten times.

Reported in the New England Journal of Medicine this August, PALB2 testing is already becoming part of screening in select circumstances.

Watch for additional updates as they become available.

ADDENDUM 10-6-14 9:35 am

PALB2 testing is routinely offered (as part of a more extended panel) to all patients seen by St. Vincent Hospital’s medical genetics department, according to medical geneticist Theresa Shuck (who is part of the St. Vincent’s team).

But because the more extensive testing takes 12 weeks to complete (compared to 2 weeks for BRCA testing alone) many patients opt out – especially those who need to make surgical decisions sooner.

These more extensive panels also challenge insurance companies. Every possible medical test and procedure is given a specific identifier called a CPT code, which allows insurers to recognize what they’re paying for. Though CPT codes are updated regularly, “there are no CPT codes for these panels yet,” says Shuck.  “Most labs are eating the costs of the panels at this point.”