A new medical study is underway in Bermuda which hopes to reduce the devastating effects of breast and ovarian cancer on the local population.

The project is being run by the King Edward VII Memorial Tumour Registry in conjunction with the Hereditary Breast and Ovarian Risk Assessment Clinic at the American hospital Massachusetts General.

By combing through family histories of those that have been affected by the disease locally, the researchers hope to identify families at high risk for the cancers earlier and more efficiently.

Roughly five to ten percent of those that develop breast cancer show a hereditary disposition for the disease, Dr.. Kevin Hughes of Massachusetts General told The Royal Gazette yesterday.

"Most hereditary breast cancer is caused by mutations in the BRCA1 or BRCA2 gene," Dr. Hughes said. "Mutations in these genes result in an extremely high incidence of breast and ovarian cancer and tend to cause these diseases at a very early age, as well as show a tendency to produce multiple cancers in a single individual."

Identifying those at risk for the cancers early on can be key to extending and even saving lives, The Royal Gazette was told.

To this end, Dr. Hughes and the Tumour Registry have contacted 763 individuals who developed breast or ovarian cancer between 1980 and 1999.

They have asked these individuals - or their families in the case of those that have passed away - to provide families histories in order to help researchers trace back common denominators in the Bermuda population.

"The most potent tool we have for finding these women is the family history," said researchers Dr. Peggy Bissell, Tumor Registrar Margo Rego and Dr. Hughes explained.

"By looking carefully at the history of cancer in the family, we can identify families at high risk of carrying a mutation.

"If a family has several women with breast cancer and/or ovarian cancer (three or more) occurring at a very early age (less than 40), and/or has one or more individuals with multiple cancers (breast cancer in both breasts or breast plus ovarian cancer), the possibility of mutation is significant."

Once the data from the family histories has been processed, local medical professionals and Dr. Hughes will be able to better predict who is at highest risk to develop one, or both, of the cancers in the future.

Dr. Hughes said there has already been a 73 percent return rate on the questionnaires which were sent out.

"That is an incredible response rate," he said. "It shows the interest of Bermudians in taking care of their own health and being proactive."

From the data the researchers have already gathered, they have identified 36 local families who may be high risk.

While many women - and researchers point out men too are affected - may be afraid to learn whether or not they are at high risk, the health benefits of early detection are considerable, Dr. Hughes said.

"If you know you at high risk for breast cancer, you may start to have mammograms at a much younger age," he said. "While most women will start to have mammograms at age 40, those at high risk could start as early as 25."

Which would allow doctors to identify a tumour much earlier, when it is easier to treat, rather than later when the situation may have worsened considerably. There is also a drug available which is thought to prevent, at least some forms of, breast cancer and taking oral contraceptives (or birth control pills) has also been shown to help prevent ovarian cancer.

In worst case scenarios, prophylactic surgery - removal of one or both breasts - may be necessary, which tends to be the possibility which terrifies most women.

But, even those found to be at high risk for the disease may never develop it, Dr. Hughes stressed.

Beyond early treatment options, he added, there is a physical benefit to simply being in more regular contact with your physician for check-ups and general health monitoring.

"While people do tend to be afraid to know, we can help manage health overall," Dr. Hughes said.

Last night researchers met with many of those individuals and families participating in the study in an effort to continue to spread information on the importance of the project.

They will conduct a similar meeting for the general public next month.

In addition to the 763 individuals on record at the KEMH Tumor Registry, there will continue to be new cases in coming years and more families will be affected.

The researchers and families will be working together to try and develop a way forward to best protect those at risk and to continue the benefits of any positive discoveries. Bermuda is uniquely suited to this type of breast and ovarian cancer management project, Dr. Hughes told The Royal Gazette, due to its central hospital and tumour registry.

"In the US, trying to do a similar project would involve hundreds of hospital," he said. "Getting the information would be much more difficult." Bermuda also has the benefit of a relatively homogenous population, he added. Which makes it easier to trace family connections and better identify genetic components to the disease in the local population. In Israel, for example, researchers were able to determine that 90 percent of the hereditary cases traced back to just three families, although those families go back hundreds of years. "The most important thing," Dr Hughes said, "is that we are trying to significantly reduce the morbidity and mortality of breast and ovarian cancer."

Those who would like more information on the research project, or would like to submit information, are encouraged to contact Margo Rego at KEMH's Oncology Services, 239-2033 or oncology.servicesbermudahospitals.bm.