Genetic Counseling

Through one-on-one consultation with a genetic counselor, you can share your concerns about the cancer history in your family and receive personalized risk assessment and information about genetic testing options. We support families choosing to pursue genetic testing. Follow-up consultation includes discussing test results and the implications of results on cancer risks and medical management recommendations for patients and their family members.

Genes contain instructions for how our bodies will grow and function. Changes within our genes can lead to the development of cancer.

In some families, these genetic changes are inherited or passed down through generations. Approximately 5-10% of cancers are due to an inherited risk. People in families with a hereditary risk of cancer are born with a change in one of their genes (also known as a mutation or pathogenic variant) that gives them a higher chance of developing cancer.

The following are clues that could indicate hereditary cancer risk in a family:

• The same or related types of cancer in two or more close relatives on the same side of the family (close relatives are parents, siblings, half-siblings, children, grandparents, grandchildren, aunts, uncles, nieces and nephews).
• Cancer diagnoses in family members across multiple generations.
• Early age cancer diagnosis (under age 50).
• Individuals with multiple cancer types, multiple primary tumors or bilateral cancer, like cancer in both breasts.
• Rare types of cancer (e.g. male breast cancer).
• High-risk ethnicity (e.g. Ashkenazi Jewish).
• Specific patterns of cancer such as breast and ovarian or colon and uterine.

Our genetic counselors can help you determine if genetic testing for a predisposition to cancer is right for you and your family members. We conduct risk assessment, explain inheritance patterns, availability of testing, prognosis, medical management and treatment options. We also discuss the risks, benefits and limitations of genetic testing and talk about how the results of testing could impact you and your family.

Our genetic counselors can also answer questions you have about hereditary forms of cancer. Issues that may impact the decision to have genetic testing, such as family dynamics, the medical management of at-risk family members with/without genetic testing, confidentiality, insurability and family planning, are also discussed. Not all individuals who talk with a genetic counselor decide to have testing.

Coverage for genetic testing varies among different health insurance plans. A genetic counselor can help you determine types of genetic tests that could be covered by your health insurance.

In 2008, the Genetic Information Non-Discrimination Act (GINA) was passed. This federal law protects individuals with genetic conditions from discrimination from health insurers and employers.

Since the law does not cover life insurance, long-term care insurance or disability insurance, it may be beneficial to establish these before having genetic testing.

During your appointment, the genetic counselor will take your family history and ask you questions about family members with cancer such as their age at diagnosis and what type of cancer they had. It is often helpful to have someone join you for your genetic counseling session, such as your spouse, parent, sibling or close friend, who can support you through the decision making process, particularly if you are planning to have genetic testing.

Prior to your appointment please try to obtain medical records documenting any cancer diagnoses in your family members. If any family members have had genetic testing, a copy of at least the first page of their test report is helpful to determine possible cancer risks and genetic testing recommendations for your family.

There is much information to review and share during a genetic counseling session. Your questions are important and we want to provide you with the information you need to make informed decisions about your cancer risks and genetic testing options. Please plan to spend 60-90 minutes with the genetic counselor.