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 provide support for families choosing to pursue genetic testing and follow-up consultation to discuss the implications of test results.

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.

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.

Find answers below to some of the most often asked questions about genetic counseling, and risks associated with family history and cancer.

How can cancer be passed down in families?

Changes within our genes, which contain instructions for how our bodies will grow and function, can lead to the development of cancer. In some families, these genetic changes are inherited or passed down through generations; people in these families were born with genetic changes that could predispose them to developing cancer later in life. Certain types of cancers, such as breast, ovarian and colon cancer, are more likely to be inherited within families. Not all people with cancer develop the disease due to an inherited (also known as "hereditary") cause. Inherited forms of cancer make up only 5 to 10% of all cancer cases.

Who can have an increased risk for inherited types of 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, children, grandparents, grandchildren, aunts, uncles, nieces and nephews).
• Family members in multiple generations diagnosed with cancer.
• Early age at cancer diagnosis (usually under age 50).
• An individual with multiple types of cancer, multiple primary tumors or bilateral cancer (like cancer in both breasts).
• Pattern of tumors consistent with a specific cancer syndrome (e.g. breast & ovarian or colon & uterine).
• Rare types of cancer.
• High-risk ethnicity (i.e. Ashkenazi Jewish).

Why do patients have genetic testing?

Genetic testing looks for changes in genes that could increase the risk for diseases, such as cancer. This type of testing usually involves collecting a sample of blood or saliva. Individuals can have genetic testing to determine if they have an increased risk of cancer and could have passed this risk on to their family members. The results of genetic testing can help you and your doctors determine cancer screening and treatment plans, help you better understand cancer risks for yourself and your family members and help you make decisions about cancer prevention. Since genetic testing is not recommended for all individuals with a personal or family history of cancer, it is important to talk to a genetic counselor before you pursue genetic testing.

Is genetic testing covered by my insurance? How could genetic testing impact my ability to keep or obtain health insurance?

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.