Regional One Health Cancer Care’s high-risk cancer clinics offer genetic counseling to help patients understand and manage their risk for hereditary cancer.
Our experts recently hosted a Lunch & Learn to spread the word about how genetic counseling can help patients take charge of their health and their family’s health.
Learning about your genetic risk for cancer can lead to additional screening, lifestyle changes, preventative treatment options and more.
Regional One Health Cancer Care is using the power of DNA to help patients be more proactive about cancer prevention, detection and surveillance – both for themselves and their loved ones.
Experts from Regional One Health’s high-risk cancer clinics hosted a Lunch & Learn to explain how genetic counseling helps patients take charge of their health.
Sarah Christian, FNP-C, a breast cancer specialist, said breast, colorectal, prostate and pancreatic cancers are the cancer types most likely to be hereditary, and about 10 percent of cases have a genetic component. Since these four cancers account for 940,000 diagnoses annually, “Cancers in about 94,000 people every year could be found earlier or, in some cases, even prevented.”
Christian explained genes are responsible for everything from physical appearance to the body’s internal operations. If you inherit a faulty tumor suppressor gene, it can increase your potential for developing cancer and having cancer at a younger age.
“Having a mutation does not necessarily mean you will get cancer, but it does increase the risk,” Christian said. “Think of DNA like a recipe, and your genes are the ingredients. When you make a cake, you can leave out vanilla and still end up with a cake. However, if you leave out flour or eggs, you won’t end up with a cake. That is the mutation.”
Genetic testing focuses on the genes known to be linked to an increased risk of hereditary cancer.
Nicole Poston, FNP-C, RNFA, who specializes in pancreatic and hepatobiliary cancer, explained how the counseling and testing process works.
She said patients can expect to spend an hour at their initial genetic counseling visit. Providers will get a detailed family medical history extending at least three generations and review the patient’s personal medical history and risk factors. Then, they’ll use criteria established by the National Comprehensive Cancer Network to determine which patients qualify for genetic testing.
Genetic testing typically is done using a routine blood draw. The sample is set to a lab, and results are usually back in 2 to 4 weeks.
For example, patients diagnosed before age 50 with breast, colon, gastric or endometrial cancer are eligible. Patients are eligible with diagnoses at any age including pancreatic cancer, ovarian cancer, triple negative breast cancer, multiple primary breast cancers, lobular breast cancer, male breast cancer, and metastatic prostate cancer. Family history qualifies a patient if a close relative has had male breast cancer, ovarian cancer, pancreatic cancer, metastatic prostate cancer, breast cancer before age 50, or multiple relatives with breast or prostate cancer.
If you meet the criteria, Poston said, you typically provide a blood sample. This goes to a genetic testing lab, with results in 2-4 weeks.
There is usually no out-of-pocket cost for the testing itself, and federal law protects patients from discrimination in employment or health insurance based on genetic testing.
Once the results are back, patients return to the high-risk clinic.
“We talk about their results, how to manage it, and what it means for their family,” Poston said. “This typically includes coordinating with a surgical oncologist with expertise in their particular disease site for consultation regarding risk reduction surgeries, preventative therapies, and high-risk screening plans. We also discuss implications for family members and recommendations for cascade testing.”
Dorothy Parish, PA-C, a skin cancer, breast cancer and sarcoma specialist, said some patients simply require enhanced surveillance, which can include additional screening like frequent skin examinations, breast MRI and mammogram, and annual colonoscopies.
There are also risk-reducing medications, such as Tamoxifen and PARP inhibitors; as well as risk-reducing surgeries like removal of the breasts, uterus, ovaries and fallopian tubes, or colon.
During a genetic counseling session, providers get a detailed family and personal medical history to determine if the patient qualifies for genetic testing.
Parish noted decisions on these options require patient education and input: “It’s a conversation based on your lifetime risk of developing cancer,” she explained.
Genetic testing can also lead to cascade testing for close relatives on both sides of the family including children, parents, siblings and other relatives. Parish noted cascade testing is typically done for relatives over age 18, since there are no therapies approved for children.
Our experts encourage patients to explore genetic counseling as a tool to manage cancer risk in themselves and their loved ones.
“It is estimated that 90 percent of mutation carriers remain unidentified, so genetic testing gives us an astounding opportunity to impact the screening and detection of cancer,” Christian said.
“There are a lot of benefits. A negative test can provide peace of mind. A positive test result can provide an opportunity to understand and in some cases manage cancer risks, and give family members an opportunity to learn about their own cancer risks. For those who are already diagnosed with cancer, genetic testing may help with decisions about treatment.”
Regional One Health offers genetic counseling and testing at five high-risk cancer clinics led by Dr. Ashley Hendrix (breast cancer), Dr. Evan Glazer (pancreatic cancer), Dr. David Shibata and Dr. Elizabeth Wood (colorectal cancer), Dr. Martin Fleming (melanoma), and Dr. John Schorge (gynecologic cancer).