What can a genetic counselor tell you about your cancer risk?
The answer is “a lot.”
Genetic counselors are the experts in understanding your risk for hereditary diseases, such as cancer; whether genetic testing is warranted; exactly who should be tested; which test is appropriate; how to interpret the results; how to work with your insurance to cover testing (if it is warranted) and what to do with the results.
Genetic counselors at the University of Minnesota Health Cancer Risk Management Program are usually the first person a patient sees. They collect medical history, assess each patient’s pedigree (the blueprint of medical history) and make recommendations based on their individual information. They can help you learn about your genetic risk for cancer and put it into perspective. They’ll also provide their evaluation to the patient, primary care physician and other relevant health care professionals.
Here are seven things you should know about genetic counselors and their services:
- Some cancers run in families.
If you had cancer at a young age, had two or more separate cancers, have several family members with cancer, or had a rare cancer, you may want to consider genetic counseling. Only 5-10 percent of cancers have a strong hereditary cause, but 10-20 percent are familial—meaning more than one person in the family has the same cancer. Knowing your personal and family risk can be empowering. With appropriate screening and surveillance, cancer can be caught very early (when it is most treatable) and may even be prevented.
- Family health history is often complex.
Genetic counselors have graduate degrees in their specialty and will take the time to help you sort through family history, evaluate and review it for patterns of inheritance.
- Not all genetic tests are equal.
So, you've thought about having a genetic test? Tests vary in the number of genes that are included and how thoroughly each gene is evaluated. Testing for more genes is not necessarily better or more cost effective. Some genetic panels (gene tests for a wide variety of genes) vary in their ability to detect genetic mutations that are linked to predicting a person’s risk cancer. That’s because they use different technology to find and confirm mutation. Your genetics counselor will assess which genes to test for and which labs are most reputable and most cost effective.
- Some insurance companies require genetic counseling before they will approve payment for a genetic test.
Insurance companies, like Medica and Cigna, require their members to visit with an independent board-certified genetic counselor or clinical geneticist prior to any genetic testing for hereditary conditions. The cost of genetic testing is considerable, and genetic counselors are objective, third-party professionals who make recommendations for genetic testing only after consideration of one’s family history. They seek out the most appropriate test.
- Genetic counselors know about support groups and other support for people with an increased chance of cancer or family histories of cancer. The “counseling” component of a genetic counselor visit can be extremely useful for patients, because genetic counselors also serve as patient advocates. Patients will not only learn more about themselves, but they may work with the genetic counselor to determine how to share information with others in their family. Genetic counselors have a wealth of information about relatively uncommon diagnoses and medical syndromes.
- Keeping up with genetic discoveries takes time and focus. Fortunately, genetic counselors devote their careers to it.
Medicine is complex and highly specialized. Genetic counselors often serve as a consultant to physicians and patients in order to make recommendations about health screening tests and management options, based on current research in specific patient populations.
- Both the National Comprehensive Cancer Network and the Society for Gynecological Oncology recommend genetics counseling.
These organizations and other medical groups have endorsed genetic counseling and, when appropriate, genetic testing for hereditary cancers.