Genetic Counseling

While the majority of cancer is sporadic and occurs by chance, 5-10% is hereditary. Hereditary cancer is caused by a genetic change that can be passed from one family member to another. These genetics changes occur in both men and woman and can increase a person’s lifetime risk for cancer. Genetic testing can detect hereditary cancer.

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Family history is a large component of a hereditary cancer risk assessment. Personal or family histories with the following features may indicate an underlying hereditary cause:

• Breast, colon, uterine or renal cancer under the age of 50
• Triple negative breast cancer
• Ashkenazi Jewish ancestry
• Ovarian, pancreatic, male breast or metastatic prostate cancer at any age
• Multiple colon polyps (especially ≥ 20 adenomas) at any age
• Tumor testing indicating a risk for hereditary cancer
• Multiple cancers in one person
• A family member with a known mutation in a cancer risk gene

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During an appointment, the genetic counselor may:

• Ask about personal and family history
• Assess your risk for hereditary cancer
• Review testing options and results
• Discus medical management
• Order genetic testing when appropriate
• Assist with sample collection (saliva or blood)
• Answer your questions

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• At your appointment we will review family history. You may want to collect information about the type of cancer and the age your relatives were diagnosed prior to your appointment.
• If a family member had genetic testing, try to obtain a copy of their test result to bring along with you to the appointment.

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If you were recently diagnosed with cancer or have a past history of cancer, genetic test results can:

• Provide additional information to help with surgical decisions, treatment decisions and eligibility for clinical trials.
• Determine if a person has an increased risk for additional cancers.
• Provide additional information for screening and medical management. This may include earlier and more frequent screening, risk-reducing surgery and/or medication.
• Help family members better understand their cancer risk.

If you do not have a history of cancer, genetic test results can:

• Determine if a person has an increased risk for cancer.
• Provide additional information for screening and medical management. This may include earlier and more frequent screening, risk-reducing surgery and/or medication.
• Help family members better understand their cancer risk.

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Yes, your medical information, including genetic test results are protected under HIPAA policies. We will not share your information unless you ask us to and provide consent.

Some individuals express concern regarding genetic discrimination. A federal law passed in 2008 called GINA, or the Genetic Information Nondiscrimination Act, made it illegal for health insurers or employers from using genetic test results to discriminate against an individual. Under this law, health insurance companies cannot use results to make decisions regarding coverages or rates and cannot consider genetic test results as a preexisting condition. This law also protects individuals from hiring, firing, or promotional decisions in the workplace based on genetic information. This law does not cover life insurance, long-term care, or disability. There are exceptions to GINA, which will be reviewed during your genetic counseling appointment. For more information about GINA, visit www.ginahelp.org.

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Most insurance plans cover the cost of genetic testing if your personal and family histories are suggestive of hereditary cancer. The out-of-pocket cost varies due to the differences in deductibles, co-payments and co-insurance defined by individual plans. Most genetic testing companies offer accessible and affordable options including low cash price for individuals with limited or no insurance coverage, and they complete a benefit investigation to notify you of your out-of-pocket cost and payment options.

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