Genetic Counseling and Genetic Testing for Cancer
Genetic counseling and testing for cancer help you and your family better understand your inherited cancer risk. As a part of delivering precision medicine and a personalized approach to cancer care, Dignity Health – Cancer Institute at St. Joseph’s Hospital and Medical Center has a highly-trained clinical genetic counseling service. Genetic counselors meet with patients and family members and discuss the different conditions that your or a family member might be diagnosed with, and discuss whether or not there’s a genetic background to them. As a part of genetic counseling, information can be shared about appropriate options for cancer screening, prevention, and treatment. Genetic counselors also discuss the implications for other family members and provide support.
When is genetic counseling needed?
As powerful as genetic testing can be in personalized cancer treatment, it’s not right for every cancer, or every patient, or every family member. You might want to consider speaking with a genetic counselor when you become aware of:
- Your own cancer diagnosis
- A family member’s diagnosis
- A family history
- An identified genetic mutation
When to seek genetic counseling?
People with a personal or family history of cancer may benefit most from genetic counseling. The cost of the genetic counseling may be covered by insurance. When calling the program to schedule an appointment, our coordinators will review the family history and insurance information and discuss anticipated coverage and cost of genetic counseling. Genetic testing is a separate cost and discussed in more detail during the genetic counseling appointment, after the personal and family history has been reviewed in depth.
You or your physician may make a referral to the Genetic Risk Assessment Program when there is a personal or family history of:
- cancer at an earlier age than expected for that type of cancer (for example, under age 50)
- an individual with more than one type of cancer or with bilateral cancer
- many close relatives with the same type of cancer, on the same side of the family
- rare cancers in the family (for example male breast cancer)
It is ideal, and most informative, to begin the process of genetic counseling and testing with the person in the family who has been diagnosed with cancer. For many reasons, this is not always possible.
An initial genetic counseling appointment lasts 60-90 minutes. At the appointment, they will:
- review your medical history
- collect detailed family history for both maternal and paternal sides of your family
- assess your individual risk to develop cancer based on the family history
- discuss if the family history is concerning for an inherited predisposition and review the risk to carry an inherited predisposition
- review the possible genetic test results
- discuss your options for surveillance, and risk reduction, review the risks, benefits and limitations of genetic testing
- explain current status of legislation regarding genetic discrimination
- arrange genetic testing if desired and indicated
- If genetic testing is pursued, results are typically available in 3-4 weeks. Once the results are received, the results will be interpreted within the context of your personal and family history. The genetic counselor will call to review the results by telephone, with additional appointments scheduled as needed. Medical management recommendations will be reviewed and implications for your family discussed.
- For more information about scheduling a genetic counseling appointment, call (602) 825-2039.
What are the benefits of genetic counseling?
With the personalized medicine that we provide at Dignity Health – Cancer Institute at St. Joseph’s, genetic testing can play a role in how we tailor care to the individual. Through the genetic counseling we provide, we are able to have a positive impact on the care and treatment of our patients through:
- Proactive screening
- Early detection
- Personalized treatment options
- Elimination of ineffective treatment options
- Treatment and/or screening options
- Influence of surgical and chemotherapy options
- Implications for other family members
What’s covered by insurance and what’s not?
Genetic counseling may be covered by your insurance plan. For those that do not have coverage for genetic counseling, a discount is available if payment is received the day of the genetic counseling. Our intake coordinators can speak with you about coverage and review your out-of-pocket cost for the genetic counseling.
If genetic testing is indicated, this is a separate cost and performed at an independent laboratory. Criteria have been developed to identify who would benefit from genetic testing and many insurance companies have their own criteria in place to determine coverage for genetic testing. During the appointment with the genetic counselor, options for genetic testing and coverage of genetic testing will be reviewed in detail based on your personal and/or family history.
Concerns about Genetic Discrimination
There are federal laws in place the prevent health insurance companies and employers from discriminating based on genetic information. The Genetic Information Nondiscrimination Act of 2008 (GINA), states that it is against the law to request, require or use genetic information to make decisions about your eligibility for health insurance or your health insurance premium, contribution amounts, or terms of coverage. GINA also includes legislation related to employment.
Additionally, the results of genetic testing are considered ‘Protected Health Information (PHI)’ as described in the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and release of these results is limited.