Genetic Counseling in Alabama
What is Genetic counseling?
Genetic counseling helps patients or their relatives who are at high risk for disease learn about their condition. It helps patients make informed decisions about testing and their treatment options and determine if children or other family members might be affected by the same genetic condition.
Genetic counseling is done prior to genetic testing to determine if the testing is actually needed and to make sure the patient understands all the components of testing which includes:
- Developing a detailed family history
- Discussing risks, benefits, and limitations of testing
- Educating the patient on basic cancer genetics and what cancer risk means
- Explaining what to expect during testing
- Discussing implications of test results for the rest of the family
- Providing an opportunity for patients to ask questions
In the oncology setting, genetic counselors assess and counsel people about their chance of having an inherited susceptibility to cancer.
Individuals are considered to be candidates for cancer risk assessment if they have a personal and/or family history (maternal or paternal lineage) with features suggestive of hereditary cancer(s).
What is a genetic counselor?
Genetic counselors are medical professionals with specialized training in medical genetics at the graduate level, specifically a Master of Science in Genetic Counseling and national board certification by the American Board of Genetic Counseling. They are skilled in understanding and explaining how genetics plays a role in health and disease, including cancer. Genetic counselors work as part of the medical professional team to help provide comprehensive cancer care related to hereditary cancers and risk assessment. Genetics is about families and preventative care, and we are here to support you!
What is discussed at a genetic counseling appointment?
A genetic counseling consultation at CCI includes meeting with our nationally board certified genetic counselor and a physician. The consultation with the genetic counselor and physician typically takes 45-60 minutes, depending on the complexity of the family history and patient questions.
The visit is billed as a specialist physician visit and subject to standard co-pay. The cost of genetic testing is reviewed in detail at the genetic counseling consultation. Our genetic counselor works very hard to obtain the appropriate genetic testing at little to no out-of-pocket cost when testing is medically indicated. Genetic testing does not move forward without patient consent.
Why consider genetic testing?
Although genetic testing can be a powerful tool for cancer prevention, it is not right for everyone. Individuals who have an average risk for cancer likely won’t gain anything from getting tested, but the test is very useful for those who may be at increased or high risk. Genetic counselors can assess your family history to see if there is a medical indication for genetic testing.
What are the benefits of genetic testing?
The answer is quite simple: it may save your life. If a genetic counselor determines that you have a high risk of developing cancer, you may want to consider options that reduce or eliminate the risk of specific cancers. Some of these options include:
You may receive cancer screenings at an earlier age and more frequently than guidelines established for the general public…early detection is key!
You may receive chemo-preventive drugs which will reduce your risk of developing the cancer
You may choose to have preventive surgery
For those who have already been diagnosed with cancer, genetic testing may help direct surgical decisions and future cancer screening recommendations, including preventative surgical options. This is also valuable information for your family as a whole.
How do I get genetically tested?
At CCI we obtain a DNA sample by a simple blood draw at our facility. Typically these labs are drawn the same day as the clinic visit for genetic counseling. However, this is not mandatory. Patients partner with our genetic counselor to make not only an informed decision about genetic testing, but also a decision that fits their individual goals. Some people may need more time to make a decision.
How much does a genetic test cost?
Our genetic counselor works very hard to ensure the cost of genetic testing remains low, and most often patients have no personal out-of-pocket cost for the testing. There are never surprise bills for genetic testing. A comprehensive conversation about genetic testing costs/insurance coverage, financial assistance (if appropriate) will be discussed in detail at the genetic counseling appointment.
Who is a candidate for genetic testing?
Below are some of the “red flags” associated with people that are considered high risk for a genetic disorder. This list is not inclusive, but if you have one or more of the following, please discuss your risks with your primary care physician to determine if you are a candidate for genetic counseling.
Red Flags for Hereditary Breast and Gynecological cancers:
A known/documented mutation in the family (e.g. BRCA1, PALB2, ATM)
Breast cancer at age 45 or younger
"Triple negative" breast cancer diagnosed at age 60 or younger
Ovarian cancer at ANY age (1 in 7 ovarian cancers are due to a genetic factor….all should be offered genetic testing at any age)
Male breast cancer at ANY age
Two separate breast cancers (same breast or bilateral) when one was diagnosed at age 50 or younger
Ashkenazi Jewish ancestry and breast cancer at any age in a close relative
Clustering of breast cancer in the maternal or paternal line (3 or more women in the same bloodline with breast cancer)
Uterine cancer at age 50 or younger
Family history of uterine and colon cancers in the same bloodline
Multiple cancers in the same individual (e.g. breast and thyroid, breast and uterine, colon and uterine)
A close family member with any of the above
Red Flags for Hereditary Colon Cancer
A known/documented mutation in the family (e.g. MLH1, MSH2, APC)
Colon cancer at age 50 or younger
Multiple family members (3 or more) with colon cancer in the same bloodline
Colon and uterine cancer in the same person on in the same bloodline
10 or more adenomatous polyps (ask your doctor what type of polyps you’ve had)
A close family member with any of the above
A personal or family history of rare cancers may warrant a genetic evaluation. There is not harm in setting up a genetic counseling consultation if you are concerned about your cancer risk.