Genetic Counseling & Testing
The Promise of Personalized Medicine is Here
When it comes to cancer, genetic testing is a valuable, often life-saving preventative tool. An elevated risk for cancer can be inherited through genetic alterations (mutations) which can affect the fidelity of our DNA as it is copied during normal cellular function and division. Those who carry an inherited mutation in a cancer predisposition gene have a higher likelihood for developing cancer during their lifetime.
A consultation with a clinician trained in genetics can provide better understanding of genetic test results and how they can be interpreted in light of personal and family history, as well as tailored risk-reducing and preventative recommendations. A genetic counselor will interpret the results so you can arrive at an informed decision on the steps you want to take to treat or prevent cancer.
The Genetics Program at the Torrance Memorial Hunt Cancer Institute, an affiliate of Cedars-Sinai Cancer, provides genetic consultations with a licensed genetic counselor. Services include:
- Interpretation of family medical history
- Coordination of appropriate genetic testing
- Interpretation of genetic test results
- Genetics education
- Risk assessment and personalized cancer screening plan
- Cancer risk-reducing recommendations
- Testing at-risk relatives
- Development of a treatment plan
- Identification of opportunities in genetic research
Who Can Benefit from Genetic Counseling?
A genetics consult and genetic testing can provide important, useful information, if:
- You have a personal history of cancer at a young age.
- You have several relatives with cancer diagnosed at a young age, or more than one relative with the same type of cancer or related cancers (e.g. breast and ovarian cancer, or colon and uterine cancers), regardless of age at diagnosis.
- You have been diagnosed with two or more types of different cancers, or have a close relative with the same history of two separate cancer diagnoses.
- You have a personal or family history of rare cancer (male breast cancer, or childhood sarcoma).
- You have a relative (distant or close) with a known mutation.
How Genetic Counseling and Testing Works
Typically, a genetics consultation begins with gathering of personal and family history, since this information will be crucial for accurate risk assessment and genetic test results interpretation. Once you contact our Genetics Clinic, we will provide you with forms which will help you gather and organize the details of you and your family's health history. Once you complete the questionnaire, we will schedule a consultation with our genetic counselor. During this meeting, the initial risk assessment and genetic testing (if indicated) will be performed. The test analyzes DNA obtained from either saliva or blood sample, and it is performed in an independent laboratory.
The cost of the genetic test is separate from that of the genetics consult, and it is covered by most insurances. Patient's out-of-pocket pay will vary based on individual plan specifics such as co-insurance, co-pay, deductibles, etc. Once genetic test results are available, a second consultation will be scheduled to discuss genetic test results, their implications and provide management recommendations.
Frequently Asked Questions
What is a genetic test and how is it performed?
Genetic testing is simple and done by collecting a small amount of blood or saliva sample, which is then sent to a genetic testing laboratory. Your DNA, the letters making up your genes, is isolated from the cells and analyzed for any 'misspellings'. Some misspellings are benign, while some are harmful. These are called gene mutations. Typically, within three weeks, you will get your test results from your genetic counselor.
How much does genetic testing cost and will my insurance cover it?
Before any medical procedure, consult with your insurance company to confirm coverage. For a majority of plans, genetic counseling is covered, however, each company has different policies. Similar to other healthcare services, you may have have an out-of-pocket fee.
Is my insurance company allowed to discriminate against me based on my genetic tests results?
No. You and your genetic information are protected in The Genetic Information Nondiscrimination Act of 2008 (GINA). This act protects your information from being used to decide both employment and medical insurance decisions. You are protected in the event that you decide to undergo a genetic test, receive medical care, or participate in a clinical trial. GINA does NOT protect against in the discrimination of purchasing life, disability or long-term care insurance.
Is genetic testing required?
Genetic testing is optional. Deciding when and whether to have genetic testing is a personal decision, and our genetic counselor can help you decide whether testing might be helpful to you and your family. Individuals often undergo genetic testing around the age when their medical management would change. This is around age 25 for women and between ages 35-40 for men.
Can I get a genetic test without having to see a genetic counselor?
Typically, a genetic test is ordered by a genetic counselor or a physician. Because the interpretation of the results is complex and not all physicians are trained in genetics, you may be left with additional questions about the implications of your results. Our genetic counselor has advanced training in medical genetics and psychosocial counseling to best prepare you for your results and explain the implications.
Can genetic counseling help me if I do not know my family's history?
Genetic counseling can still be helpful even if you do not have information on your family's history or you are an adopted individual. A genetic counselor can help you decide whether a genetic test would be beneficial.
Can genetic testing help me if I have already been diagnosed with cancer?
Yes. A genetic test will help determine if the cancer was inherited through a gene mutation which can help physicians treat you more efficiently. It has been found that some types of inherited cancer won't respond to certain treatments while some respond very well. A genetic test can also help determine if other family members may be at risk for carrying the same mutation.
Who in my family should get genetic testing?
The best strategy is to start testing someone in the family who has had a cancer diagnosis. This is because that family member is more likely than an unaffected relative to have an inherited gene mutation, if a detectable mutation exists in the family. Testing can still be performed on an individual who has not been affected by cancer. The genetic counselor can help you establish the best testing strategy that will be most informative for you and your family.
