Family Cancer Risk Program
Our Cancer Genetic Testing and Counseling Services
If you or a family member has received a cancer diagnosis in the past, you may have a genetic risk of developing cancer in the future. Knowing your risk can help you make better, more-informed decisions about your healthcare and potentially lower your chances of developing certain types of cancer.
How Our Cancer Genetic Testing and Counseling Process Works
You’ll need a referral from your primary care provider or another provider to receive genetic testing and counseling. If your provider refers you to us for genetic counseling, we’ll work with you by phone or through secure email to gather the information we need before your counseling appointment. That information includes:
- Cancer histories for three generations of your mother’s and father’s sides of your family (i.e., up to your grandparents’ generation)
- Information about any family members who have had genetic testing for cancer risk
- Copies of those genetic test results
Once we review this information we can determine if you or a family member may benefit from a consultation with a genetic counselor. In some cases, we may recommend testing one of your family members first. Due to this unique process, we are often able to offer shorter wait times for appointments than some other genetics practices.
During your genetic counseling appointment, we will offer a personalized risk assessment of your personal and family history to determine if you could benefit from genetic testing. If genetic testing makes sense for you, we will review pros, cons, and limitations regarding genetic testing.
If you decide to proceed with genetic testing, we can usually perform this testing with a blood or saliva sample the same day as your genetic counseling visit. This test lets us look for mutations (like spelling mistakes in the genes) that can lead to an increased risk for certain types of cancer or cancer-related conditions, such as Lynch syndrome or hereditary breast and ovarian cancer syndrome (the two most common genetic disorders that can lead to an increased risk for developing several types of cancer).
Next Steps After Cancer Genetic Testing and Counseling
If your genetic test reveals a mutation, you’ll speak again with your genetic counselors to discuss your results and what they mean for you and your family. Most of the time this follow-up can be done over the phone. If appropriate, you may also meet with one of our medical oncologists to discuss ways to lower your risk for cancer, as well as the need for regular screening. For example, if your tests shows you have an increased risk for developing breast cancer, you may be a candidate for our High Risk Screening Program at the Baystate Breast & Wellness Center.
If your tests don’t reveal a mutation, or if you choose to not undergo genetic testing, you may still be at increased risk for developing cancer because of your family history or other factors. The providers in our High Risk Clinic have experience in working with individuals who may be at higher risk to develop breast cancer. They can work with you to develop a plan for additional cancer screenings and follow-up care from our team of cancer specialists. Your recommendations for follow-up appointments will likely depend on what type of cancer you may be at higher risk of developing.
Frequently Asked Questions About Cancer Genetic Testing and Counseling
We work with referring providers in primary care, oncology, and other specialties to be on the lookout for patients whose medical and family histories include certain types of cancer, as well as ages of when cancer has been diagnosed. These can indicate the potential for a genetic risk to develop cancer.
If any of the following apply to you or your family, you may be at increased genetic risk to develop cancer:
- Cancers diagnosed at a young age (e.g., breast cancer or kidney cancer diagnosed before 45, other cancers diagnosed before age 50, etc.)
- Diagnosis of 10 or more precancerous (adenomatous) colon polyps, which can indicate an increased risk of colon cancer
- Diagnoses of certain groupings of cancer (e.g., breast and ovarian cancer, colon and uterine cancer, etc.)
- Diagnoses of multiple types of cancer for one person
- Multiple generations of your family diagnosed with the same type of cancer (e.g., three or more family members diagnosed with breast cancer or colon cancer)
- Rare types of cancer, such as ovarian cancer, pancreatic cancer, or certain types of endocrine tumors
If genetic test results indicate you are at increased risk for certain cancers, such as breast cancer or colorectal cancer, your doctor may offer you more intensive surgical treatment options if you do develop those cancers to lower the chance of that type cancer occurring again. For example, you may discuss bilateral mastectomy (surgical removal of both breasts) if you develop breast cancer, or your doctor may propose surgical removal of some or all of your colon if you develop colon cancer.
Some people may decide not to move forward with genetic testing (or postpone it). Some anticipate that they would be highly worried about developing cancer if their test results are positive. Others feel they would not be willing to undergo the extra screening, preventative surgeries, or take preventative medication recommended after a positive result. Another common concern is the impact of positive genetic test results on certain types of insurance.
As noted in the Genetic Information Nondiscrimination Act of 2008 (GINA), most employers and health insurance providers can’t hold your genetic information against you. That means it’s illegal for you to face any negative effects at your job or from your health insurance if your genetic testing shows an increased risk for developing cancer. However, that protection does not apply to several other types of insurance, such as:
- Disability insurance
- Life insurance
- Long-term-care insurance
This may mean you will want to obtain these types of insurance before you undergo genetic testing, as your rates/premiums may be affected by a positive test result.
We’ll work with you during your initial genetic counseling visit so you understand the benefits and any potential disadvantages of genetic testing so you can make the best possible decision for yourself.
Learn more about GINA, its protections, and what you should know about genetic discrimination.
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