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Monday Medical: Better understand your cancer risk with genetic counseling

Susan Cunningham
For Steamboat Pilot & Today

Whether you have a history of cancer in your family or are worried about your risk of the disease, you may want to consider genetic counseling.

“Our hope is to identify families and individuals who are at higher risk for cancer and protect them the best we can,” said Kim Kinnear, a genetic counselor for UCHealth cancer centers in Northwest Colorado, who sees patients at the UCHealth Jan Bishop Cancer Center in Steamboat Springs. “The stories I love to hear are when we’ve either caught a cancer super early or protected a family member because of the results.”

Who should receive genetic counseling for cancer?

Your primary care provider is your best resource for determining whether genetic counseling for cancer may be helpful for you. In general, people who may want to consider genetic counseling include those with a first- or second-degree relative with ovarian cancer, pancreatic cancer or a young cancer; those with three or more relatives with certain cancers on the same side of the family; and those with a known genetic risk in the family.



“But we’re always happy to see anyone if they’re concerned about cancer risk in the family, even if they don’t meet the typical criteria,” Kinnear said.

Depending on your risk for cancer, insurance may cover the test; if it doesn’t, the out-of-pocket cost is about $250.

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How does it work?

Kinnear begins by meeting with a patient, either in person or virtually, to review their medical and family history and to provide information about the process. Then, a blood or saliva sample is tested to determine whether someone has specific sequences of genes that have been connected to higher cancer risk.

Once Kinnear receives results, she meets with the patient, again. “We talk about results with everyone, no matter what the results are,” Kinnear said.

What happens if the test is positive?

If the genetic test reveals someone is at higher risk for a cancer, earlier screenings and other preventative measures may be recommended.

For instance, a woman who is at higher risk for breast or ovarian cancer may begin screening for breast cancer as young as age 25 and may decide to have her ovaries removed when she’s 35 to 45. People who show higher risk for colon and uterine cancers may start colonoscopies in their 20s, and women may decide to have their uterus removed by age 50.

“Our goal is always earlier detection,” Kinnear said. “Any cancer is always better treated if it’s found earlier.”

What if results are inconclusive?

Inconclusive results mean that genetics labs are gathering more information to determine whether a particular gene sequence is related to increased cancer risk.

“It’s pretty common to get uncertain results,” Kinnear said. “About 90% to 95% of those end up being downgraded to benign.”

No further testing is needed, but once more information is available, Kinnear reaches back out to patients, whether that’s months or years later.

Are there risks?

By law, health insurance companies and employers cannot penalize a person based on results of a genetic test for cancer. However, results may be used to determine cost or eligibility for a new life insurance plan. Kinnear always talks through that risk with patients.

She also reminds them that no test is perfect. Just as a positive test doesn’t mean someone is definitely going to get cancer, a negative test doesn’t mean that they won’t.

“I remind them the result is negative based on the genes we’re looking at the time of the test,” Kinnear said. “If results are negative, we go back to family history and make screening recommendations based on that.”

Is this test the same as ones online?

No. The tests done through a genetic counselor are much more specific and detailed, and results are private.

“If you have strong family history of cancer, see a genetic counselor,” Kinnear said. “You can use other tests with caution — they’re good for fun, but take the health information with a grain of salt.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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