Cancer/Oncology

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Cancer/Oncology

Cancer Genetics Clinic

The HealthEast Cancer Genetics Clinic sees patients who have concerns about their risk for cancer or the possibility of cancer running in their family.

Our clinic offers genetic counseling and testing to help you make informed decisions about medical care. Knowing your cancer risk can affect the way you approach cancer prevention, detection and treatment.

Contact the Cancer Genetics Clinic

We're here to help you take a proactive approach.

Concerned about your inherited cancer risk? We offer genetic counseling and testing to help you make informed medical decisions.
651-326-7610

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Frequently Asked Questions

Q: How can genes affect cancer risk?

A: Each cell of the human body has around 25,000 pairs of genes. Genes are the instructions that tell our body how to grow and develop. Some genes help decide your hair and eye color, while other genes work to help prevent cancer. In some families, mutations or problems in these genes are passed from one generation to the next, increasing a person’s risk to develop cancer, and at a younger age.

Q: What is genetic counseling?

A: Genetic counseling involves meeting with a genetic counselor who has specialized training in medical genetics. The genetic counselor will collect a detailed personal and family history and provide an assessment of your cancer risk. The genetic counselor will also determine whether genetic testing is appropriate and, if so, which test (s) should be completed. If you choose to proceed, the genetic counselor will arrange for testing and help you and your family members understand the results, which can be complex. Genetic counselors also have training in psychosocial counseling to help navigate the unique family dynamics, emotions and complex decisions that sometimes accompany genetic testing and genetic disease.

Q: How can genetic counseling and testing help me?

A: For individuals that have already had cancer, genetic testing may help to clarify your chance of getting a new cancer (including the same type or even a different type of cancer), so that your medical team can treat your current disease while also looking out for your future risks. For those newly diagnosed, results of genetic testing may impact decisions about cancer surgery or, in some cases, treatment.

For individuals that have not had cancer, genetic counseling and/or genetic testing can help evaluate how your risk is impacted by your family history.  Better understanding your risk for cancer will help to determine whether you may benefit from proactive measures, such as additional screening tests, preventative surgeries or risk-reducing medications. Likewise, genetic counseling and testing may provide reassurance that these measures are unnecessary for some. 

Test results and any recommendations for increased screening or prevention measures will be provided to your doctor so you can work together to implement a personal and effective care plan.

Q: How can genetic counseling and testing help my family?

A: Genetic mutations often run in families. So, if you have an inherited risk for cancer, others in your family may, too. If a gene mutation is identified in you, the genetic counselor will explain the inheritance pattern and outline the information to share with your relatives. If you have had cancer, your testing may be the most informative way to evaluate risk of a hereditary predisposition, not just for yourself, but for your family as a whole. Providing relatives with information about their risk can be a powerful tool to help change the course of cancer in your family.

Q: What does genetic testing involve?

A: Genetic testing usually involves a blood draw sent for DNA analysis at an outside laboratory. There are many genetic tests available and the genetic counselor will discuss your options with you including benefits and limitations of each.  

Not everyone is a candidate for genetic testing and some people who are may decide not to pursue testing, or to take additional time to consider their options after meeting with a genetic counselor.  

Those who do not pursue testing may still benefit from genetic counseling. For some, increased screening or prevention measures will be recommended based on assessment of the family history alone.

Q: Who should consider genetic counseling and testing?

A: Individuals with a personal or close family history of any of the following may benefit from genetic counseling/testing:

  • Known gene mutation in the family (even in more extended relatives)
  • Breast cancer and any of the following:
    • Diagnosed at age 45 or younger
    • Diagnosed at age 50 or younger with a second breast cancer in the same or another relative, regardless of age
    • Two other relatives (on same side of family) with breast, prostate or pancreatic cancer, regardless of age
    • Jewish ancestry
  • Other cancers:
    • Ovarian, fallopian tube or primary peritoneal cancer diagnosed at any age
    • Colon cancer diagnosed at age 50 or younger
    • Endometrial (uterine) cancer diagnosed at age 50 or younger
    • Renal (kidney) cancer diagnosed at age 45 or younger
    • 10 or more colon polyps (adenomas)
  • Rare diagnoses:
    • Male breast cancer
    • Medullary thyroid cancer
    • Paraganglioma/pheochromocytoma
    • Hemangioblastoma
    • Choroid plexus tumor
    • Adrenal cortical carcinoma
    • Retinoblastoma
    • Wilm’s tumor
    • Multiple Peutz-Jeghers or juvenile polyps

Relevant family history includes diagnoses in a parent, child, sibling, aunt/uncle, grandparent or niece/nephew. History in more extended relatives (for example, first cousins) may also be significant.

Keep in mind, this is an abbreviated list of indications for cancer genetic counseling/testing. Other features in a family may also warrant genetic counseling, including early-onset cancers, bilateral or multiple primary cancers, or familial clustering of cancers. Anyone concerned about their risk for cancer is welcome to meet with a genetic counselor to more thoroughly assess their personal/family history.  

Q: Is genetic counseling/testing covered by insurance?

A: Genetic counseling is often covered by medical insurance, although there are some exceptions. You are encouraged to check with your insurance company to find out about your specific coverage. If genetic counseling is not covered, it is still generally a much lower cost than that of genetic testing.

If you decide to pursue genetic testing, the genetic counselor and laboratory will work with your insurance to obtain pre-authorization of testing for you. Some insurance companies require genetic counseling prior to testing.

Q: Can genetic counseling/testing impact my health insurance coverage?

A: There is a federal law in place called GINA that makes it illegal for health insurance companies to use family health history or genetic test results as a reason to deny health insurance, or decide how much an individual pays for health insurance. Groups not covered by GINA generally have policies in place that provide protections similar to GINA.

Q: Who can I call with questions or to make an appointment?

A: You may contact the HealthEast Genetics Clinic at 651-326-7610. If your doctor has submitted a referral for genetic counseling, the Genetics Clinic will contact you to schedule your visit. Appointments are available at St. John’s Hospital in Maplewood or at Woodwinds Health Campus in Woodbury.

What’s New in Cancer Genetics

  • A landmark Supreme Court ruling has over-turned a patent previously held by Myriad Genetics Laboratory on the BRCA1 and BRCA2 genes, which means this testing is now more widely available. Some laboratories now offer this testing at a lower cost, although choosing an adequate laboratory involves more factors than cost alone.  
  • New technology called next-generation sequencing has created more testing options for patients concerned about their risk for cancer than ever before. For example, gene panels offer simultaneous analysis of multiple (5-50) genes related to cancer risk. Of course, this can also lead to more complex test results.
  • Angelina Jolie publicly shared her story of pursuing bilateral mastectomy after testing positive for a mutation in the BRCA1 gene. Women with mutations in BRCA1 or BRCA2 have several options to manage their increased risk for breast as well as other cancers. Some women will opt for preventative mastectomy like Angelina while others will pursue heightened breast surveillance. For Angelina, testing was prompted by her family history of breast and ovarian cancer.  
  • Research continues to grow around individualized cancer treatments that target the genetic error in individuals with a hereditary predisposition leading to their diagnosis. Clinical trials are currently available for some individuals with a positive genetic test and more broad access to these treatments is expected in the future. 

Genetics support groups

People with hereditary cancer predisposition face unique medical challenges and complex decisions. Feelings of frustration or isolation may impact individuals and family members. The purpose of these groups is to bring together those facing similar challenges and to provide a forum to discuss the latest information.

  • The BRCA Information and Support Group is for women with a mutation in the BRCA1 or BRCA2 gene. It meets once a month for 90 minutes, four times in the spring and four times in the fall, with an additional special summer family event. Meetings alternate between general support and in-depth discussion of selected topics.
  • The Lynch Syndrome Information and Support Group meets once in the spring, and twice in the fall. Together with the annual Living with Lynch Syndrome summer conference, this totals four meetings per year.

Contact Rachel for meeting dates or other questions.