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Thu, Jun 24, 2021 at 05:00 PM

Marshall Cancer Center provides genetic testing, counseling

Teleconferencing brings genetic services to Marshall County patients

Thanks to the Marshall Cancer Care Center’s association with UAB Cancer Network, local patients have access to genetic testing and in-house consultations with a genetic counselor.

Genetic counseling and possible testing are options for those with a strong immediate family history of cancer, especially if they have a history of multiple cancers, such as breast and ovarian cancer in the same family, said Tara Burnor, nurse navigator at the Cancer Care Center. Age also can be a factor.

“Patients diagnosed with cancer at a younger age are more likely to have a genetic mutation,” she said.

Genetic testing is a type of medical test that identifies harmful differences in chromosomes or genes. The results of a genetic test may be able to confirm or rule out a suspected genetic condition or help determine a person's chance of developing or passing on a genetic disorder. Tests require only a simple blood test or saliva test to be sent to a qualified laboratory.

Some testing has been done since the Cancer Center opened in 2013 but there’s a growing use of local patients teleconferencing with UAB’s genetic counselor. Having that service available in Marshall County saves patients from having to drive to Birmingham.   

“The genetic counselor goes over the patient’s history of cancer and history of family genetics,” Burnor said. “She tells us which tests to do and sends the orders. We draw blood and send it out to a lab.”

Meagan Farmer, a licensed genetic counselor with UAB’s Department of Genetics, explained that, in general, genetic counselors are professionals who have specialized education in genetics and counseling to provide the personalized help that people need as they make decisions about their genetic health. Genetic counselors work in many areas of medicine.

In oncology, patients and their physicians want to know:

  • If their cancer or a relative's cancer had a hereditary cause
  • Whether they might be at increased risk to develop cancer, or if they have cancer whether their genetic status may change treatment options or indicate they're at increased risk to develop a new cancer
  • If they have an increased risk of cancer based on their genetic status what can be done to reduce this risk or detect cancer earlier
  • Who else in the family might be at risk

Genetic counselors take extensive medical and family histories, review these histories for clues that there may be an underlying hereditary cause for the cancers seen, identify what genetic test may be most appropriate, interpret the test results and outline implications of the results for the patient and their relatives, to include screening and risk-reducing options when possible, Farmer said. Patients can then discuss these options with their physicians. Through all of this, the genetic counselor offers psychosocial support and considers when additional sources of support may be appropriate. This might include support groups, patient advocacy groups and/or professional counseling.

With only about 5,000 certified genetic counselors in the country, many healthcare and cancer centers do not have access to their services. Telemedicine is helping fill that gap.

“UAB believes equitable access to specialized care is critical, so we provide telehealth access to specialty care such as genetic counseling to our partners in rural areas,” Farmer said.

For instance, if a patient’s BRCA test results come back positive, a teleconference will be scheduled with the genetic counselor. She will explain the results, what cancer screening and risk reducing options are available, what tests the patient’s children and other close relatives might need, and when they should be scheduled. 

The BRCA gene test is a blood test that's done to determine if you have changes (mutations) in your DNA that increase the risk of breast cancer. Mutations in either breast cancer gene — BRCA1 or BRCA2 — significantly increase the risk of breast cancer.

Sometimes testing is recommended around the age of 18 for children of those with genetic mutations. Mammograms could be recommended for those in their 20s, Burnor said. With colorectal cancer, results can apply to brothers and sisters, in addition to children. Siblings may need to start colonoscopies as early as 18.

Marshall Cancer Care Center has arranged genetic tests for patients with:

  • Pancreatic cancer
  • Lung cancer
  • Skin cancers
  • Ovarian cancer
  • Breast cancer
  • Colon cancer

After results are in, a teleconference can be scheduled in the cancer center or at the patient’s home.

As doctors learn more about the genetic causes of and genetic influences on disease, genetic testing can provide important clues about the origin of disease or symptoms. Genetic testing can also provide families with more information about long-term needs, health care needs and future family planning.

“We can tell a patient’s family members when to start looking for cancer, when they need to start scheduling exams, especially with children,” Burnor explained.

It’s been known for years that early detection is the key to fighting cancer.  Genetic testing allows doctors to start looking for cancer when they know a patient is genetically disposed to it.

“It’s definitely making us look for cancer earlier,” Burnor said. “Earlier screening, earlier detection. It gives us a baseline of when we need to start.”

Patients need a referral from their doctor to have a test. The staff works with insurance companies in an effort to get the cost covered. Genetic testing can be expensive, but costs have come down significantly over time, and it is often covered by health insurance when testing guidelines are met.  When there is not full insurance coverage, testing may still be possible with a nominal cash payment option and/or patient assistance programs.