Genetic Counseling and Testing

New Patient Appointment or 214-645-2563

Approximately 5 to 10% of cancers are caused by an inherited genetic change (mutation). Such changes or mutations can lead to a higher lifetime risk for certain cancers.

Our Hereditary Cancer Team

Our team consists of certified genetic counselors, physicians, nurse practitioners, patient navigators, schedulers and genetic counseling assistants. Contact us at 214-645-2563 or cancergenetics@utsouthwestern.edu for additional information on cancer syndromes, genetic testing, patient care, referrals and genetic counseling.

Cancer Genetics Program Co-Medical Directors

Meet Our Team

Genetic Counseling

Genetic counseling at UT Southwestern Medical Center helps families determine if they have an inherited predisposition to certain cancers. Our board-certified genetic counselors are trained to identify high-risk families and help them understand their risk of developing cancer as well as their options for prevention, early detection, and treatment.

Genetic counseling is important because, if a patient is found to have an increased risk of cancer, he or she might choose to take certain preventive measures to reduce the risk of actually developing the disease. Also, when patients discover they or their family members do not have an increased risk of cancer, it can relieve anxiety and avoid unnecessarily intensive monitoring strategies.

Cancer Risk Assessment

During a genetic counseling appointment, our genetic counselors perform a personalized hereditary cancer evaluation and provide each patient with a risk assessment.

The evaluation takes about 45 minutes and includes:

A detailed family medical history
Review of risk factors that includes the inherited nature of cancer, as well as environment, lifestyle, and diet
Genetic tests, when indicated, and interpretation of the results
Recommended screenings and medical interventions, if necessary
Referrals to resources for follow-up care and support

Preparing for Genetic Counseling

Prior to a genetic counseling appointment, it’s important for patients to gather as much information about their own medical history as possible and bring a copy of their medical records to the appointment.

Patients should discuss their family history with their relatives to find out who in the family had cancer, what type of cancer they had, how old they were at diagnosis, and any specific treatments they had.

If other relatives have had genetic testing, it’s useful to have a copy of their results.

Prior to genetic counseling appointment at UT Southwestern, patients will be asked to fill out our online questionnaire called CancerGene Connect. This questionnaire helps provide our genetic counselors with the maximum information about patients’ personal medical history and any family history of cancer prior to the appointment. It also allows our counselors to spend more time evaluating and discussing a patient’s particular concerns during the appointment.

The Results

After the first appointment, we will complete a cancer risk analysis and calculation. If appropriate, we might recommend genetic testing. Our genetic counselors will discuss the advantages and limitations of genetic testing with each patient.

Learn More About Genetic Counseling

The following genetic testing educational video helps explain why it’s important for patients to understand their risk for hereditary cancer.

Genetic Testing

Genetic testing is a rapidly evolving field with a wide range of testing options from a variety of labs. Many factors are taken into consideration prior to ordering testing.

Germline genetic testing looks at the genes a person is born with to help identify whether they have a higher chance of developing certain cancers. Testing is available for more than 20 hereditary cancer conditions and over 50 genes linked to inherited cancer risk, and this number continues to grow.

Most often, testing is done using a gene panel, which means many cancer-related genes are checked at the same time instead of testing just one gene. In some cases, testing a single gene may be the best option, such as when a known genetic change has already been found in the family.

Genetic counselors can help decide which type of testing is most appropriate for each person. Genetic testing technology is also continually evolving. As a result, if someone has already had genetic testing, it’s important to review previous genetic test results to determine if changes to testing technology or additional genes are now available.

Somatic Testing

Individuals who are diagnosed with cancer may also hear about or be offered another type of genetic testing called somatic, or tumor, testing. This type of testing is often ordered by a medical oncologist. It looks at genetic changes found only in the cancer cells, not the genes a person is born with.

Somatic testing is usually done on a sample of the tumor and is used to help guide treatment decisions, understand how a cancer may behave, or identify possible clinical trial options. Sometimes a blood sample is also collected to help tell the difference between inherited and non-inherited genetic changes.

While somatic testing is a form of genetic testing, it is different from germline testing and is not designed to look for inherited cancer risk. Finding a genetic change in a tumor does not mean a person has a hereditary cancer condition, and not finding one does not rule it out. Because of this, some people may still be referred for separate germline genetic testing if there is concern about inherited cancer risk.

Direct-to-consumer Testing

Some individuals may also learn about genetic testing that is sold directly to consumers, often called direct-to-consumer (DTC) genetic testing. These tests are usually done at home using a saliva sample that is mailed to a company, with results sent directly to the individual.

Most DTC tests look at small genetic differences, called SNPs, that have been linked to certain diseases or traits through research studies. Some tests focus on a few health risks, while others report on many conditions and traits. Unlike medical genetic testing, DTC results often do not provide clear or well-proven predictions about disease risk. Family history and lifestyle factors usually play a larger role in health risk and should be considered when interpreting these results.

It is important to talk to a genetic counselor to determine if clinical genetic testing is still indicated regardless of DTC results.

Billing and Insurance

Genetic testing for common high-risk hereditary cancer genes is covered by most insurance plans; however, most insurance plans do require patients meet certain criteria. The criteria are typically modeled after National Comprehensive Cancer Network guidelines.

Many genetic testing laboratories offer financial assistance programs that have income criteria to help reduce the cost of genetic testing. During a genetic counseling appointment, genetic counselors can review billing options provided by the genetic testing laboratories.

Appointments with Cancer Genetics are also billed to insurance. Discounted self-pay options are available for those who have insurance plans that are not expected to cover this service or are out of network.

Genetic Information Non-Discrimination Act

A common question people may have is if genetic testing will impact their insurance. The Genetic Information Nondiscrimination Act (GINA) is a federal law that helps protect people from discrimination based on their genetic information. GINA makes it illegal for health insurance companies and most employers to use genetic test results to make decisions about coverage, rates, hiring, or promotions. However, there are limitations to GINA. For example, GINA does not cover life insurance, disability insurance, or long-term care insurance. Genetic counselors can help explain what protections apply and answer questions about privacy and genetic information.