Understanding the complexity of genetic and genomic testing can be daunting for patients. UT Southwestern has a large team of board-certified cancer genetic counselors who help patients through the various stages of testing and medical action. Genetic counselors have master’s level postgraduate training in human genetics and patient education. They work with patients to determine if genetic testing is right for them and what genes should be analyzed.
Prior to their appointment, patients at UT Southwestern are given access to an online program called CancerGene Connect (developed at UT Southwestern) to complete their medical and family history of cancer. This program allows patients to reach out to family members for information about their family’s cancer history and submit that data before the appointment to our genetic counselors, who then use various risk assessment models to quantitate the patient’s chance of having a genetic predisposition to cancer. Risk assessment helps determine if genetic testing is warranted, as well as if other medical interventions or surveillance tests, such as breast MRI scans, are needed.
Genetic testing has become more complex in just the past two years with the advent of next generation sequencing (NGS) panel testing. With more than 100 commercially available germline gene tests, deciding which test is best for a patient requires the expertise of a genetic specialist. In some cases, it’s appropriate to look for a single, specific gene, but in other cases a select NGS panel is needed to target all the known genes that fit the patient’s family history. Our genetics team uses national guidelines and clinical expertise to determine which genes should be tested. The entire team of counselors and the program’s director hold a weekly case conference to review all cases in depth as well as emerging data on new developments in cancer genetics. For example, we continuously evaluate the various commercial genetic testing laboratories to determine the quality of their tests.
When to refer for genetic counseling?
- Early age of cancer onset
- Multiple family members with the same cancer
- Bilateral cancers
- Cancers in the family that are part of a known cancer predisposition syndrome