Should I see an oncology genetic counselor?

May 30, 2024

The Lewis Cancer & Research Pavilion has two genetic counselors to help you learn if you are at a higher risk of cancer due to your genes

We all know smoking can lead to lung cancer; frequent sun exposure can cause skin cancer. But there are a percentage of cancers not caused by lifestyle or environment. Instead, it’s due to mutations in our genes we naturally inherit from our family.

There’s no need to be mad at grandma or dad. Certain people are born with a predisposition, a genetic mutation that puts them at higher risk of getting cancer. How do you know if you are one of these people? Genetic testing.

Cancer is a genetic disease in that it is caused by certain changes to genes that control the way our cells function, especially how they grow and divide. Up to 90 percent of cancer is sporadic and due to certain lifestyle and environmental factors or aging. However, inherited genetic mutations play a role in the remaining percentage of cancer cases.

To help our cancer patients and their family members better understand DNA and cancer, the Nancy N. and J.C. Lewis Cancer & Research Pavilion has two genetic counselors, Jacob South and Mugdha Devalkar.

Genetic Counselor Mudgha Devalkar

“A genetic counselor is someone who helps a patient who is either battling a genetic disorder or has a family member with a genetic disorder better understand how it came to be and their risks,” explains Devalkar. “One of the main things I enjoy about being a genetic counselor is it’s not just about the genetic testing but the counseling side of it. We are on this journey with them.”

Who should see a genetic counselor?

The genetic counselors meet with individuals already diagnosed with cancer or individuals with family history of cancer who meet criteria that they may be at greater risk of one day developing cancer. They may also meet with someone who is just curious about their risk of cancer; for example, someone who is adopted and has limited information about their biological family, Devalkar says.

You need a referral to see a genetic counselor. Your oncologist or primary care physician can refer you or you can self-refer by calling the office at 912-819-8679.

Genetic counselors do not meet with every single cancer patient, as some cancers are less likely caused by genetic mutations. Skin (except melanoma) and lung are often caused by lifestyle and environmental factors.

However, there are certain cancers that are more hereditary than others. For example, if you have a family member with ovarian cancer, you should consider genetic testing because about one in five, or 20 percent, of ovarian cancers are hereditary. Other common hereditary cancers include breast, pancreatic, stomach, colon and some thyroid related cancers.

So it’s not just females who need to be aware of this, Devalkar advises. She encourages anyone with a large family history of cancer to consider genetic counseling.

Related Article: Should I have my genes tested if my mother or grandmother had breast or ovarian cancer? 

What to expect during the meeting?

You can meet your genetic counselor either in person or through a telehealth appointment, says Devalkar. Telehealth has proven to be especially helpful for patients who can’t or don’t want to come to Savannah, such as our Hinesville and Bluffton patients.

You will be asked to answer questions about your medical history and family history. As best you can, we want to know any cancers or diseases in your family. It’s also helpful to know how and at what age your deceased relatives passed away. We closely look at the medical history of children, siblings, parents and grandparents.

“We are looking at patterns in the family that would make us suspicious that this is inherited in the family,” Devalkar says.

Then based on that, you’ll go over testing options, potential results and what those results could mean. During the visit, we also discuss cost for genetic testing, Devalkar says. Genetic testing is not nearly as expensive as before. Most labs offer a self-pay price that can range between $200 to $300. Patients can be offered financial assistance based on eligibility.

It’s important to note, not everyone who sees a genetic counselor may choose to be tested.

“We do not force people to get tested. We facilitate shared decision making based on the person’s values and beliefs,” Devalkar says. “Not everyone wants to know and that’s completely OK. I think it’s better to see the information we share so you can make a well-informed decision.”

If you do choose to get tested, you can do it on the same day as your counseling appointment at the LCRP. If you do a telehealth appointment and want to continue with testing, we’ll mail you a kit. The blood draw can be further facilitated at our nearby sites or your primary care physician’s office.

When the results are in, your genetic counselor will call you with the results.

“Even if it’s negative, there can be different managements you may want to consider based on personal and family history,” Devalkar says. “You may test negative, but if you have a family history of colon cancer, for example, you may qualify for increased screening.”

It’s also important to note, any type of positive result doesn’t automatically mean you’re going to get cancer.

“Just because someone is positive (for a certain gene mutation) doesn’t mean they have or are going to get cancer,” Devalkar says. “It means they have an increased risk than someone who doesn’t have a genetic predisposition and should be screened differently. Based on the genetic predisposition, individuals can qualify for additional screenings like mammogram, MRIs, colonoscopies, etc.”

The future of genetic testing

Genetic testing is more available and affordable than in the past, and it’s only going to continue to grow. Especially in the field of oncology, researchers are learning more and more about our DNA and cancer.

“Labs often update their gene panels to match up with the current research,” Devalkar says. “A decade or so ago, genetic testing for cancers primary involved two genes: BRCA1 and BRCA2. Now, we have more comprehensive panels that can better help with risk assessments for our patients.”

If you are interested in genetic counseling, talk to your physician or call us at 912-819-8679.


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