Genetic counseling is a professional healthcare service designed to help you understand how the genes you were born with, and your family history, may affect your future health. For example, you may have a higher risk of developing colon cancer than the average person because of your genetic test results and/or family history.

Genetic counseling gives you an empowered understanding of your family history and genetic test results. Our genetic counselors also offer ongoing support and updates on personalized cancer prevention and treatment plans tailored to your life.

Approximately 5-15% of cancers are hereditary, caused by inherited “errors” or mutations in genes that normally work to protect us against cancer. These mutations can increase an individual's risk of developing certain types of cancer.

However, it's important to note that having a mutation doesn’t ensure that cancer will develop. The presence of a genetic mutation indicates a higher risk, but it doesn't mean that a cancer diagnosis is inevitable.

If cancer runs in your family, genetic counseling may be a good option for you, especially if you have a personal or family history of any of the following:

• Early-onset cancer; cancer diagnosed before age 50, particularly types like breast, colon or uterine
• High-risk cancers including ovarian, pancreatic or aggressive prostate cancers
• Family cancer patterns like several close relatives with similar or related cancer types on the same side of the family
• Rare cancer types such as medullary thyroid cancer, childhood sarcomas or pheochromocytoma/paraganglioma
• Multiple primary cancers, meaning multiple cancers diagnosed in one individual
• High-risk groups including those with over 10 pre-cancerous colorectal polyps or Ashkenazi Jewish ancestry with diagnosed breast or prostate cancer

The possible test results of genetic testing could be:

• Positive: An identified gene mutation – also known as a genetic error – may increase your risks of developing certain conditions, such as cancer. It's important to note that carrying a mutation doesn’t mean that you’ll develop cancer; however, earlier and more frequent cancer screenings, along with other preventive measures, may be recommended to manage your risks.
• Negative: No mutations are identified. The risk to develop cancer is based on personal and/or family history of cancer.
• Variant of unknown significance (VUS): A gene variation is identified that has limited or conflicting evidence of disease risk. Most VUS are ultimately reclassified as benign.

Ultimately, in the context of your personal and/or family history, your genetic test results will help you understand your future cancer risks. If testing reveals that you’re high risk, your care team will explain the next steps and your options.

Information from genetic testing can be highly valuable in optimizing your health and wellness. Here’s how you can use it effectively:

• Determine if you have an increased risk of developing certain diseases, including various types of cancer
• Develop a personalized risk reduction plan, which may include earlier and more frequent screenings, medications, lifestyle modifications, wellness programs and preventive surgical options
• Share the information with your family to expand the benefits of your genetic testing to your children, siblings and other relatives

If you’ve already been diagnosed with cancer, genetic testing can still play a crucial role in optimizing your treatment and managing your health.

Cancers can develop due to specific genetic mutations, and some are inherited. Understanding your genetic test result allows your cancer care team to personalize your treatment. Often referred to as precision medicine, this approach enables the use of targeted therapies that can be more effective against some cancers with specific mutations.

Inherited cancer syndromes often carry heightened risks for various types of cancer. Managing your personalized risk might involve enhanced measures for other risk reduction and cancer prevention.

Integrating your cancer diagnosis with genetic test results has powerful benefits when it comes to accurately understanding future cancer risks to your children, siblings and other relatives.

Even if you’ve undergone previous genetic testing, whether on your healthy cells (germline testing) or on your cancer cells (somatic testing), further testing and periodic reviews might still be necessary.

Here’s why:

• The field of genetics is rapidly evolving; updates in testing technology, overall knowledge and family histories change over time and may have implications for your healthcare.
• We recommend updating your germline testing every 3-5 years. If your previous genetic test results identified a variant of uncertain significance (VUS), please contact us to review the variant every 1-3 years.
• All cancer cells have mutations, so your oncologist may have ordered somatic genetic testing to better understand and predict cancer behavior and treatment options. However, cancer cells cannot accurately represent germline cells, and hereditary cancer genetic testing may still be needed to identify or confirm an inherited cancer syndrome.

Yes. Providence Cancer Institute of Orange County Genetics Program offers comprehensive genetic counseling and testing for hereditary cancer, inherited heart conditions and other select genetic disorders.

Our specialized cardiovascular genetics services are particularly beneficial for individuals concerned about their personal and/or family history of heart disease. Additionally, our lipid clinics offer advanced care for patients with high cholesterol levels who face increased risks of heart and blood vessel disease.

Available at select locations, these clinics feature a holistic team approach with specialists addressing issues including cardiac risk, nutritional counseling, pharmaceutical support and genetic testing.

If you or your family members have experienced any of the following, cardiac genetic counseling and testing may be recommended:

• Aortic aneurysms or dissections of the thorax (upper body) or abdomen (lower body)
• Arrhythmias, or heart rhythm issues, like Brugada syndrome, Long QT syndrome and catecholaminergic polymorphic ventricular tachycardia (CPVT)
• Cardiomyopathies, or enlarged heart conditions, including hypertrophic (HCM), dilated (DCM), arrhythmogenic right ventricular dysplasia (ARVC), left ventricular non-compaction (LVNC) and familial ATTR amyloidosis
• Heart disease occurring before age 50, or 3 or more close relatives on the same side of the family affected by similar heart conditions at any age
• Very high cholesterol – total cholesterol over 350mg/dL – LDL cholesterol over 190mg/dL or a history of familial hyperlipidemia
• Unexplained sudden cardiac arrest or death, especially before age 45

If you have concerns about a family history of other diseases, our genetic counselors can help you explore available options. Please reach out to our office to discuss your specific needs and concerns.

Health insurance typically covers genetic counseling consultations. The cost of genetic testing for people who qualify based on the pattern of cancer in their personal and/or family history also tends to be covered. If you have healthcare coverage through an insurance exchange, the Affordable Care Act (ACA) includes provisions for genetic testing. If genetic counseling and/or genetic testing aren’t covered by your health insurance, there are low-cost options and you may be eligible.

In keeping with the Providence Mission, we offer financial assistance programs that provide free and low-cost care to those who are eligible. You can fill out an application or contact us for more information.

Yes. All your personal and family history information, along with genetic test results, remain confidential. Only you, your referring physician and any healthcare providers or relatives you authorize will receive copies of genetic counseling reports and test results.

We adhere to healthcare privacy laws and won't release your information without your written or verbal consent.

No. The Genetic Information Nondiscrimination Act (GINA) prevents health insurers from using your genetic information to deny coverage, set rates or influence any form of underwriting for health insurance. However, GINA doesn’t cover other types of insurance such as life, disability or long-term care.

GINA also protects against the use of other family members’ genetic test results or medical history for health insurance discrimination. The act also protects against discrimination by employers. Questions and concerns about privacy relating to genetic test results are reviewed during a genetic counseling visit.