Genetics and Genomics Program
Our Approach
The Cancer Genetics Program at St. Jude Crosson Comprehensive Cancer Center helps patients and families with a history of cancer better understand and manage their cancer risk. We provide genetic cancer risk assessment and develop individualized management plans for persons with hereditary or familial occurrences of cancer.
Cancer genetics is a dynamic and evolving field. Considered the leading edge of medicine, genetic testing and counseling shift the focus of cancer from treatment to prevention and early detection. For many hereditary cancer syndromes, genetic testing is available and can potentially identify the cause of cancer in the family and quantify future cancer risks for the patient and their family members.
Please call for more information about the Cancer Genetics Program, to refer a patient, or to schedule an appointment.
The Cancer Genetics Program has evolved to include experts in Genetic Counseling, Medical Oncology, Surgery, and Research. Our board certified genetic counselors and physicians provide individuals with:
- Detailed genetic counseling and cancer risk assessment
- Facilitation and interpretation of genetic testing when appropriate
- An individualized cancer screening and prevention plan
- Summary management recommendations for you and your family members
- Detailed consultation reports for you and your doctor
In an effort to provide individuals with access to cancer genetics research, all of our patients are invited to participate in a Hereditary Cancer Research Registry, which is in collaboration with the City of Hope Clinical Cancer Genetics Department.
Test results and reports vary depending on the type of cancer you are being screened for.
- Breast cancer genetic testing results are typically available in approximately 3 weeks.
- Colon cancer genetic testing and melanoma genetic testing results are typically available in 3-6 weeks depending on the specific test ordered.
- For more rare hereditary cancer syndromes, genetic testing may take 6-8 weeks.
After your genetic cancer risk evaluation is completed, you will return to your managing physician(s) for coordination of care.
Most insurance policies cover genetic counseling and testing. Our patient account specialists verify coverage prior to the patient consultation and alert the patient if genetic services are not a covered benefit. The third party laboratory that performs and bills for the genetic test will also verify coverage as a second check and confirmation of coverage.
Federal and state laws protect patients against insurance companies using genetic results to deny coverage. There are no documented cases of genetic discrimination following genetic counseling or testing for cancer risk.
Advanced Cardiovascular Genetics Care
Providence offers advanced cardiovascular genetics services for individuals and families with inherited heart disease including arrhythmias, cardiomyopathy and aortic conditions. Our experts provide cardiovascular genetic counseling, genetic testing and personalized risk assessment to help clarify diagnosis, guide treatment and identify risks for family members before serious heart events occur.
Cardiovascular Genetic Testing at Providence
Bree Johnston shares how cardiovascular genetic testing at Providence helped uncover the reason behind her high cholesterol and family history of heart disease, giving her answers and a path forward.
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- Innovative screening that can detect more than 50 types of cancer through a single blood draw.
- Patient navigators for each cancer type who will help you manage your treatment and find the resources you need.
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Frequently Asked Questions
Genetic testing may help to rule out an inherited syndrome, provide an explanation for the occurrence of cancer or heart disease in you or in your family and predict elevated risk of developing additional disease. For individuals with a current cancer diagnosis, genetic testing can provide valuable information to your treating physicians in developing the best treatment plan.
Genetic counseling is a process of receiving risk estimates, accurate understanding, management planning and empowerment for individuals and families who are concerned about their risks. It involves meeting with a licensed certified genetic counselor to review your personal and family history, to accurately interpret genetic test results, and to receive compassionate support. Genetic counselors provide personalized recommendations for screening, prevention, and risk reduction.
Genetic testing and genetic counseling testing results can provide management recommendations to help treat and prevent disease and can be used to more accurately advise family members.
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.
Our genetic counselors are qualified genetics professionals for all types of inherited risks, and are prepared to discuss the risk of developing other disorders of familial concern, including hematologic and adult neurologic syndromes. They can also help interpret direct-to-consumer tests and provide clarity on the implications of results for you and your family members.
On average, genetic test results are available within 2-3 weeks./p>
- Positive: A harmful mutation identified that may increase risk of developing certain conditions.
- Negative: No mutation identified.
- Variant of Unknown Significance: Genetic alteration identified, but our understanding of it is limited at this time.
Genetic testing is just one tool that genetic counselors use to provide you with the very best in personalized medicine that genetic testing alone cannot provide. Genetic counselors are genetic experts and remain up to date on the constantly changing field of genetics. They are trained to tailor, translate, and communicate complex genetic information into practical, accurate, and understandable decision-making information that you, your relatives, and your healthcare team can use to provide the best in individualized healthcare management. They help to insure the very best outcomes for you and your relatives.
Continued contact with genetic professionals is advised for many individuals who have undergone genetic counseling and/or genetic testing. Over time, new technologies are developed, new genes become available for testing, insurance criteria for testing may change making testing more accessible and management updates for mutation carriers become available. Additionally, family histories change over time making reassessment of the family history beneficial. We recommend having genetic counseling if you have significant family history and you previously had genetic testing without seeing a genetic counselor. In addition, we recommend contacting your genetic counselor every few years.
- If you previously had genetic counseling but genetic testing was not done: If you underwent genetic counseling without genetic testing, you may benefit from meeting with a genetic counselor again. The criteria for genetic testing have expanded, insurance companies are much more likely to cover genetic testing, and the cost of genetic testing has decreased significantly. A genetic counselor can help you review your options, order the appropriate test, and review your results and their implications.
- If you previously had genetic testing which identified a pathogenic mutation (positive results): With time, more information becomes available regarding specific hereditary cancer syndromes. If your previous genetic testing identified a mutation, it is important to keep in touch with your genetic counselor periodically to review the most up to date information regarding cancer risks and management guidelines and to make sure that your previous genetic testing was comprehensive.
- If you previously had genetic testing which did not identify any mutations (negative results): With time, more hereditary cancer genes are being identified, comprehensive genetic testing is becoming more accessible, and genetic technologies are advancing. If your previous genetic testing was uninformative because it did not identify any mutations, updated genetic testing may be indicated.
- If you previously had genetic testing which identified a variant of unknown or uncertain significance (VUS): With time, more information becomes available and variants of uncertain significance may get reclassified. A genetic counselor can review the current literature and data regarding your VUS, discuss what is known, what steps may be taken to reclassify it, and recommend further genetic testing if indicated.
Genetic testing for tumor molecular profiling (somatic) is different than genetic testing for inherited cancer risk (germline). Genetic testing of cancer tissue helps to characterize the tumor while genetic testing for inherited risk helps to estimate and reduce familial cancer risk. A genetic counselor can review tumor genetic test results in conjunction with your personal and family history to help you understand your results and your risk for an inherited cancer susceptibility syndrome.
Some DTC companies, such as 23andMe and Ancestry, offer "health" tests. These tests are not diagnostic and should not be used to make medical decisions. If you previously had DTC genetic testing and were told you had an increased risk of developing a certain condition, such as cancer, a genetic counselor can review these results with you and, if indicated, order diagnostic confirmatory testing.
In addition, DTC testing is very limited, looking at a few mutations while clinical genetic testing fully analyzes those and other relevant genes. Therefore, "normal" DTC testing results do not actually rule out hereditary cancer syndromes or other hereditary risks.
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.