Smilow Cancer Genetics & Prevention Program

The Smilow Cancer Genetics & Prevention Program is a team of specialists, including physicians, geneticists, genetic counselors, genetics clinical coordinators, and advanced practice providers, who work together to provide cancer genetics education and coordination of genetic testing to inform cancer risk assessment, precision treatment for patients with cancer, and surgical management decisions.

Patients seen in the Smilow Cancer Genetics & Prevention Program will typically first meet with a genetic counselor, a genetics clinical coordinator, or have a combined visit with one of our specialty providers and a genetic counselor. Genetic counselors are licensed medical professionals with advanced training in genetics who help patients understand and adapt to the medical, psychological, and familial implications of genetic contributions to diseases such as cancer. Genetics clinical coordinators are key team members who enable expedited evaluation and genetic testing for patients who meet the criteria for genetic testing as part of our novel Fast-Track Program.

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Tuesday, March 12, 2024

What Is Genetic Testing for Hereditary Cancer?

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Our Approach

An initial pre-test visit in the program typically includes the following:

Detailed review of a patient’s medical history and their family history of cancer
Risk assessment of the chance that the cancer(s) in the family are hereditary
Discussion of the risks, benefits, and limitations of genetic testing
Coordination of genetic testing and detailed discussion of genetic test results
Discussion of appropriate medical management recommendations, implications for family members, and support resources
Coordination of cascade testing, which is genetic testing of blood relatives of individuals with genetic pathogenic variants identified

Our specific goals include the following:

Clinical: Provide patient-centered care and foster collaboration among health care providers
Research: Advance the field of cancer genetics, risk prediction and prevention, and related treatment options
Education: Provide clinical/didactic experiences for genetic counseling students, medical students, residents, fellows, and other providers
Community Outreach: Promote awareness of hereditary cancer risk and provide broad-based education about cancer prevention options

Who may benefit from a hereditary cancer genetics evaluation and testing?

Someone with:

A personal or family history of early-onset cancer (age 50 years or younger)
Several family members on the same side of the family with cancer
A personal or family history of breast cancer and Jewish ancestry
A personal or family history of ovarian, pancreatic, triple-negative breast cancer, or metastatic prostate cancer at any age
A personal or family history of multiple colon polyps
A personal or family history of multiple cancer diagnoses within the same individual
A personal or family history of a rare type of cancer/tumor (breast cancer in a male, medullary thyroid cancer, sebaceous carcinoma, or adenoma)
A family history of a known gene pathogenic variant (such as BRCA1, BRCA2, MLH1, MSH2, etc.)
A person with cancer where the genetic results may help determine eligibility for targeted therapy
A strong personal and/or family history of cancer who has had prior negative genetic testing performed more than five years ago. Additional testing may be appropriate.

Our Services

The services we offer to help patients have access to genetic testing include:

Genetic counseling: This approach entails meeting with a licensed genetic counselor to review the benefits of and considerations for genetic testing, genetic testing options, and the potential impact of genetic test results for patients and their relatives to make an informed choice about genetic testing. As part of the cancer genetics risk assessment, the genetic counselor will also discuss medical management recommendations following national guidelines. This approach may be particularly beneficial for people who have a family history of a hereditary cancer syndrome or a complex personal or family history of cancer.
Fast-Track Program: In this novel approach, patients meet with a genetics clinical coordinator for an expedited visit to receive information about hereditary cancer and coordination of genetic testing. Results will be disclosed to patients with the medical management recommendations under the oversight of a licensed, certified genetic counselor.
Point-of-Care Testing: Our program partners with multiple clinical teams to help clinicians introduce and discuss genetic testing with their existing patients, order genetic testing, and review results to expedite the testing process in the care of patients. Our team works together with clinical teams to see patients after testing is completed for a full review of recommendations based on genetic results and family history, and to discuss cascade testing as needed.

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Learn more about the Smilow Cancer Genetics & Prevention Program.