Genetic Counseling

Determine Your Risk of Hereditary Cancer

BayCare now offers genetic counseling. The goal of genetic counseling is to provide patients with information about hereditary cancer risk and guidelines for cancer screening and treatment.

During an appointment with a genetic counselor, patients can discuss concerns about the cancer history in their family. Patients will receive a personalized risk assessment and information about genetic testing options. Genetic counselors have specialized training and certification in how to provide support for families choosing to pursue genetic testing and follow-up consultation to discuss the implications of test results.

How can cancer be passed down in families?

DNA is passed from parent to child. Each person inherits half of their DNA from their father, and half from their mother. DNA serves as the blueprint for the body, and tells the body how to grow and change. Genes are parts of DNA that have a specific job including providing instructions for things like hair color, eye color or protecting a person’s body against cancer. Changes within genes can lead to the development of cancer. In some families, these genetic changes are inherited, or passed down from generation to generation. People who are born with these genetic changes have a higher risk to develop cancer. Certain types of cancers including breast, ovarian, and colon cancer, are more likely to be inherited within families. Most people with cancer do not develop the disease due to an inherited (also known as "hereditary") cause. Inherited forms of cancer make up 5 to 10 percent of all cancer cases.

Who is at risk for being affected by inherited types of cancer?

The following are clues that could indicate hereditary cancer risk in a family:

• Multiple generations of a family with diagnoses of cancer
• Two or more close relatives on the same side of the family affected by the same or related cancers. Close relatives are parents, siblings, children, grandparents, grandchildren, aunts, uncles, nieces, and nephews.
• Cancer diagnosis at an early age (usually under age 50)
• An individual with multiple primary tumors, or bilateral cancer (like cancer in both breasts), or multiple types of cancer
• Pattern of tumors consistent with a specific cancer syndrome (e.g. breast and ovarian, or colon and uterine)
• Rare types of cancer including male breast cancer, medullary thyroid cancer, or ovarian cancer
• High-risk ethnicity (i.e. Ashkenazi Jewish)

What is the purpose of genetic testing?

Genetic testing detects changes in genes that could increase the risk for diseases, including cancer. This type of testing involves collecting a sample of blood or saliva. Genetic testing can be used to determine if individuals have an increased risk of cancer. Genetic testing results can help you and your healthcare team make a cancer screening and/or treatment plan, help you better understand your cancer risks, and help you make decisions about cancer prevention. In addition, genetic testing results may affect medical management of family members. It is important to talk to a genetic counselor before you pursue genetic testing since genetic testing may not be right for everyone.

Is it important to talk to a genetic counselor before having genetic testing? What does genetic counseling include?

A genetic counselor can help you determine if genetic testing for a predisposition to cancer is right for you and your family. Genetic counselors understand both the science and the emotional impact of genetics. They’re trained to support you, from explaining your individual risks and options to helping you work through your decision of whether to proceed with genetic testing. Based on your medical and family history, genetic counselors can estimate your cancer risk and recommend testing, screening and management options. Genetic counselors can also answer questions you have about hereditary forms of cancer. Issues that may impact the decision to have genetic testing, such as family dynamics, the medical management of at-risk family members with/without genetic testing, confidentiality, insurability and family planning, are also discussed. Not all individuals who talk with a genetic counselor decide to have testing. Genetic counseling includes an initial consult, and may also include a result consult.

Initial Appointment

During the initial appointment, your medical and family history will be collected. It is helpful to come prepared to discuss this information. Questions about your family members will include:

• Who in your family has been diagnosed with cancer?
• What type of cancer were they diagnosed with and what age?
• Has anyone in your family received genetic testing? If so, can these results be obtained and brought to the appointment for review?

Our genetic counselor will create a detailed family tree, or pedigree. The goal of this visit is to determine if genetic testing is right for you, and assess you and your family member's risk for different types of cancer. A genetic counselor will discuss benefit and limitations of genetic testing, explain the different types of tests, and implications of genetic test results. If you decide to proceed with genetic testing, a genetic counselor will coordinate the process for you. A sample, either blood or saliva, will be collected following your initial consult.

Follow-Up Appointment

During the follow-up appointment, the genetic counselor will review your results with you and help you understand the implications for you and your family members. The genetic counselor will review screening, preventative and treatment options that may help you and your family lower your cancer risks. It’s important to know that even when a person’s genetic result does not show a hereditary predisposition to cancer, they still may have a higher than average risk of cancer due to their family history. Therefore, some increased screening options may be available to them. This is all reviewed during a follow-up appointment. Your genetic testing results and the follow-up note will be sent to your referring healthcare provider to ensure you receive appropriate medical care.

Will my insurance cover the cost of genetic counseling and testing?

Coverage for genetic testing varies among health insurance plans. When patients are called to schedule their initial appointment, information can be provided to them to determine if their plan covers the cost of the genetic counseling consultation. In addition, a genetic counselor can help you determine types of genetic tests that could be covered by your health insurance.

Can I lose my health insurance because of genetic test results?

The Genetic Information Non-Discrimination Act (GINA) was passed in 2008. This federal law protects individuals with genetic conditions from discrimination from health insurers and employers.

In 2020, Florida was the first state to enact a law that protects genetic information from life, long-term care and disability insurers. This law is House Bill 1189.

Schedule an Appointment:

Our BayCare genetic counselor is ready to meet with you and discuss your risk of cancer. Patients can be seen at the following locations:

St. Joseph’s Women’s Hospital
Laboratory Outreach
4321 N. MacDill Ave., Suite 407
Tampa, FL 33607

Axelrod Pavilion at Morton Plant Hospital
Cancer Patient Support Services
400 Pinellas St.
Suite 280
Clearwater, FL 33756

St. Anthony’s Hospital Cancer Center
Radiation Oncology
1201 Fifth Ave. N., Suite 130
St. Petersburg, FL 33705

Winter Haven Hospital
Hematology and Oncology
200 Ave. F N.E.
Winter Haven, FL 33881

Virtual visits for genetic counseling services are now offered for the safety of our patients and team members.

If you have questions about the genetic counseling services at BayCare, please call (813) 870-4238, or you can email us at cancergeneticsprogram@baycare.org.

To be seen by a BayCare genetic counselor, ask your healthcare provider to fax a referral to the following number: (813) 605-6126 with attention to BayCare Cancer Genetics Program.