What is a Genetic Counselor? Should You See One?

Genetic Counselor Marianne Vivien, MS, LCGC, with Overlake Cancer Center, answers your questions about what genetic counseling entails, when a patient should seek genetic counseling and what to expect when meeting with a genetic counselor.

What is genetic counseling? How does it work?

Genetic counselors are healthcare professionals with specialized graduate degrees and experience in medical genetics and counseling.

Genetic counselors guide and support patients who are seeking more information about:

• How inherited diseases and conditions might affect them or their families.
• Whether genetic testing is appropriate.
• Interpreting genetic test results based on a patient's personal and family history.

Genetic counselors can specialize in prenatal, pediatric, oncology, neurology, ophthalmology, psychiatry and many other areas. You may be referred to a genetic counselor by a doctor (such as an obstetrician, oncologist or medical geneticist) to discuss your family history and genetic risks. With expertise in counseling, genetic counselors can also provide emotional support and empower patients with information they can use to make important healthcare decisions.

Who should seek genetic counseling and when?

Generally, people are offered testing if they are diagnosed with a genetic condition or have a family history of a particular genetic condition.

In the case of cancer, someone may seek genetic counseling and testing if they have been diagnosed with cancer at a young age or have a significant family history of cancer. Some types of cancer, such as ovarian or pancreatic cancer, warrant testing at any age—even without a family history.

Consider genetic counseling and testing if you have a personal or family history of any of the following:

• Diagnosed with breast cancer in 50s or younger.
• History of ovarian cancer, pancreatic cancer or metastatic prostate cancer at any age.
• Colorectal or uterine cancer in 50s or younger.
• Diagnosed with any cancer in 50s or younger.
• Significant family history of a variety of cancers.
• Ashkenazi Jewish ancestry.

What should you expect when meeting with a genetic counselor?

A genetic counseling session typically takes 30 minutes to an hour. During the session, your genetic counselor will review your family health history in detail. This is to help your medical care team make appropriate management and prevention decisions, and attempt to determine which side of the family the inherited condition came from. Your counselor will also assess the chances for other family members, such as your children, to develop the same condition. They will discuss genetic testing available for your condition and how such testing can help you and your family. They will guide you through decision-making about genetic testing, family planning and medical management.

In the case of cancer, genetic counselors and doctors use test results and other cancer risk factors to design individualized risk management programs—including recommendations for cancer screening and options for preventive measures.

How did you become interested in genetic counseling?

I was 15 years old when I figured out what I wanted to do with my life. We were learning about genetics in biology class and a genetic counselor came to talk to my class about her job. Something clicked for me then—which ultimately led me to pursue a career in this field. The more I learned, the more fascinated I became. Getting to be a part of this dynamic and growing profession, as we continue to make advances in genetics and precision medicine, is really cool. The work I do is incredibly rewarding and there is never a dull moment.