Genetic Counselor Helps Patients Manage Cancer Risks

Friday, February 27, 2015

WellSpan now offers expert counseling in the burgeoning field of genetics in York, Adams and Lancaster counties.

WellSpan licensed genetic counselor Amanda Matchette works with physicians to help their patients understand the cancer risks they might carry within their genes, and the options available for managing those risks.

“We are like detectives when gathering information about the family history,” Matchette explains. “We discuss the genetics of cancer and explain how gene mutations can be passed down through families. When test results come back, we go over what the implications are for the individual and their family and how to proceed with these results.”

Many patients are unfamiliar with cancer genetics, or only associate it with Angelina Jolie. In 2013, the film star opted for a preventive double mastectomy based on her family’s extensive history of breast and ovarian cancer and known familial mutation.

“We call it the Angelina Jolie effect,” Matchette says. “It did make people more aware of the role that genetics has in cancer development.”

Jolie’s case also highlighted the importance of personal choice, Matchette says. People with the same risk factors may choose completely different treatment plans.

“It can be difficult when an individual doesn’t have cancer but knows they have a gene mutation that causes an increased risk for cancer,” she says. “They haven’t been affected but now have to think about their increased risks and what this means for their future. It’s a very personal decision.”

A genetic counselor can provide information and an additional resource to physicians who are helping a patient with a cancer diagnosis. Matchette guides patients and families through the decision-making process and helps with related issues, such as anxiety.

Matchette says it was counseling’s personal interaction that drew her out of the lab and into the profession. She gets to play the roles of scientist, teacher, listener and advocate.

In the past, oncology patients who needed genetic counseling were sometimes referred to healthcare organizations outside of the area. With this new service offered by WellSpan, genetic counseling fits seamlessly into a patient’s care plan.

“We’ve had a lot of referrals from providers,” says Shelli Laux, Administrative Director of WellSpan’s Oncology Service Line. “We actually had a waiting list for Amanda when she started.”

Douglas Arbittier, MD, MBA, Vice President of WellSpan’s Oncology Service Line, says patients aren’t the only ones to benefit from the addition of a genetics expert. It is a boon to physicians as well.

“It seems there are new genetic tests every month, and they’re all very complex,” Dr. Arbittier notes. “It gets hard to know which tests to order, and then it’s hard to interpret the results. Now a physician’s office doesn’t need to worry about acquiring all that expertise on their own.”

Matchette can partner with physicians to identify patients who are appropriate for genetic testing. It might be obvious to consult a genetic counselor about a patient who has a strong family history of cancer or who has had multiple cancer diagnoses. However, WellSpan’s genetic counselor can also help physicians’ patients who:

  • Have been diagnosed with cancer at a young age (usually before age 50)
  • Have a family member who has a known genetic mutation discovered through genetic testing
  • Have a personal or family history of rare cancers (such as male breast cancer or pancreatic cancer)

Performed by a blood or saliva test, genetic testing can determine if cancer in an individual or family is due to a single change in their gene(s).

“Genetic testing looks to see if the specific letter code of our DNA that make up our genes are in the correct order,” Matchette explains. “If not, you can think of the change as a ‘misspelling,’ or mutation.

“Based on patients’ personal and family history, we will determine if they are candidates for genetic testing and which gene(s) to test (a gene panel). For example, if there is a lot of breast and ovarian cancer in the family, we might think of testing the BRCA1 and BRCA2 genes.”

Matchette adds: “We don’t want patients to become anxious about their cancer risk. Genetic counseling and testing can help alleviate some stress and give patients and their physicians information to help understand their situation and what options are available.”

If you are interested in learning more about genetic counseling and testing, call WellSpan’s genetic counselor at 717-741-8077.