Genetic Counseling Services
What causes cancer?
In general, cancer occurs as a result of multiple errors (mutations) in the genes of a cell. The mutations are often the result of aging and/or environmental exposures. There are various factors that can impact a person’s risk of cancer including smoking, use of hormones, dietary intake, viral infection, and many other factors. Mutations accumulate in cells over many years (which can begin as early as after a person is born) - much the same way that errors can be introduced into a long report that has been retyped many times - and eventually, the accumulation of mutations results in cells that grow uncontrollably. These abnormal cells may spread to other parts of the body if not detected and treated early. Most cancers tend to occur after age 50, in part because it may take that long for cells to lose their control mechanisms.
The majority of cancers are considered to be sporadic – they occur by chance and involve both genetic and environmental factors.
What is hereditary cancer?
Five to 10% of cancers are related to a hereditary cancer condition, caused by mutations in cancer predisposition genes that are inherited or passed on from parent to child. A mutation in a cancer predisposition gene causes an individual to be predisposed (have a high chance compared to the general population risk) to develop cancer. Some cancer predisposition genes have been identified for breast and ovarian cancer (e.g., BRCA1 and BRCA2 genes), colon cancer (genes for familiar adenomatous polyposis or hereditary nonpolyposis colorectal cancer, HNPCC), medullary thyroid cancer, and many others.
In families with a hereditary cancer condition, there are usually several people in the family, often in more than one generation, with the same or a particular pattern of cancers. Cancer in these families tends to occur at an earlier age than average, frequently when people are in their 30's or 40's. Individuals who carry a cancer predisposition gene mutation may develop more than one cancer in their lifetime. For example, a carrier of a BRCA1 or BRCA2 gene mutation may develop breast and ovarian cancer or cancer in both breasts.
For more information about hereditary cancer syndromes, you may wish to visit the Kaiser Permanente Regional Genetics website, speak with a genetic counselor in the Genetics Department at Kaiser San Jose or visit the Cancer Genetics Overview website of the National Cancer Institute.
Genetic Counseling Services
Genetic counseling services are available at Kaiser Permanente San Jose and other Kaiser centers throughout Northern California. Genetic providers include clinical geneticists (MD-trained providers), genetic counselors (master’s degree trained providers), genetic psychologist (PsyD-trained provider) and laboratory geneticists (PhD-trained providers). As part of a genetic evaluation, you may meet with one or more of these health care providers.
Although the field of genetic counseling has been around for over 30 years, many people are unfamiliar with the role of genetic counselors in medicine. Genetic counselors are health professionals with specialized graduate degrees and experience in the areas of medical genetics and counseling. They work as members of a health care team, providing support and information to patients and families about genetic conditions. Genetic counselors identify families at risk for a genetic disease, investigate the health conditions present in the family, interpret information about the disorder, analyze inheritance patterns and risks of recurrence, and review available options with the patient and/or family. Genetic counselors also provide support to cope with the emotional, psychological, medical and social consequences of genetic disease and/or genetic testing.
How can I speak with a genetic counselor?
You may wish to discuss your specific concerns about your personal and/or family history with your health care provider, who may refer you to Genetics. Alternatively, you can also call the Kaiser Permanente San Jose Genetics Department at 408-972-3300, or the Genetics Department in your area. If your personal and/or family history includes breast and ovarian cancer, you may be asked to attend a Genetics class on Breast and Ovarian Cancer (either in-person or online) prior to meeting with the genetic counselor.
What can I expect during the genetic counseling session?
Initial discussion with a genetic counselor may occur by phone. The counselor will review your medical history and take a detailed family medical history (i.e., a pedigree or medical family tree), discuss patterns of inheritance, provide a risk assessment, and address psychosocial concerns. An in-person appointment may be scheduled based on your history, risk assessment and/or concerns. Often, the counselor may request that you obtain medical records on affected relatives prior to scheduling the appointment. If genetic testing is initiated (and it may not be in all cases), you can expect to meet with providers in the Genetics department several times.
Cancer Genetics Services offered at Kaiser Permanente San Jose.
Physician/Clinician Directory San Jose Genetics Department.
