Mary E. Freivogel, MS, CGC, is president-elect of the National Society of Genetic Counselors and a genetic counselor at Invision Sally Jobe in Denver, CO.
Assessing a patient’s risk for cancer is an exciting area for collaboration between oncology nurses and genetic counselors. Oncology nurses have a very specialized skill set, and genetic counselors can complement it.
Oncology nurses are well suited to gather important patient information such as family history of cancer, identify the need for genetic counseling or testing, and talk with patients about why counseling and testing are important. Collaboration between genetic counselors and oncology nurses is especially important when approaching a case that may be particularly challenging or complex or outside of what a nurse might be comfortable handling.
With the massive changes that have occurred in genetic testing in the past few years, oncology nurses can rely on the expertise of genetic counselors in a number of ways. Multiple technologies are used to test genes: deletion/duplication analysis, multiplex ligation-dependent probe amplification, and next-generation sequencing, to name a few. So it’s really important to know the benefits and limitations of each technology to make sure you’re picking the right test for each patient, and that’s where genetic counselors can help.
Nurses and genetic counselors can also work together to address any potential fears that may keep patients from participating in genetic testing. One of the biggest concerns genetics counselors hear is that patients’ insurance won’t cover genetic testing. This typically isn’t a problem, especially if it has a clinical indication, but nurses and counselors can work together to educate patients.
Patients may also decline genetic testing because they are afraid of the results. It’s important to note that if a mutation is found, it does increase the risk for cancer, but, depending on which gene is involved, cancer risk can vary. We try to communicate to patients that genetic testing helps us know if those risks are there and if we can do something to reduce those cancer risks moving forward.
Most of all, I encourage oncology nurses and genetic counselors to form a collaborative professional relationship with each other. Discuss identification and management of high-risk patients, explore partnerships to provide quality genetic counseling services, and encourage compliance with referrals and recommendations. Oncology nurses can help dispel the myths and fears surrounding genetic testing and can act as the bridge to help patients understand the reasons why genetic testing is important. Tools like the National Society of Genetics Counselors’ “Find a Counselor” resource at NSGC.org can be extremely helpful when referring patients and connecting with a genetic counselor in your area.