Genetic Counseling for Gynecologic Cancers

The Division of Gynecologic Oncology offers Hereditary Cancer Risk Counseling to individuals with ovarian or endometrial cancer who may have a family history of cancer or who are concerned about inherited risk. The service offers information, genetic testing and guidance about the inheritable risk of gynecologic cancers so that informed choices can be made, and treatment can be personalized to the patient.  Many patients and families use the service annually. The genetic counseling team includes: doctors, oncology nurse specialists, psychologists, and a board-certified genetic counselor that are specially trained to provide current information about the risk of developing cancer based upon the personal and the family history of cancer.  Patients may be referred by their own physicians or self-refer.

Genetic counseling and testing for inherited risk is offered to most ovarian cancer patients. In addition, anyone who has initial endometrial cancer surgery at Siteman has tumor genetic screening with their pathology testing.

Pre-test genetic counseling is important to make an informed choice on genetic testing and dealing with the results. The service helps women and their families make informed decisions about genetic testing for genes that predispose to cancer, providing individualized recommendations for cancer screening and prevention based on personal medical history, cancer family history and/or genetic testing results.

Counseling and testing is recommended specifically for the person in the family who has a diagnosis of cancer. It can help determine if there is risk for other cancer types or recurrence. Research continues to sort out individualized treatment, based on genetic characteristics. Genetic counseling can be scheduled at the same time as a consult with the gynecologic oncologist.

Fortunately, most cancer is not due to hereditary risk in the form of gene mutations passed down from the previous generation, but rather from a combination of genetic and environmental interactions, such as smoking and diet. A family history of cancer does not necessarily mean you are high risk for developing cancer. Hereditary risk for cancer, due to a single gene mutation, is responsible for only about 5 percent to 10 percent of cancers overall. Ovarian cancer due to hereditary risk is estimated at 10 to 15 percent of cases.

Heredity risk for uterine cancer is about 5 percent. Surgery is the primary treatment for endometrial (uterine) cancer.  After surgery, the tumor is carefully studied and the findings are summarized in a pathology report that your doctor will review with you at your post-operative visit.  A genetic screening test called IHC (immunohistochemistry) will be performed on newly diagnosed endometrial cancers as part of the pathology evaluation. The IHC test is used to determine if your endometrial cancer may be due hereditary risk for cancer called Lynch Syndrome and if genetic testing is indicated.

Genetic counseling and testing may be appropriate for women with endometrial cancer and another cancer type such as colon or ovarian cancer, and a family history of cancer.

Some of these genes have been identified, making genetic testing available for several different hereditary cancer predisposition genes. Different factors, such as the pattern of cancer and ages of diagnosis in your family, guide recommendations for genetic testing and/or cancer screening and prevention.

To find out if genetic counseling is appropriate for you, review the Heredity Risk Assessment website.