Hereditary Services

Hereditary Cancer Risk Clinic

The Hereditary Cancer Risk Clinic identifies and manages patients who may have a significantly higher chance of developing certain types of cancer based on definable genetic mutations. About 5 to 10% of cancers are directly related to an inherited harmful genetic change from either the maternal or paternal side for which we can test with a saliva or blood test. These cancer types include breast, ovarian, uterine, colon, pancreatic, skin (including melanoma), prostate cancer, and a number of others. Most of these mutations are autosomal dominant, which means that if one person in the family carries the mutation, each first degree relative has a 50% chance of carrying the same mutation.

Genetic Testing

Genetic testing has become much more affordable over time, and is generally covered by insurance if a person meets specific criteria. Fortunately, if a harmful mutation is identified, we can implement screening and prevention protocols that facilitate prevention and early diagnosis. Ideally, we try to test the affected person first (the one in the family who has the index cancer). However, if they are unavailable or prefer not to be tested, we offer testing for their blood relatives if interested. Federal law prohibits discrimination against anyone who tests positive for a mutation with respect to their medical insurance (GINA).

Initial Consultation

During your initial appointment, Dr. Smith will review details of your personal and family cancer history, focusing primarily on types of cancer in the family as well as ages at first diagnosis. For this reason, it is critical for you to find out about these details and bring with you to your appointment. Dr. Smith will create a pedigree (“family tree”) to help assess whether or not you would meet criteria for genetic testing, if interested. Hereditary cancer families tend to have common patterns in the types and distribution of cancer in the family, often at much younger ages. If you decide to test, the results are typically back in 10 to 14 days.

Preparing for your Appointment

Appointments typically last 45 minutes and can be in office or via tele-health*:

Prior to your appointment, we request that you try to get an accurate cancer family history including cancer types and age of first diagnosis.
We request for you to have an accurate medication list with doses and schedules so we can update your list if applicable.
Most insurers will cover genetic testing with very little to no out of pocket cost for the patient.
Results are typically available via a secure patient portal in 2-3 weeks.
For patients who have an identified genetic mutation, we will assist with referral to a certified genetic counselor.
Follow up appointment for results disclosure is required to ensure that you have good understanding of your results.
Dr. Smith is in currently in network for Blue Cross of Idaho and Regence. He is becoming credentialed with a number of other insurers. Please call our office to check.

HELPFUL LINKS

Risk assessment (PDF)

Clinical Management tools for mutation carriers:

Gene Table

Medical management & guides

Patient Resources for mutation carriers:

facingourrisk.org