Genetic Counseling

If you think genetic counseling would be helpful, discuss it with your doctor. For more information or to schedule a consultation with one of our certified genetic counselors, please contact us at 859-323-2798 or email us at cancergenetics@uky.edu.

For referring physicians: To refer a patient for genetic counseling, please submit the Clinical Genetic Counseling referral form via fax (859-257-0475) or e-mail it to us directly. If you have questions, please contact us at 859-323-2798. For referral guidelines, please visit our clinical genetic counseling webpage.

Our appointments are currently being done via both telecare and in-person visits. You can learn more about Telecare at Markey online. For more information on these appointments, please ask your healthcare team for more details. We will send you an email with an appointment time and a Zoom link once your telecare visit is scheduled.

The majority of insurance plans cover the cost of genetic counseling and genetic testing when you are an appropriate candidate. If genetic testing is offered to you, the laboratory will pre-authorize with your insurance company prior to testing. Our genetic counselors can provide more detailed information during your appointment.

Genetic counseling may be beneficial if you or any close relatives have had:

• Rare cancers such as ovarian cancer, male breast cancer, pancreatic cancer, triple-negative breast cancer, or medullary thyroid cancer.
• Metastatic prostate cancer or Her2 negative breast cancer.
• Early-onset cancer (typically diagnosed before the age of 50).
• One or more family members with two primary cancers (two original tumors that develop cancer in different sites).
• Multiple family members with the same type of cancer or related types of cancer (such as breast and ovarian cancer, or colon and uterine cancer).
• Ashkenazi (Eastern European) Jewish background and family history of breast or ovarian cancer.
• A known cancer-causing gene mutation (such as BRCA, Lynch, etc.)

Genetic counselors are specially trained in medical genetics in order to provide the following:

• A complete review of your medical and family history.
• Information regarding the best individual in the family to undergo testing, risks, benefits and possible outcomes of genetic testing.
• Discussion of your specific chances of having a hereditary cancer syndrome.
• Personalized risk-evaluation for management and screening recommendations, based on your personal and family history as well as any genetic testing results.

You may also learn more about genetic counselors by visiting AboutGeneticCounselors.com.

Complete the questionnaire that was sent to you by the genetic counseling office and gather the following information prior to your visit:

• Ages and causes of death for immediate family members.
• Types of cancer diagnosed in the family and ages they were diagnosed.
• If you have a cancer diagnosis, consider bringing pathology reports and medical records if they are not on file at UK HealthCare.
• A copy of any genetic test results from family members.

People are often worried that they may be treated differently by their health insurance company or their employer if they choose to be screened for genetic cancers. The Genetic Information Nondiscrimination Act (GINA) is federal legislation that protects people from genetic discrimination. Your genetic counselor at Markey can talk with you about this legislation and how it protects you.

Learn more about the Genetic Information Non-Discrimination Act at GINAHelp.org.

How can genetic counseling help you?

If you have a family history of cancer, genetic counseling can help you.

What happens during a clinical genetic counseling appointment?

The goal of genetic counseling is to provide understandable information about your risk of hereditary cancer in a supportive and educational setting. You will meet with a genetic counselor who is specially trained in cancer genetics, which means that you will get a thorough and accurate assessment of your risk of hereditary cancer. The genetic counseling appointment usually takes about 60 minutes. The length of your appointment will depend on the complexity of your medical and family history.

What is genetic testing?

Genetic testing is a laboratory test, usually done on a blood or saliva sample, which can help us determine your risk for cancer. Genetic testing may help you and your physician make important decisions about your medical care. Deciding whether or not to have genetic testing is a personal choice that can be made at the time of the counseling session or at a future date.

You will receive a cancer risk assessment from your genetic counseling session whether or not you undergo genetic testing; you are not required to have genetic testing if you come for a genetic counseling appointment. However, you must receive genetic counseling before we will perform a genetic test. Genetic counseling allows us to obtain the necessary information to give you accurate information about the risk of hereditary cancer, to determine if a genetic test would be useful, to determine which genetic test is appropriate, and to help you and your family make informed decisions about your medical care.

Who can participate?

Genetic counseling is available to anyone who is concerned about a personal or family history of cancer. A specially trained genetic counselor provides a personalized assessment of your risk of hereditary cancer; discusses cancer detection, management, and risk reduction options; and offers genetic testing when appropriate.

Who can benefit from genetic counseling?

If you answer "yes" to any of the following questions, you may benefit from genetic counseling:

Have you or a close relative been diagnosed with cancer at age 50 or younger? Has more than one member of your family been diagnosed with the same type of cancer? Have you or a family member been diagnosed with more than one type of cancer? Are you related to someone who is known to have a genetic condition or mutation that increases the risk of cancer?

We understand that many personal factors must be considered when making decisions regarding cancer detection, prevention, and genetic testing. These include your medical issues, your state of mind, your beliefs, and your family's experience with cancer. The genetic counselor can address your concerns with sensitivity and support, and tailor each counseling session to fit your personal needs.

Is genetic counseling for cancer and genetic testing covered by insurance?

Most insurance companies cover genetic counseling and testing. To determine whether genetic counseling is covered by your specific insurance, you may contact your insurance company directly. The procedure code that we bill is 96040. Genetic testing is billed separately from genetic counseling and is typically covered, provided that you meet the criteria.

The option of genetic testing and any insurance issues regarding testing will be discussed with you during your appointment. If you do not have insurance or if you are covered by Medicare or Medicaid, you can contact our office at 859-323-2798 with your questions regarding coverage.

Can genetic testing affect my insurance?

Federal law (Genetic Information Nondiscrimination Act) makes it illegal for health insurers to use genetic information to deny insurance coverage, change the terms of coverage or increase individual premiums. If you have concerns about the effect of genetic testing on your insurance, they will be addressed during the genetic counseling appointment.

What about my privacy?

We will not release information about your hereditary cancer risk assessment to anyone other than you and your referring physician without your prior written consent.

Is clinical genetic counseling right for me?

If you think genetic counseling might be helpful to you, discuss it with your doctor.

For more information, or to schedule an appointment, call the UK Markey Cancer Center's Clinical Genetic Counseling Program at 859-323-2798.