Cancer genetic testing: A key to better care and outcomes at the WVU Cancer Institute
Each year, about 2 million Americans are diagnosed with cancer. More than 13,000 of those patients live in West Virginia, according to the American Cancer Society. While most tumors or blood cancers develop randomly, genetic mutations are responsible for up to 20 percent of cases. If you have cancer, or a family history of cancer, the expert cancer genetics team at the WVU Cancer Institute can help determine if your DNA increases your risk.
“Whether it’s from genetics or environmental factors, West Virginia has one of the highest rates of cancer in the United States,” Samantha Hall, NP, NP-C, APRN, a hematology and oncology nurse practitioner who is part of the cancer genetics team, said. “Many patients across the state don’t realize that genetic testing is available to them, but it is. We work with anyone to make sure they get the testing they need. And that testing can help direct their care.”
Genetic testing is a vital part of precision oncology care. The test results help create a personalized treatment plan designed around each patient’s specific needs, according to Amanda Moran, PA-C, a breast surgery and surgical oncology physician assistant who is also part of the program.
“Genetics plays a role in every aspect of cancer care and treatment,” she explained. “It’s important to identify all patients who have the potential to carry these genetic mutations. It can significantly impact their treatment planning.”
A caring, specialty-trained cancer genetics team
The WVU Cancer Institute genetics team is unique. Hall, Moran, and Christen Jordan, MPAS, PA-C, a hematology and oncology physician assistant, do more than just examine genes.
“Our program is unique because we not only evaluate and diagnose but also treat patients through medical or surgical oncology,” Moran said. “Our team’s additional genetics training and certification help us assess a patient’s health history, family history, and genetic test results when we are concerned about an inherited cancer.”
Each team member has completed specialized cancer genetics training through the City of Hope Intensive Course in Genomic Cancer Risk Assessment, one of the nation’s leading cancer research programs. This training helps ensure that patients receive accurate answers and understand how their genes might influence current or future cancer risks.
Comprehensive testing to guide your care
Following National Comprehensive Cancer Network guidelines, the team determines which patients need genetic testing. It routinely provides this analysis to patients newly diagnosed with breast, colon, ovarian, or pancreatic cancer, as well as those with a family history of certain other cancers. Testing services are available to Cancer Institute patients and those referred by community-based providers.
The genetic testing process is simple, according to Hall. “During in-person or virtual appointments, a team member asks about your lifestyle behaviors. They also ask about your personal and family health histories. It’s important for us to understand which of your family members had cancer, what type of cancer it was, and their age at diagnosis. We’ll collect a small sample of your blood or saliva (spit) and send it to a lab for analysis. If you’re unable to come to our office, we can send a collection kit to your home. You can mail a saliva sample directly to the lab.”
Each hereditary genetic test evaluates a patient’s DNA to identify genetic mutations linked to cancer. The lab uses a method called Next Generation sequencing. It examines the building blocks of each patient’s DNA to give them the most detailed analysis possible. Test results are available in MyWVUChart accounts within two to four weeks, and members of the genetics team will follow up with a phone call to discuss the outcome.
Medical insurance may pay for genetic testing. For those without insurance, the analysis costs between $100 and $250 out-of-pocket. Many genetic testing companies offer payment plans or financial assistance programs. Also, under the Genetic Information Nondiscrimination Act, medical insurance companies can’t use test results to deny coverage or discriminate.
How cancer genetic testing impacts your care
According to Jordan, test results frequently lead to changes in care plans or screening recommendations. With this knowledge, the team can better support patients and help them make informed decisions about their treatment options.
“Genetic testing often impacts how we manage patients,” she said. “You never have to choose a treatment you’re uncomfortable with. But for people who have cancer, test results can open up medication and surgical treatment choices. Testing can also help us identify future cancers risks and inform care for you and your family.”
A positive result may mean a patient needs additional medication. For example, some breast cancer patients with a BRCA1 mutation qualify for an oral medication called a PARP inhibitor. Patients usually take this medication after chemotherapy or radiation. It can help reduce the risk that cancer will come back.
A patient’s genetic analysis may also change surgical plans. For instance, it can help a patient decide between a lumpectomy or mastectomy. A lumpectomy removes a tumor from the breast. A mastectomy completely removes the breasts to prevent future cancer.
Even if a patient doesn’t have cancer, test results can show they need certain tests that can help protect their health. For example, the genetics team may recommend a patient start colonoscopies earlier and have them more often. Or they may need a mammogram and a more detailed breast MRI to help detect breast cancer.
Genetic testing results can also affect families, Moran said. “If you have a positive result, your immediate family members should undergo testing as well. Family cascade testing is often offered by the participating lab free of charge for these relatives.”
An investment in long-term well-being
Moran said the overarching goal for the cancer genetics team is to provide valuable, individualized health information. This knowledge can improve each patient’s current and future health.
“For us, genetic testing isn’t just about capturing a patient’s mutation and guiding care plans. It’s about using advanced technologies for early detection and disease prevention,” Moran explained. “We want to reduce overall mortality for the coming generations.”