by Chester County Hospital
Nicholas Jensen is the new genetic counselor at The Abramson Cancer Center at Chester County Hospital.
Nick, who comes to the Center after earning his master’s in genetic counseling this year from Arcadia University, sums up his little-known field this way:
"I meet with individuals who have a personal or family history of cancer that is indicative of hereditary cancer syndrome – meaning a genetic change that has been passed down and increases the personal risk for developing cancer in one's lifetime."
"My job is to look at that picture to see if there is a genetic predisposition to certain cancers, and then to help people navigate the world of testing to see what can be offered and what is right for an individual patient.
Nick is one of more than 4,000 genetic counselors across the country working in clinics and hospitals with obstetricians, oncologists and other doctors, according to the National Society of Genetic Counselors. Their advanced training in medical genetics and counseling not only allows them to interpret genetic test results, according to the Society, but also to guide and support patients as they weigh and process information on:
- How inherited diseases and conditions might affect them or their families
- How family and medical histories may impact the chance of disease occurrence or recurrence
- Which genetic tests may or may not be right for them, and what those tests may or may not tell
- How to make the most informed choices about health-care conditions
In short, genetic counselors are the bridge between a complex and ever-evolving science and the individual. They translate the potentially overwhelming information on tests and their impact and guide the patient into a partnership with health-care providers and scientists toward the best course of testing or treatment for them – the very definition of personalized medicine.
While Nick's work will focus exclusively on cancer, genetic counselors work in a variety of specialties, including: preconception and prenatal, pediatric, cardiovascular, and neurology.
A wide range of patients come to see Nick, both men and women of all ages. Many are referred by breast surgeons or medical oncology teams because they fit profiles indicative of hereditary cancer syndrome, including being younger than average for a diagnosis, multiple generations of their family diagnosed with certain cancers, or signs of rare cancers.
These genetic tests differ greatly from those looking solely at ancestry. "While both tests are looking at DNA, they are using different technologies and provide very different results," Nick said. "The clinical testing ordered by genetic counselors is targeted, diagnostic and much more comprehensive." In addition, Nick delivers test results to his patients personally – so they are hearing them from a counselor who knows them and their family and medical histories.
Nick suggests thinking of the 20,000 genes in the human genome as the seven-book Harry Potter series. His genetic tests don’t need to comb through the entire series. Instead, they zero in on the genes known to be related to the cancers seen in a person’s history – checking every letter on pages 7 to 20 in book four, for example. The goal is to discover if genes designed to suppress cancer or tumors have mutated, explaining a diagnosis or alerting a patient that they are at risk for certain cancers.
While there is a psychological benefit to explaining the prevalence of a disease within a family, the test results also help determine next steps. For example, for a woman already diagnosed with breast cancer, testing positive for a disposition to the disease can strengthen the case for a more serious surgical option such as a bilateral mastectomy – or suggest more aggressive screening with annual MRIs or mammograms. If there is no previous cancer diagnosis, a positive test result can point to increased screening.
Nick is not only there to counsel patients as they receive such life-altering news, but to help them work through sharing the news with family members. Some patients may not want to be the bearer of bad news, or feel guilt at passing on a potential medical issue.
"We help them with ways to cope, how to approach that conversation," Nick said. "And we can guide them and their family members toward additional testing and counseling, depending on what's best for them."
Nick’s personal approach to his work, and the challenges and rewards of the field, are neatly summed up in a TEDx Talk by genetic counselor Jaclyn Haven:
"We often find ourselves in the middle of very complex and difficult situations, oftentimes involving multiple family members and … very difficult emotions like guilt and blame. Mostly we see love between family and it is a tremendous privilege for me to help families through those situations."
Related Information from Chester County Hospital: