June 4, 2017

By: Anna Victorine, MS, CGC

Thanks to advances in cancer treatments, the mortality rate of most cancers today is lower than it has ever been. That means we have more cancer survivors than ever before.

Today is National Cancer Survivor Day, a day where we celebrate life.

For those who have survived cancer, today is a day to reflect on the difficult journey and celebrate victory with friends and family.

For those who have been recently diagnosed with cancer, today is a day to connect with cancer survivors who can offer you support, guidance, and inspiration during a difficult time.

Today is also a day for previvors, people who carry a predisposition to cancer and have never developed cancer. They are survivors too. They have survived the emotional journey of learning they carry a risk of cancer and have used this information to garner strength in a challenging time.

Finally, today is a day for friends and family of those affected with cancer. These individuals survived the difficult task of watching a loved one in pain and provided support and encouragement throughout the journey.

For more information on National Cancer Survivor Day, visit: http://www.ncsd.org/about-us

If you would like to connect with other cancer survivors, consider one of the following support groups. Your genetic counselor can provide you with additional support group resources for your particular cancer or hereditary cancer condition.

Breast/Ovarian Cancers: Facing Our Risk of Cancer Empowered (FORCE)

Male Breast Cancer: The Male Breast Cancer Coalition

Colon Cancer: The Colon Cancer Alliance

 About the author:

Anna Victorine, MS, CGC is a board-certified genetic counselor at Provenance Healthcare. She currently specializes in cancer genetics and personalized medicine and can help connect cancer patients and their families to local and national support groups. Appointments with Anna can be made by calling 702-478-2524.

May 17, 2017

By: Anna Victorine, MS, CGC 

Did you know that skin cancer is the most common type of cancer in the United States?

The three major types of skin cancer are melanoma, squamous cell carcinoma, and basal cell carcinoma (though other types can occur). Melanoma is the most aggressive and most-famous type of skin cancer.

Most skin cancers, including melanoma, are caused by UV radiation from the sun or tanning beds. It also tends to be more common in Caucasians and fair-skinned people and those with many moles.

Genetic predispositions to melanoma can also run in families. Some predispositions towards melanoma can also put you and your family at an increased risk of other cancers too. One example is the BRCA1 and BRCA2 genes – though these genes famously are known to increase the risk of breast and ovarian cancer, they also pose a modest increased risk of melanoma!

If you or a close family member has had any of the following signs, consider meeting with a genetic counselor to see if you could be at risk for a hereditary predisposition to melanoma:

-Multiple melanoma diagnoses in one person

-Melanoma in non-sun-exposed areas (i.e. armpit, groin, bottom)

-Multiple close family members who have had melanoma

-Melanoma diagnosed under age 50

-Multiple family members with young breast or ovarian cancers

If you’re interested in learning more about melanoma, visit this website or ask your dermatologist: https://www.cancer.org/cancer/melanoma-skin-cancer.html

 About the author:

Anna Victorine, MS, CGC is a board-certified genetic counselor at Provenance Healthcare. She currently specializes in cancer genetics and personalized medicine. Appointments with Anna can be made by calling 702-478-2524.

May 8th, 2017

By: Anna Victorine, MS, CGC

 I see patients all the time who are adopted or who do not know much information about their family history. Just because your family history is full of question marks does not mean that genetic testing is not an option for you. Though a detailed family history can guide the genetic consultation, there are many genetic testing options that can still help someone identify his or her health risks.

For people who are adopted, genetic testing can actually

 be an enormous tool in managing their health!

If an adopted person is planning his or her family, for instance, carrier testing is available to see if they are at risk to have a baby with various genetic disorders that may cause birth defects, intellectual disabilities, or other major medical issues. For many conditions, carriers are healthy but if their partner is also a carrier, they are at an increased risk to have a baby with the condition. A common example is cystic fibrosis, a chronic lung disease which causes a build-up of thickened mucus in the lungs which makes breathing extremely difficult. Carrier couples are typically healthy but have a 25% risk to have a baby with the condition with each pregnancy. 1 in every 25 people of Caucasian descent is a carrier of this condition, so many people will test to see if they are a carrier even if they have no family history of the condition. Many people who are adopted consider carrier testing in their family planning decisions.

A variety of genetic testing options also exist for adopted people who are simply looking to learn more about their risk of health conditions, especially cancers and cardiovascular disease.  Ancestry testing, which can be ordered without a doctor, can be used to learn about your family’s ethnic background. Some ancestry testing even has the capability of linking related family members together through shared DNA registries. There have been several stories on the news of close relatives finding each other simply through these registries!

If you’re adopted, don’t be discouraged. Genetic testing is absolutely still an option for you and we welcome you as a patient!

About the author:

Anna Victorine, MS, CGC is a board-certified genetic counselor at Provenance Healthcare. She currently specializes in cancer genetics and personalized medicine. Appointments with Anna can be made by calling 702-478-2524.

April 10, 2017

One of the hottest stories in the news right now is the FDA’s recent decision to allow direct-to-consumer (DTC) genetic testing company, 23andMe, to market and offer genetic testing for genetic predispositions towards ten common conditions, like Alzheimer’s disease and celiac disease. One question you may immediately find yourself asking is:

“Why does this matter?”

Simply put, the FDA’s decision is monumental because it points to a growing acceptance of allowing patients to explore their DNA without the guidance of a healthcare professional like a doctor, nurse, or genetic counselor. DTC tests, unlike clinical tests, are available from the comfort of your own home. All patients have a right to make an independent decision to pursue this type of testing and the FDA’s groundbreaking decision emphasizes that point.

Before you decide to undergo the 23andMe test or any other direct-to-consumer test, consider a few things:

1)    Genes are not fate. Our health is influenced by a combination of genes and the environment. Just because you test positive for predispositions to disease does not mean you will ever, actually, develop the disease. Similarly, a negative result does not mean there is no risk. Though we know a lot about how genetics impacts our risk of disease, there is still much we do not yet understand.

2)    Results could be upsetting or startling. Before typing in that credit card information, read through the explanations of possible health conditions you could learn about and make sure you are comfortable with the possibility of discovering an increased risk of a condition. Think about what you might do with that information – would you feel empowered or anxious?

3)    Surprises happen. Some ancestry tests, for instance, allow you to import your genetic data into genealogy tools and help you find distant relatives. Occasionally, though, these tests may discover something surprising like a half-sibling you didn’t know about, for instance. There are also cases of adopted individuals accidentally discovering a biological parent. Though rare, consider surprises and how you might react – would you be excited by surprise information or upset?

4)    Genetic counseling can help you understand your results. Most DTC genetic testing companies will give you results but won’t give you a customized risk assessment. Genetic counseling after receiving DTC results can help you to understand where your risk falls on the spectrum and what steps you and your family can take to reduce the risk. In some circumstances, additional genetic testing through a doctor or genetic counselor may be needed to further clarify your risk.

5)    Your results can impact your relatives. If you carry a risk for disease, for instance, your children, siblings, parents, and other relatives may also be at risk. Start a discussion with your family and see what types of genetic information your relatives do and do not wish to know.

6)    Your DNA is private until it isn’t. DTC tests may not be forthcoming on who has access to your genetic data. Some companies go to great lengths to keep your genetic data secure. Others may make your data anonymous and sell it to third parties. Some companies allow you to opt-out of sharing while others require an opt-in and others have no clear option at all. If you are concerned about the privacy of your data, do your research before mailing in a DTC test and pay attention to the fine print.

7)    DTC tests are generally not covered by insurance. Medical grade genetic tests, on the other hand, often are covered by insurance if certain criteria are met. If there is a specific medical question you are trying to answer using genetic testing, consider meeting with a genetic counselor before clicking the “buy” button to see if a DTC test is sufficient or whether a medical grade test is a better use of your time and money.

DTC tests are an exciting new way for patients to explore their DNA. If you have questions about a DTC test, do your research, contact the laboratory, or consider meeting with a genetic counselor to learn more.

About the author:

Anna Victorine, MS, CGC is a board-certified genetic counselor at Provenance Healthcare. She currently specializes in cancer genetics and personalized medicine and is happy to meet with patients to discuss DTC testing. Appointments with Anna can be made by calling 702-478-2524.

March 10th, 2017

Colon cancer is one of the most common cancers in the United States, affecting approximately 1 in every 22 people.

Though the majority of colon cancers occur randomly, at least 5-10% of all colon cancers are due to an inherited, genetic risk in the family. Unfortunately, many people who carry genetic predispositions to colon cancer never know they are at risk until they develop cancer.

Genetic counseling, paired with genetic testing, can identify genetic predispositions to colon cancer before it ever develops. Armed with information, we can enhance colon cancer surveillance to help these patients avoid ever developing the disease. For those who have already had colon cancer, genetic testing can provide an explanation for why they developed the cancer and help to protect the patient from future cancers.

There are many warnings signs that genetic counselors use to evaluate families for the presence of an underlying genetic predisposition to colon cancer. These warnings signs can help the genetic counselor determine the best genetic test to offer and identify the family members who are at risk. Some of these warnings signs include:

Multiple relatives on the same side of the family with colon cancer

Family member with colon cancer under the age of 60

Family member with multiple colon polyps (precancerous bumps)

Multiple types of cancer in the same relative

Know Your Risk!

If you are concerned that you or your family member may carry a predisposition to colon cancer, or any other cancer, the first step is to gather as much information as you can about your family history of cancer and schedule a genetic counseling appointment!

About the author:

Anna Victorine, MS, CGC is a board-certified genetic counselor at Provenance Healthcare. She currently specializes in cancer genetics and personalized medicine. Appointments with Anna can be made by calling 702-478-2524.

February 4th, 2017

February is Cancer Prevention Month! Cancer prevention is an art and requires a combination of healthy choices, screenings, and regular conversations with your doctor. The following are some helpful tips that can be used to start a discussion with your doctor on ways to reduce your risk of cancer.

Know Your Family History:

Your family history can be a big clue into establishing which cancers you may be at highest riskfor. Write down the cancers on each side of the family, including who had the cancer and how old they were when they were diagnosed. Ask your relatives on both sides of the family and make sure to share this list with your doctor. If you have a family history of cancer, especially when it involves people under age 60, genetic counseling and genetic testing may be a helpful next-step to determining your risk.

Screening:

One of the strongest ways to prevent cancer is to stay current on cancer screenings. The earlier a cancer is detected, the better the patient’s prognosis. How do you find early-stage cancers? Screening! For women, routine pap tests substantially reduce the risk of cervical cancer, making cervical cancer one of the most preventable cancers. Routine mammograms can help find breast cancer in early, more treatable stages. For both sexes, colonoscopies can reduce the risk of colon cancer by removing precancerous lesions called polyps. There are many types of additional cancer screening options, which are often selected by your doctor due to your personal and family history of cancer.

Vaccines:

Vaccines do not replace the need for cancer screening, but can be used to reduce your risk of certain cancers. The human papilloma virus (HPV) is the culprit behind the majority of cases of cervical cancer. The HPV vaccine is a powerful tool in decreasing the risk of cervical cancer, vulvar cancer, vaginal cancer, and anal cancer. The hepatitis B vaccine can be used to reduce the risk of liver cancer, which is commonly caused by the hepatitis B virus.

Lifestyle:

Cigarettes are responsible for the majority of cases of lung and bladder cancers, but did you know that smoking can also increase your risk for many other cancers? If you’re a smoker and want to reduce your risk of cancer, quitting is one of the best choices you can make for your health. For those who do not smoke, try to avoid excessive second-hand smoke exposure. Skin cancer is the most common cancer in the United States. To prevent skin cancer, avoid excessive sun exposure and sun burns by wearing sunblock, avoid tanning beds, seek out shaded areas, and utilize hats and protective clothing. Maintaining a healthy weight, staying active, and eating a diet high in fruits and vegetables have been shown to reduce the risk of many diseases, including cancers. Excessive alcohol consumption has been shown to increase the risk of a variety of cancers, including cancers of the mouth, throat, liver, breast, and colon so limit alcohol consumption to reduce your risk.

January 18th, 2017

By: Anna Victorine, MS, CGC

When patients are referred to a genetic counselor, one of the most common questions we get is “what should I expect?” There are many reasons why a patient may be referred to a genetic counselor, such as a personal or family history of cancer, cardiovascular disease, or birth defects, but consults will often include the following elements. First off, though, what exactly is a genetic counselor?

A genetic counselor is a specialized healthcare professional that assists patients through the genetic testing process. Genetic counselors teach patients about genetic conditions, guide them through genetic testing options, order the appropriate genetic test, interpret the result, and make management recommendations based on the result.

During the session, the genetic counselor will review your medical history in detail and will typically draw a diagram of your family (called a “pedigree”) and the various health conditions affecting your relatives. The genetic counselor will use these tools to teach you about the genetic condition(s) in your family. This typically includes a background discussion of DNA, genes, and abnormal genetic changes (called “mutations”). They will use this information to calculate the chance that you or other family members will be affected with the condition(s). They will review the features of the condition, associated risks, and treatment options with you.  If you are a good candidate for genetic testing to confirm if you have the condition, they will discuss your genetic testing options, including benefits, limitations, insurance coverage, anticipated cost, and how the results will impact you and your family. They will also interpret the genetic test results for you and your physicians, making medical management recommendations based on the result. Though these conversations can be quite detailed, genetic counselors often use visual aids, analogies, and descriptions to make sure to understand all information discussed. Genetic consultations often are 30-60 minutes, which leaves plenty of time to answer all of your questions.

Think of your genetic counselor as your advocate, helping you to make an informed decision about your risk for disease and in managing your health.

About the author:

Anna Victorine, MS, CGC is a board-certified genetic counselor at Provenance Healthcare. She currently specializes in cancer genetics and personalized medicine. Appointments with Anna can be made by calling 702-478-2524.

December 12th, 2016

As 2016 winds down, it is time to look to the future of Provenance Healthcare. And, in order to look to the future we surely cannot ignore the past. Our practice’s goal is to help patient’s identify and manage their disease risk, through comprehensive genetic evaluations and genetic testing.

This year, we saw a substantial rise in patient volume and phone calls, showing that patients and physicians alike share in our goals. We worked with teenagers, grandparents, and everyone in between. We met patients struggling with cancer, patients looking to start families, and patients who had been stuck in diagnostic odysseys. Each patient had a story to tell and we are so grateful to have been part of their journeys. As a practice, we continue to grow from the empowerment and bravery of our patients and their families.  We look forward to serving our community for many years to come. . We are excited to meet a new wave of patients in 2017 and spread the word to even greater distances around the Las Vegas valley.

Thank you again for a wonderful 2016! We cannot wait to see what 2017 has in store for Provenance Healthcare!

October 24th, 2016 

It’s a fact many of us are all too familiar with – breast cancer is common. On average, 1 in every 8 women will develop breast cancer at some point in her lifetime; female breast cancer makes up nearly 15% of all new cancer cases in the US each year according to the National Cancer Institute. Though there is still much to learn on the risk factors for breast cancer, there is one risk factor which is very well established – genetics.

Women who have a family history of breast cancer, especially when diagnosed under age 50, have a higher risk of breast cancer compared to women who have no family history of the disease. Why? Genes.

A gene is a small subset of your DNA which carries out a specific function in your body. We all have thousands of genes, including a subset whose jobs are to protect us from cancer. When one of these genes does not work properly, it can put the person in a higher-risk category for cancer. Two of the most famous genes that can increase the risk of cancer when they are not working properly are BRCA1 and BRCA2. Though these genes are responsible for a large portion of hereditary breast cancers, there are many other genes that can increase the risk of breast cancer as well.

What should you do if you have a family history of breast cancer? Talk to your doctor or genetic counselor about your risk. In certain situations, evaluations by a trained genetics professional can be crucial in determining whether you may carry one of these genetic predispositions to breast cancer and can also establish the right screening guidelines for you. With the right screening in place, cancers can often be caught in early, more treatable stages. Knowing your genetic risk of cancer can be life-saving.

About the author:

Anna Victorine, MS, CGC is a board-certified genetic counselor at Provenance Healthcare. She currently specializes in cancer genetics and personalized medicine. Appointments with Anna can be made by calling 702-478-2524.