MS Certified Genetic Counselor
By KEN MOSIER
For What2Be
Who am I?
Name: Julie Sawyer
Title: Certified Genetic Counselor
Affiliation: Miami Valley Hospital South
Education: Bachelor’s degree, Biochemistry, The Ohio State University
Master’s degree, Medical Genetics, University of Cincinnati
Quote: “I happened to be at a health fair where there was a genetic counselor,” she said. “I really hadn’t heard of that field before so I read about it and talked to her. I thought this would be a good combination of what I liked and what I wanted. I think it was a very good choice.”
What’s2Like:
►Helping families by making science meaningful to them.
►Sharing information about the mystery world of the cell and its effects on the body.
►Usually day shift work in a controlled environment.
►Decent pay
What’s Not 2 Like:
►Having to give someone bad news.
►Possible hassles with insurance companies
►Being a newer discipline, not as many job openings exist yet.
No sci-fi here. Julie Sawyer, a certified genetic counselor, doesn’t manipulate genes to create monsters nor is she able to pull out a scanner and read your DNA.
“Basically genetic counseling is an education process,” she said. Sawyer works at the Miami Valley Hospital South campus in Centerville. Breast cancer is one topic that she covers frequently.
“(Genetic counseling) is designed to translate a lot of the basic science and medical information specifically related to genetics and inheritance to people to whom it’s relevant,” she explained. “We help to explain things that are often found in ultrasounds, help (patients) understand some of the screening test results.
“Often if there is a family history of a genetic disease, we can calculate the odds that (the disease) will occur in a baby.”
She added that most genetic counselors have spent some time in a pre-natal — usually a high-risk pre-natal center — where they help interpret test results and review family history to look for a genetic risk. “For instance, if there is a family history of cystic fibrosis or sickle-cell (anemia) or even if somebody had a particular ethnic background like African or Jewish — there can be certain conditions that can be more prevalent (to those ethnicities) and we can discuss those conditions and the testing options to screen for those,” she said.
Whereas it was more common to find genetic counselors in pre-natal and pediatric settings — such as working in children’s hospitals — counselors have been expanding into other areas and venues.
“Probably in the last 10 to 15 years, genetic counselors have been branching out into other areas of genetics such as cancer. (They are) working in laboratories helping design testing panels and interpreting test results and even in things like marketing and PR from commercial testing laboratories and things like that,” Sawyer said.
“My work here is working with women who have an increased risk for — primarily — breast and ovarian cancer,” Sawyer explained. “There are a couple of genes that were discovered in the mid-1990s called BRCA-1 and BRCA-2 that are related to breast cancer risk.
“So those genes, which we all have, can be inherited in some families in a damaged form and they are not providing the health benefits that they should,” she continued. “In those situations, women (and men) are at increased risk for breast cancer.”
To study a patient’s family history, genetic counselors usually construct a family tree. “Usually at least three generations — sometimes four or more,” Sawyer said. “(We draw) in all the closest relatives and make a little graph with squares and circles to look at their family to see who has what health problem. We look for patterns. We look to see if it is something that seems to be passed on from parent to child or is it hit-and-miss here and there? Does it seem to be coming from both sides of the family?
“That can help us get a sense of whether or not something is genetic and how it might be inherited,” she said.
The counseling part of her title then comes to the forefront.
“Patient care usually involves a pretty long discussion where we review the person’s background information. After all that is done, we talk about — in cancer counseling — what cancer really is and the relationship between cancer and genes and (we talk about) the difference between sporadic cancer (which is always genetic) and inherited cancer risks (which are actually fairly uncommon,)” Sawyer explained. “Cancer always involves our cells and our genes but is usually something that happens over time in a person’s body — in their own cells — and not what they inherited from their family.”
Inheritance, however, is the setting that makes some families more susceptible to develop cancer than others. “That is what we test for — that inherited susceptibility.”
She added that, when a person is determined to be at higher risk, then the patient may decide to have more frequent diagnostic procedures. “More frequent mammograms, MRIs and things like that, particularly for breast cancer risks.
“I think this is where the value of genetic counseling is — helping people decide whether or not that testing is right for them. They have a lot to think about. It is not just a test from themselves, it is a test that could imply information about their parents, their brothers and sisters and their children,” she continued.
“It is not a simple decision.” She added that at-risk patients might want to have surgery to prevent the cancer from forming. There might also be questions about health and/or life insurance. She added that genetic testing is usually very costly.
Sawyer said that she enjoys meeting the families — not just the patient but often other members of the family as well. Their discussions are unlike being in a physician’s office where you are told something in a few minutes with the doctor and are expected to remember all of it when you get home.
Her job is to make sure the process is understood so that it can be remembered.
Sawyer, a native of Marysville, got her bachelor’s degree in biochemistry from The Ohio State University. She then worked for a couple of years and went to the University of Cincinnati where she received her master’s degree in medical genetics.
