Together We Can -- Newsletter of the Joan Karnell Cancer Center

Fall 2005

Putting Patients Back in the Center of their Care
Message From the Administrator
Understanding Computer Assisted Tomography
Cancer Risk Evaluation
Shiatsu Bodywork
Honors, Awards & Publications
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New CREP Coordinator:
Empowering Patients With Information

The Cancer Risk Evaluation Program (CREP) at the Joan Karnell Cancer Center at Pennsylvania Hospital welcomes Jill D. Siegfried, MS, as its new genetic counselor and program coordinator. CREP evaluates patients for risk of breast and ovarian cancer, as well as sarcomas and gastrointestinal cancers such as colon or rectal cancer.

Prior to joining the Joan Karnell Cancer Center, Siegfried worked as a cancer genetic counseling intern for CREP at the Abramson Cancer Center of the University of Pennsylvania, while pursuing a graduate degree in medical genetics at the University of Cincinnati.

As genetic counselor at the Joan Karnell Cancer Center, Siegfried meets with patients on a daily basis. She first performs an extensive evaluation of a patient’s family history, medical records and lifestyle in order to assess his or her risk for cancer as accurately as possible. Then, Siegfried educates the patient on this risk, empowering them with information to make an informed decision about the next steps in their care plan.

“Informed decision-making is central to genetic counseling,” says Siegfried. “Genetic counselors aim to take a non-directive approach, which is not typically true in the medical model of patient care. Instead of diagnosing patients, the goal is to provide them with information they need so they can make decisions about testing and treatments that are best for them.”

The knowledge that Siegfried and her counterparts at the Joan Karnell Cancer Center give their patients is extremely powerful. For instance, Siegfried says that in a small number of people, they can identify a gene that explains an increased risk for cancer in the family. In some cases, this is due to a gene alteration that causes an increased risk for breast and ovarian cancer, with women facing a 60 to 80 percent lifetime risk for breast cancer and up to a 45 percent lifetime risk for ovarian cancer. In this situation, the CREP team can educate the patient on preventive measures that can significantly reduce these risks, such as increasing surveillance, taking preventive medication or undergoing preventive surgeries.

According to Siegfried, many people have the misconception that most cancers are hereditary. In actuality, the majority of cancers are not due to a specific hereditary cause. Rather, they are most often caused by a combination of environmental and lower genetic risk factors. However, those patients whose family histories do not suggest a significant risk for a particular cancer can still benefit from cancer risk evaluation.

“Honestly, many patients leave with a sense of relief, discovering their risk may not be as high as they had perceived,” says Siegfried. “Others who discover they are at a higher then average risk for cancer often leave with a sense of empowerment, knowing there are preventive strategies that can be taken to reduce their risks.”

The philosophy of prevention resonates in the work of Siegfried and the team of health care professionals involved in the care of patients. This team includes the genetic counselor, program assistant and medical oncologists, as well as the patient’s referring physician, who recognizes the benefits gained from their patient having the information from the cancer risk-assessment.

“Some people would assert that cancer-free individuals benefit even more from the risk-assessment process, because they are able to take their known elevated risk and follow-up with measures to prevent cancer altogether,” says Siegfried. “For these people, risk reduction measures clearly help to increase quality of life and can even be life-saving.”


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