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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