Patient Resources

MedStar Georgetown Cancer Institute Patient Resources 

The MedStar Georgetown Cancer Institute offers many resources to patients ranging from support groups to psychosocial oncology. Oncology-certified clinical social workers who help navigate the many unexpected needs that arise due to cancer and its treatment. Our social workers are available free of charge to assist our patients and their families with a range of services that can reduce stress during any phase of their care.

Learn more about patient services offered at the different hospitals within the Network.

Patient Resources at MedStar Georgetown Lombardi Comprehensive Cancer Center

Psychosocial Oncology – Lombardi Comprehensive Cancer Center

Oncology-certified clinical social workers who help navigate the many expected -- and unexpected -- needs that arise due to cancer and its treatment. Our social workers are available free of charge to assist our patients and their families with a range of services that can reduce stress during any phase of their cancer care.

  • Joanne Assarsson, LICSW, OSW-C
    • 202-444-3755
  • Leonard Ellentuck, LICSW, OSW-C
    • 202-444-6288
  • Cheryl Hughes, LICSW, OSW-C
    • 202-444-3020

Psychosocial Oncology – Betty Lou Ourisman Breast Health Center

Psychosocial Support

Provides counseling and psychosocial support to patients of the Ourisman Breast Center to help manage patient’s psychosocial concerns, and provide resources in the community. Our social workers are available free of charge to assist our patients and their families with a range of services that can reduce stress during any phase of their care.

Contact: Colleen McClain, LICSW at 202-444-8091.

Psycho-Oncology Services

Kimberly Davis, Ph.D.

Dr. Davis is a clinical psychologist and assistant professor in the Department of Psychiatry at MedStar Georgetown University Hospital. She provides individual therapy to patients, survivors and family members of patients who have been impacted by a cancer diagnosis and treatment.  Dr. Davis has provided direct clinical care at the Lombardi Comprehensive Cancer Center for more than a decade, and works very closely with the providers, staff and other members of the psychosocial oncology team to address the needs of both patients and staff. 

Contact Dr. Kimberly Davis at 202-687-6925.

Patient Services

Look Good, Feel Better

These group workshops teach beauty techniques to female cancer patients to help them combat the appearance-related side effects of cancer treatment.  Cosmetology professional provide learning sessions using products donated by the cosmetic industry. In addition, each two-hour, hands-on workshop includes professional advice from a hair stylist on how to deal with hair loss using wigs, scarves, hats, hairpieces, and other accessories. Patients at various stages of treatment receive personal attention and take home instruction booklets and complimentary cosmetic kits in shades that match their skin tones.

4th Monday of every Month (except August and December) between 9:30 - 11:30 a.m.

Registration Required.

Contact: Joanne Assarsson, LICSW – 202-444-3755

Survivors Offering Support (S.O.S.)

A program at MedStar Georgetown University Hospital called Survivors Offering Support pairs women who have recently been diagnosed with breast cancer with trained volunteers who can offer emotional support and insight like no one else can, because they've tackled the disease themselves. This important "buddy support system" can help make the breast cancer journey less confusing and solitary. Whether you are facing breast cancer and could benefit from the help of a mentor or you are a breast cancer survivor and can offer help to another, SOS is for you.

Contact: Denise O’Neill at 202-444-5285 or [email protected]

Partner Support Workshop

This new workshop is designed for spouses and significant others of newly diagnosed breast cancer patients, to provide insight into caregiving and the types of support patients and their families require during a highly emotional and difficult time.

The free two-hour workshop is available to families of breast cancer patients at MedStar Georgetown University Hospital. The sessions share support methods and ideas from books like The Breast Cancer Husband, written by Marc Silver, and Caregiving, a book from the American Cancer Society, as well as real-life survivor family lessons.

Contact: Denise O’Neill at 202-444-5285 or [email protected]

Transition to Wellness - A toolkit to jumpstart your life as a breast cancer survivor 

You have successfully completed the important treatment phase of your journey and are embarking on a transition to newfound wellness. Many breast cancer patients encounter difficulties when the contact with their medical team is reduced at the same time as the fears of cancer returning begin to increase. To assist you in embracing your transition to wellness, MedStar Georgetown University Hospital encourages you to attend this free workshop that includes: 

  • Roundtable discussion by breast cancer survivors on the challenges they faced in transitioning to wellness and how to overcome those challenges.
  • Checklist of key health areas and lifestyle changes, as well as a survivorship care plan, that can assist you as you embrace life as a survivor, improving general health and well-being.
  • Wellness practitioners demonstrating new ways for incorporating lifestyle changes into your life following cancer treatment. Practitioners include nutritionists, massage therapists, journalists, exercise instructors and more.

Contact: Denise O’Neill at 202-444-5285 or [email protected]

Support Groups

Head & Neck Cancer

3rd Monday of the month between 1:30 - 3 p.m.

Registration Required. Contact Joanne Assarsson, LICSW at 202-444-3755

GI Cancers Support

1st & 3rd  Mondays of the month between 11:00-Noon

          Registration Required: Contact Leonard Ellentuck, LICSW at 202-444-6288                 

Arts and Humanities Department

This program promotes an optimum life experience for patients, family and medical caregivers with events, resources, education and environments that encourage a creative and constructive response to illness.

  • Painting
    • Monday – 10 a.m - 1 p.m. 
      MGCN Patient Resources 2
    • 2nd & 4th Tuesdays – 11 a.m. - 4 p.m.
  • Expressive Writing
    • Tuesday – 11 a.m. - 3 p.m.
  • Fabric Art
    • Wednesday – Noon - 5 p.m.
    • Thursday – 10 a.m. -3 p.m.
  • Knitting
    • Tuesday – Noon-1 p.m.MGCN Patient Resources 1
    • 1st Tuesday of the month – 5:30-7:30 p.m.
    • Wednesday – 10 a.m. - 1 p.m. 
  • Beadwork
    • Wednesday – 10:30 a.m. - 1 p.m.

*Please Note: All times are approximate. Artists move throughout the Lombardi Comprehensive Cancer Center clinic and MedStar Georgetown University Hospital. For specific scheduling information, please contact Arts and Humanities Director, Julia Langley – 202-444-7228.

Wig Closet

Donated wigs are provided to patients in need – or who need a new look.

Contact Cheryl Hughes, LICSW, OSW-C at 202-444-3020.

 

Community Outreach at The Ruesch Center for the Cure of Gastrointestinal Cancers

Learn more about upcoming events and community outreach initiatives

Patient Resources at MedStar Washington Cancer Institute

Clinical Social Work Services

 

Licensed clinical social workers are available to help navigate the many unexpected needs that arise due to cancer and its treatment. Our social workers are available free of charge to assist our patients and their families with a range of services that can reduce stress during any phase of their care.

Click on the link for a listing of monthly programs offered. For information about the clinical social work services or programs, please call 202.877.8758 or 202.877.6681.

Oncology Nutrition 

Licensed oncology nutritionist is available to assist patient with eating well before, during and after cancer treatment can help you fell better and stay stronger. The stronger your body is, the better you may respond to the cancer treatments.

Click on the link for a listing of monthly programs offered. For information about the oncology nutrition services and programs, please call 202.877.8577

Other Services

Reiki

A light touch therapy that helps reduces the stress of medical illness and treatment. Reiki creates a deep state of relaxation. Reiki is offered as part of the pain management program at MedStar Washington Hospital Center. Research shows that when patients are relaxed, the body’s natural healing abilities are awakened

Sit and Knit Shawl Program

The Sit and Knit program is intended to embrace, inspire, and celebrate life with all new patients who are treated with cancer at the Washington Cancer Institute by providing all newly diagnosed patients with a free shawl.

Images Program

Additionally, these programs attend to the personal and emotional needs of cancer patients by recognizing the importance of self-image during cancer treatment and are offered throughout the year.

Genetic Counseling

Genetic Counseling is provided to patients and their family if there is a personal and/or family history (maternal or paternal lineage) with features of hereditary cancer. Genetic counseling or testing is a way to learn more about the risk of cancer and if you carry the cancer gene.

Patient Resource Center

The patient resource center was created to provide education material to support our patients and their family. The resource center has free education literature on coping with cancer, cancer treatment and side effects and information about various cancer sites. We also have a functional library and computers for use. The patient resource center is open from 8 a.m. to 4 p.m. Monday through Friday.

Smoking Cessation Program

One on one counseling with the clinical social workers or participation to one of our workshops is available.

For more information on all of the programs and services offered, please call 202.877.2273

Patient Resources at MedStar Montgomery Medical Center

Psychosocial Oncology

Oncology-certified clinical social workers who help navigate the many unexpected needs that arise due to cancer and its treatment. Our social workers are available free of charge to assist our patients and their families with a range of services that can reduce stress during any phase of their care.

Bunny Ebling, LCSW-C, OSW-C

  • 301-570-7878 office
  • 301-774-8846 fax

Patient Services

Gentle Yoga for Cancer Patients

       Thursdays between 10:30 – 1130 a.m.

Look Good Feel Better

These group workshops teach beauty techniques to female cancer patients to help them combat the    appearance-related side effects of cancer treatment.  Cosmetology professional provide learning sessions using products donated by the cosmetic industry. In addition, each two-hour, hands-on workshop includes professional advice from a hair stylist on how to deal with hair loss using wigs, scarves, hats, hairpieces, and other accessories. Patients at various stages of treatment receive personal attention and take home instruction booklets and complimentary cosmetic kits in shades that match their skin tones

 6 times per year on a Wednesday afternoon between 2 – 4 p.m.

Contact Bunny Ebling, LICSW at 301-570-7878.

Support Groups

All Cancers Support Group (Telephone)

1st and 3rd Wednesdays, Noon to 1 p.m.

Registration required.

Contact Bunny Ebling, LICSW at 301-570-7878.

Thyroid Cancer Treatments

Thyroid cancer treatment: Our approach

The experienced, highly trained endocrinology doctors with the MedStar Georgetown Cancer Institute offer patients the most advanced care and treatment options. Our team is dedicated to answering your questions and to working together with you and your family to develop the best treatment plan for you.

We take a multidisciplinary approach to your care by collaborating with other doctors you may see, including a thyroid oncologist when appropriate or any other specialist. 

Options for thyroid cancer treatment depend on:

  • The type of cancer and whether it has spread
  • Whether it’s a new diagnosis or has returned
  • The tumor’s size and stage
  • Your age and general health

For the main type of thyroid cancer, earlier-stage tumors are treated with surgery—either removing one of the gland’s two lobes (lobectomy) and cancerous lymph nodes, or taking out all or most of the gland (thyroidectomy). When necessary, we use special monitoring to protect the nerve for the voice box (larynx) that passes under the thyroid.

Often, thyroid surgery is followed by drugs to prevent the production of thyroid-stimulating hormone (TSH) or radiation delivered with radioactive iodine (RAI), swallowed and only absorbed by thyroid tissue. External radiation is sometimes used after surgery for more advanced thyroid cancer, and we offer clinical trials.

Follow-Up Care

Patients who have had thyroid cancer are at risk of developing a second head or neck cancer, and our doctors also want to catch any original cancer that might return. After treatment, they will ask you to come in for regular checkups, as frequently as once a month for the first year.

Metastatic thyroid cancer to the bone: Our approach

Our endocrinologists are specially trained in treating thyroid cancer that has spread to the bone, called metastatic thyroid cancer to the bone. In collaboration with your other specialists, we generally recommend the following therapies:

  • Medication, including thyroid hormone suppression
  • External radiation therapy
  • Radioactive iodine
  • Use of dosimetry, an individualized approach to therapy
  • Targeted agents, which are specially developed drugs to treat tumor growth
  • Medications that help decrease the progression of bone metastases

Thyroid Cancer

Thyroid cancer is a malignant (cancerous) growth found in the thyroid gland. The gland sits in the throat below the voice box (larynx) and makes thyroid hormone and the hormone calcitonin. Thyroid cancer is highly treatable if caught early, because of its location. In addition to other head and neck specialists, our thyroid cancer team includes endocrinologists, doctors who specialize in the endocrine system and hormone production.

Risk Factors

Often, no one knows why cells grow out of control and form thyroid cancers. But there are several risk factors:

  • Family history of thyroid disease or cancer, including certain genetic conditions; in the case of a rare cancer called medullary, a defect in the gene RET can get passed on from parents.
  • Radiation therapy to the head or neck as a child
  • Gender (women are more likely to develop thyroid cancer)
  • Age (higher risk between 25 and 65)
  • History of enlarged thyroid (goiter)
  • Ethnicity (Asians face a higher risk)

Are You at Risk for Thyroid Disease?

Approximately 12 million Americans are affected by thyroid disease. Thyroid diseases occur at least five times more frequently in women than in men.

  • As many as ten percent of women over age 65 have an underactive thyroid.
  • Thyroid dysfunction complicates between 5 percent and 9 percent of all pregnancies.
  • Thyroid nodules are common, but only between 5 and 10 percent of these are cancerous.

Symptoms

Symptoms of thyroid cancer may include:

  • A lump, or nodule, in the front of the neck near the Adam's apple (for men)
  • Hoarseness
  • Swollen lymph nodes, especially in the neck
  • Difficulty swallowing or breathing
  • Pain in the throat or neck

Other condition can also cause these symptoms, so it’s important to see a doctor right away.

Thyroid Cancer and Nodules

Thyroid nodules are growths, or collections of cells, that form on the thyroid. In most cases, thyroid nodules are benign, meaning they are not cancerous. They usually do not grow or spread and do not cause pain or other symptoms. In some cases, though, thyroid nodules are malignant, or cancerous. Cancerous thyroid growths can affect the functioning of the thyroid and cause other symptoms, including difficulty swallowing and swelling in the neck.

Diagnosis

To make a diagnosis, our doctors:

  • Take a full medical history
  • Perform a complete head and neck exam
  • Possibly remove a small amount of the tumor during a biopsy, for further study
  • Potentially run lab and imaging tests, including:
    • Laryngoscopy: examination of the larynx (voice box) with a laryngoscope
    • Blood Tests: look for abnormal levels of calcium and hormones, including the thyroid-stimulating hormone (TSH) that controls how fast thyroid cells grow
    • Ultrasound
    • CT (CAT) scan
    • X-ray

These exams and tests help the doctor determine:

  • The type of cancer and its stage
  • How aggressive it is
  • Whether it has spread
  • How best to treat it

The MedStar Georgetown Cancer Institute has thyroid cancer specialists who can offer you individualized treatment based on your needs. Thyroid cancer occurs in tissues of the endocrine system which consists of your body’s hormone-secreting glands including the thyroid, parathyroid, adrenal, pancreas, and pituitary glands. These glands are located in different areas of the body and produce hormones that regulate many bodily functions. 

Endocrine cancers are the fastest growing cancer in women and affect women three times more often than men. At the time of diagnosis, most women are usually between the ages 40 and 50. Men who develop endocrine cancer are usually diagnosed in later years, between the ages 60 and 70.  The most common type of endocrine cancer is thyroid cancer. Your thyroid is a small, butterfly-shaped gland at the base of your throat. It has two main sections, a left lobe and a right lobe. The middle of the thyroid gland, where the lobes meet, is called the isthmus. Your thyroid makes the hormone thyroxine which helps control metabolism, blood pressure, heart rate, body temperature, and weight.

Most thyroid cancers are very treatable and usually can be cured with surgery and appropriate therapy. 

Kidney Cancer Treatments

Treatments for Kidney Cancer

The kidney is a bean-shaped organ that is situated in the back, just below the ribcage, on both sides of the body. Their job is to clean the blood from any impurities. This extra waste is sent to the bladder, where it is stored until urination. Approximately 30,000 cases of kidney cancer will be diagnosed in the United States yearly, according to the American Cancer Society.

The MedStar Georgetown Cancer Institute specialists provide comprehensive care for kidney cancer including:

  • Laparoscopic radical nephrectomy
  • Open radical nephrectomy for large tumors
  • Partial nephrectomy for preservation of the kidney. This procedure can be done through traditional open surgery, laparoscopically or through robotic surgery.
  • Small molecule targeted therapy for late stage treatment
  • Palliative​ services

Fortunately, the treatment for kidney cancer has become technologically advanced. Sophisticated imaging scans like CTs and MRIs make finding smaller tumors easier. In some cases, your doctor will be able to determine if the mass on your kidney is malignant from a scan.

Minimally Invasive Techniques

One of the main goals of kidney cancer treatments is to use minimally invasive techniques such as laparoscopic and robotic surgeries to speed healing and recovery after surgery. During laparoscopic surgery, small instruments are placed into the abdomen and the kidney or part of the kidney is removed through smaller incisions. This often results in markedly reduced pain, shorter hospital stays, and quick resumption of normal activities than traditional surgery.

Kidney Cancer

The kidney is a bean-shaped organ that is situated in the back, just below the ribcage, on both sides of the body. Their job is to clean the blood from any impurities. This extra waste is sent to the bladder, where it is stored until urination. Approximately 30,000 cases of kidney cancer will be diagnosed in the United States yearly, according to the American Cancer Society.

The MedStar Georgetown Cancer Institute specialists provide comprehensive care for kidney cancer including:

  • Laparoscopic radical nephrectomy
  • Open radical nephrectomy for large tumors
  • Partial nephrectomy for preservation of the kidney. This procedure can be done through traditional open surgery, laparoscopically or through robotic surgery.
  • Small molecule targeted therapy for late stage treatment
  • Palliative services

Symptoms of Kidney Cancer

Symptoms of kidney cancer may include:

  • Blood in the urine
  • Pain during urination
  • Pain in the pelvis
  • A feeling of generalized pressure in the pelvis. This may be caused by the tumor pressing on other organs near the kidneys.

Diagnosis of Kidney Cancer

Your doctor will ask for a complete medical history and will perform a thorough physical examination. Diagnostic tests may include:

  • Analysis of urine under a microscope to check for blood
  • Radiological imaging of the entire urologic system, including ultrasound
  • CT scan
  • MRI
  • Bone scan, to check for spread of cancer
  • PET scan

Gastrointestinal Cancer Treatments

Gastrointestinal (GI) cancer includes cancer of the:

  • Esophagus, the tube used to bring food from your mouth to your stomach
  • Stomach
  • Small bowel
  • Colon and rectum
  • Pancreas, an organ which produces enzymes that aid in digestion
  • Bile duct, a tube which carries bile, a fluid used to digest fat
  • Liver
  • Gallbladder

Treating Gastrointestinal Cancer

If you received a cancer diagnosis, or if you are still awaiting a final diagnosis, we understand how scared and anxious you probably feel. Your team at MedStar Health will be with you every step of the way. Our knowledgeable doctors and nurses can answer any questions you may have, and we will support you throughout your journey, from diagnosis to treatment and follow-up.

Here is what you can expect during the cancer process:

  • Diagnosis: Our doctors will carefully examine you, using blood tests, imaging scans and biopsies in order to get the most accurate diagnosis possible.
  • Treatment: Once your health team confirms your diagnosis, we will work with you to create an individualized treatment plan. Treatment options differ from patient to patient, but most often include surgery and/or radiation therapy and/or chemotherapy.
  • Recovery: After you have completed your treatment, we will monitor you closely during the recovery process. Proper follow-up care is the final crucial step in cancer treatment.

If you have a cancer of the gastrointestinal tract, surgery will likely be recommended to remove the tumor and/or to help maintain normal function.

Gastrointestinal Cancer Surgery Expertise

Surgical oncologists at MedStar Health are experts in a wide range of surgeries, from minimally invasive laparoscopic procedures to more complicated surgeries that remove and rebuild portions of the gastrointestinal tract.

They are also leading the latest research on new drugs to treat unusual tumors, such as gastrointestinal stromal tumors (GISTs). Each patient's treatment plan is tailored to his or her specific case and needs, with the input from a wide range of specialists dedicated to his or her care.

Our patients benefit from a multidisciplinary approach that devotes a team of specialists to their care:

  • Our surgical oncologists work with specialists in the fields of radiation oncology and chemotherapy
  • Each patient is evaluated weekly multidisciplinary to formulate the best plan of care
  • We offer the whole spectrum of surgical options, from minimally-invasive laparoscopic procedures to complex resections and reconstructions of the gastrointestinal tract
  • We regularly treat even the rarest forms of stomach cancer, such as GIST tumors, and lead the clinical trials that have revolutionized the treatment of this disease
  • Our doctors are experts in intraperitoneal chemotherapy for peritoneal metastases from gastrointestinal cancers, allowing direct contact of cancer-fighting drugs into the abdomen
  • Diagnostic procedures for gastrointestinal cancers

Patients with gastrointestinal cancers may undergo several tests to diagnose their cancer and/or determine its location and extent:

  • Endoscopic ultrasound (EUS): This procedure allows your doctor to examine your esophageal and stomach linings and the walls of your upper and lower gastrointestinal tract, using a thin probe that records high-quality ultrasound images. Your doctor will look for signs of cancer, determine if your cancer has spread or biopsy a mass.
  • Laparoscopic surgery: Your doctor may need to perform exploratory surgery to find out if your cancer has spread. Laparoscopic surgery is a minimally invasive procedure that allows your doctor to insert a small camera and surgical instruments through several small abdominal incisions.
  • Imaging tests: Your doctor may order other imaging tests, including computed tomography (CT scan), positron emission tomography (PET) and magnetic resonance imaging (MRI). 

Treatment Options for Gastrointestinal Stromal Tumor (GIST)

Gastrointestinal stromal tumor, commonly called GIST, is a rare type of sarcoma that forms along the gastrointestinal tract, but mostly starts in the stomach or small intestine.

Surgery is the standard treatment, but not all GISTs can be removed. Our clinical trials have studied the newest drugs available to target GIST, including imatinib, sunitinib and nilotinib. Our cancer team was among the first to study imatinib, the first targeted therapy developed for GIST.

These drugs do not cure the disease, but they do help some tumors stop growing or shrink, which has extended the survival rate for patients with recurrent or metastatic GIST.

Intraperitoneal Chemotherapy for Peritoneal Metastasis from Gastrointestinal Cancers

Gastrointestinal cancers, such as appendix cancer, colon cancer and gastric cancer, can spread to the peritoneum. The peritoneum is the lining of the peritoneal cavity.

In the past, patients with peritoneal cancer had few or no treatment options. An innovative treatment option is now available for patients with peritoneal metastases, involving cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC). Heated intraperitoneal chemotherapy allows your doctor to target chemotherapy drugs directly at cancer cells, and minimize exposure to healthy tissues.

Gastrointestinal Cancer Surgery

Surgical procedures we use to treat esophageal cancer and gastric, or stomach, cancer include:

  • Esophagectomy: This procedure removes all or part of the esophagus. The patient's stomach or part of the colon may be transplanted into the neck to take its place.
  • Subtotal/total gastrectomy: These surgeries remove a portion or all of the stomach. In a total gastrectomy, the patient's esophagus is connected directly to the small intestine.

Pancreatic Cancer Surgery 

Surgery is the only way to cure pancreatic cancer that has not spread (metastasized), and the best way to contain tumors. Unfortunately, doctors often see later-stage disease, with tumors wrapped around arteries and veins, nerves and the bile duct—making operations more challenging or even impossible.

Our goal in surgery is to leave enough of the pancreas to produce digestive juices and insulin, reattaching the remaining organ so that it functions like it did before. But sometimes that’s not possible. We often have to remove all or other parts of nearby organs as well, to ensure we get as much of the cancer as possible. 

We provide a full range of pancreatic cancer treatment, with our recommendations based on:

  • The cancer’s stage (the size of the tumor, how far it has grown into the wall of the pancreas and whether the cancer has spread to nearby tissues, lymph nodes or other parts of the body)
  • Whether the tumor is operable
  • Whether the cancer is newly diagnosed or has returned
  • Your overall health

At MedStar Health, we’re pioneering new ways to make these tumors operable, including chemotherapy followed by precise radiation (CyberKnife). We’re also looking at a new way to give heated chemotherapy (HIPEC) immediately after surgery, to reduce the chance the cancer will return (recur).

While pancreatic surgeries are the most complex abdominal operations, we have the most experienced team in the area, performing more procedures than any other group.

Colorectal Surgery

Surgery is usually the cornerstone of colorectal cancer treatment, with the goal to remove the tumor, or as much of it as possible. Our experienced specialists can also remove parts of other organs such as the liver, lungs and ovaries when colorectal cancer has spread or returned.

Small Bowel Cancer Surgery

Surgery is the most common treatment of small bowel cancer. One of the following types of surgery may be done:

  • Resection: Surgery to remove part or all of an organ that contains cancer. The resection may include the small intestine and nearby organs (if the cancer has spread). The doctor may remove the section of the small intestine that contains cancer and perform an anastomosis (joining the cut ends of the intestine together). The doctor will usually remove lymph nodes near the small intestine and examine them under a microscope to see whether they contain cancer.
  • Bypass: Surgery to allow food in the small intestine to go around (bypass) a tumor that is blocking the intestine but cannot be removed. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Hereditary Risk

genetric counseling

Is Genetic Counseling Right for You?

  • Does cancer run in your family? 
  • Were you diagnosed with cancer at a young age? 
  • When you heard about Angelina Jolie’s experience with BRCA1 genetic testing and her decision to have her breasts and ovaries removed to reduce her risk, did you wonder whether you or someone in your family should get tested? 

If you answered yes to any of these questions, genetic counseling – and possibly genetic testing – can help you and your family. 

Although many people have a family history of cancer, only 5-10 percent of cancers are due to an inherited susceptibility.  Genetic counseling can help you learn more about hereditary risks for cancer, and how genetic testing may provide important information for you and your family. 

Genetic Counseling at MedStar Georgetown Cancer Institute

Our program provides a full range of services to help you and your family when inherited, cancer-related mutations are suspected. We offer:

  • Expertise: We are the most experienced hereditary cancer team in the D.C. metro area—our doctors and researchers are nationally recognized, and our genetic counselors are certified by the American Board of Genetic Counseling. Such expertise is important, because:
    • Hereditary cancer is a complex, rapidly evolving field—studies show that doctors who don’t specialize in the subject often order the wrong tests or don’t interpret them correctly.
    • Most at-home genetic testing kits (direct-to-consumer, or DTC) don’t look for clinically important genes, and none come with the counseling that can ease anxiety, provide meaning and help guide care, including preventive steps.
  • Research and Clinical Trials: We are leaders in local, national, and international research efforts to understand cancer risks associated with gene mutations and cancer family histories; evaluate genetic counseling approaches; help people make decisions about management after genetic testing; identify additional inherited mutations that can cause cancer; and to find better ways to detect, treat and prevent hereditary cancers.
    • Through Georgetown Lombardi’s Fisher Center for Hereditary Cancer and Clinical Genomics Research, the Lombardi Research Participant Registry, and the MedStar Georgetown Cancer Institute, we are able to provide you with information about many research opportunities. You may benefit by:
      • Getting access to local and national clinical trials that test new approaches to genetic counseling, cancer screening and cancer risk management
      • Helping the next generation of your family
  • Seamless Care: We work closely with MedStar Georgetown Cancer Institute cancer specialists covering all types of cancer. While those doctors know when to send us patients, we also encourage you to contact us. We work with doctors outside the network, too, sharing results and collaborating on management plans.
  • Insurance Coverage for Genetic Testing and Counseling: Most insurance companies cover all or part of genetic counseling. For testing, we work with your insurer to get approval beforehand (pre-authorization).

Should I Get Genetic Counseling for Hereditary Cancer Risk?

Please contact us with any questions — we’d rather be in a position to determine you might not be a good candidate rather than miss the opportunity to provide help.

Generally speaking, these are the signs that cancer might run in your family:

Please keep in mind that:

  • If you have not had cancer and nobody in your family with cancer has undergone genetic testing, we may suggest that a relative who has one of the cancers above be tested first. This process may greatly help us understand the basis of cancer in your family.
  • Even if a cancer risk gene mutation runs in your family, you may not have it yourself.
  • Even if you have a cancer risk gene mutation, you won’t necessarily get cancer.
  • Confirmed history of a harmful alteration (mutation) in a cancer risk gene
  • One or more individuals with cancer diagnosed before age 50, such as:
    • Breast cancer in women: Triple negative breast cancer diagnosed before age 60 (these are breast cancers that are negative for estrogen and progesterone receptors and   HER2/neu)
    • Colon cancer
    • Uterine or endometrial cancer
    • Gastric cancer, especially diffuse type
    • Pancreatic cancer
    • Renal cancer
    • Sarcoma of bone or muscle
  • One or more individuals who have had any of these cancers:
    • Ovarian, fallopian tube, or peritoneal cancer
    • Male breast cancer
    • Medullary thyroid cancer
    • Sebaceous carcinoma
    • Adrenocortical cancer
    • Choroid plexus cancer
  • More than one cancer in the same person, especially if the first one was diagnosed before age 50, such as:
    • Breast and ovarian cancer
    • Breast and thyroid cancer
    • Colon and uterine cancer
    • Melanomas
  • One or more individuals with multiple colon polyps (adenomatous, hamartomatous or juvenile)
  • Individuals with the same or related cancers on the same side of the family, such as:
    • Breast, ovarian, prostate, and/or pancreatic cancers
    • Colon, uterine, ovarian, and/or stomach cancers
  • Abnormal testing results from colon or uterine tumors
    • These tests are called microsatellite instability, or MSI, and immunohistochemistry, or IHC
    • Abnormal results may indicate an increased hereditary risk
  • Jewish ancestry, especially with a personal or family history of breast, ovarian, or pancreatic cancer

What Does Genetic Counseling for Hereditary Cancer Risk Involve?

Genetic counseling provides a full range of support for individuals concerned about potential hereditary risks of cancer.  During your session, your certified genetic counselor will:

  • Take a complete personal and family medical history — particularly for brothers, sisters, parents, children, grandparents, aunts, uncles, nieces, nephews and first cousins-focusing on cancer diagnoses in the family and the age when family members were diagnosed.  
  • Explain how harmful gene changes (mutations) may be passed down in families and contribute to cancer risk, along with other factors
  • Discuss options for genetic testing, including the potential benefits, risks, and limitations of testing
  • Assess the chance that cancer will develop at some point in your life, or your chance of developing a second (primary) cancer
  • Create a personalized plan for cancer screening and risk reduction based on national guidelines and current research
  • Review the likelihood that relatives may have an inherited cancer risk mutation
  • Refer you to research and clinical trial opportunities
  • Provide emotional support and referrals to support groups
  • Review previous cancer genetic test results and identify possible new options for testing

Cancer and Genetic Testing

Testing for inherited mutations that are associated with increased cancer risks  is a powerful tool, one that continues to improve all the time. We can now test for mutations in over 20 different genes with just one blood or saliva sample.

If you choose to have genetic testing, in most cases, you can provide a sample immediately following your initial genetic counseling session. 

Some people who get counseling choose not to get testing. That is okay. We help you weigh the decision and encourage careful consideration — while you can get tested during your initial visit, you can also come back to do so.

Cancer and Genetic Testing: Things to Consider

We help you consider several factors when deciding whether to undergo genetic testing for cancer risk:

  • Impact: Most people who get genetic testing cope very well with the results. You may be relieved and feel good about taking action to protect your health and become more informed.  But sometimes coping with genetic test results can be challenging.  We provide information and support resources to help meet your individual needs. 
  • Family: Obtaining information for family members is often a key reason for choosing to have genetic testing. But sometimes relationships can be strained by prospects of testing and by the results — not everyone wants to know this type of information.
  • Uncertainty: Sometimes genetic testing fails to provide a definitive answer about cancer risk.
    • This can happen when extensive testing is pursued and no mutation is found.  This type of test result does not always rule out hereditary risks for cancer.
    • Sometimes a gene change is found and the cancer risks that are associated with it are very unclear. 
  • Timing: The length of time to receive results varies depending on the type of test and the lab used. Sometimes results take several weeks to obtain.
  • Cost: The cost of genetic testing varies widely depending on what tests are ordered, what lab is used, and whether you have insurance. 
  • Genetic Discrimination: The federal Affordable Care Act and the Genetic Information Nondiscrimination Act (GINA) as well as some state laws provide many protections against employers and health insurers treating people differently based on genetic information. 

If you do choose to get tested, we will help you to thoroughly understand the results, their meaning and their implications for you and your family.

  • We will give you a detailed written report summarizing your genetic counseling session, the interpretation of any genetic testing results, the recommendations for your medical management and implications for your relatives.
  • We will also make specific referrals for medical and other follow-up if needed.

Hereditary Cancer and Cancer Prevention 

There are several steps you and your family can take to lower the risk of cancer. We craft an individualized set of recommendations based on your family history, risk level, and if pursued, genetic testing results. We also help you weigh the options, which might include:

  • Earlier and more frequent cancer screening than people at average risk, sometimes with specific tests
  • Use of medications (for example, tamoxifen) to prevent cancer (called chemoprevention)
  • Preventative surgery (risk-reducing or prophylactic procedures) to remove the breast(s), the colon or the ovaries and fallopian tubes
  • If appropriate, lifestyle changes such as changing your diet, limiting alcohol consumption, getting more exercise or giving up smoking

If you have been newly diagnosed with cancer, genetic testing may provide information for your treatment planning, such as helping you make decisions about surgery. 

Insurance Coverage for Genetic Testing and Counseling

Many insurance companies cover all or part of genetic counseling. For testing, we submit the necessary paperwork to the laboratory who will then work with your insurer to obtain approval beforehand (pre-authorization). We can tell you what your out of pocket costs for testing will be before you get tested.  Of note, genetic testing may not be approved by certain Medicaid plans.

If you do not have any health insurance, you may be eligible to receive genetic testing at no charge, or at a reduced rate, provided you meet certain criteria.