Salem health center launches cancer genetics program
SALEM, Ore. (AP) — The Salem Health Cancer Institute has launched a program to identify patients whose family history makes them an easier target for cancer.
The cancer genetics program kicked off in July with enough operating capital from the Salem Health Foundation to last through the end of the year. The program is running under the guidance of a new hire, Clinical Nurse Specialist Nancy Ledbetter.
Salem Health Hospitals & Clinics say cancer is the top cause of death among communities the health care provider serves. Anywhere from 5 to 10 percent of cancers stem from gene mutations passed down by family, Salem Health officials said.
Genetics testing can uncover inherited mutations inside patients’ genes, proteins or chromosomes, which can increase a patient’s risk of getting cancer, officials said.
Salem Health officials say the new program will save patients a trip out of town. Before they had to go to Portland where Oregon Health & Science University’s Knight Cancer Institute and Providence Health & Services’ Genetic Risk Clinics offer the counseling.
Testing was previously available to Salem Health patients by referral under a contract with OHSU. Salem Health and OHSU used to operate with a formal partnership until they split in 2017.
However, genetics testing “was not tied to the partnership,” said Josh Franke, director of the Salem Health Cancer Institute.
The Salem Health Foundation granted $84,000 in seed money to get Salem’s genetics program going. “This funding should help us build the program to a self-sustaining one by the end of the year,” Franke said.
In a statement, Salem Health Foundation Director Lisa Roth said, “The foundation understands the need and has invested to bring this pilot program to the Mid-Willamette Valley.”
“Additional testing can help save lives,” Roth said.
Approximately one in three Americans develop cancer, according to the American Cancer Society.
Most cases within families are either a product of happenstance or exposure to risk factors such as smoking, according to the society. In some cases, though, cancer develops due to an inherited gene mutation in a family cancer syndrome.
That’s where genetics testing comes in.
Ledbetter said part of the genetics counseling is to check whether patients meet clinical testing criteria, which helps determine if their insurance will likely cover it. “If a person meets the criteria, insurance, including Medicare, typically covers it,” she said.
The list of criteria is long, she said. Generally speaking, however, being diagnosed with colon or breast cancer before age 50 or having certain cancer “clusters,” such as ovarian and breast cancer in a family, are factors.
“Those types of clusters point to various syndromes. There’s a long list of hereditary cancer syndromes. Each of them is pretty rare,” Ledbetter said.
Patients are usually referred to testing by their medical provider instead of self-referring. As for the tests themselves, blood or saliva is collected and shipped to an out-of-state lab.
“The DNA is extracted and they do the test,” she said. “It takes a few weeks to get the results. And then we meet again and talk about those.”
“Most of the time, they’re negative,” she said. “If there’s a mutation, we tell them what the recommendations are for screening.
“So for example, people might start colon cancer screening much younger than usual — like 20s versus 45,” Ledbetter said.
In gynecological cases, surgery can be performed to remove a patients’ ovaries or uterus if those organs are at risk.
Ledbetter knew from a young age she wanted to work in health care. “This field didn’t exist when I was a kid,” she said.
After graduating with a bachelor’s of science in nursing from the Vanderbilt University School of Nursing in Nashville, Tennessee, Ledbetter ended up in oncology.
She lived and worked in Nashville, California’s Bay Area, where she obtained her master’s degree, and Portland, where she worked for Providence Health & Services for about 15 years starting in 2000. She also briefly worked at a private practice.
Ledbetter was plucked to run the cancer genetics program after applying for another job at Salem Health that dealt with ovarian cancer.
“Nancy came out of the blue from another posting that we had, and she’s really a diamond in the rough,” Franke said. “She has all of the experience. She has the ability to operate independently.”
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Information from: Statesman Journal, http://www.statesmanjournal.com