• Genetic counseling
• Genetic testing
• Cancer genetics risk assessment
• Genetic consultation
• Cancer testing
• Genetic cancer screening
• Familial hypercholesterolemia testing

Many people undergoing genetic testing will benefit from a formal pre-test consultation with a genetic counselor. For some people however, especially those with a cancer diagnosis, a visit to our Walk-In clinic is a convenient alternative that allows eligible patients to provide a blood or saliva sample and receive expedited information for a standard, comprehensive genetic test with a brief overview of possible results. These programs are overseen by expert genetic counselors and an opportunity for a formal post-test consultation with our providers is offered once genetic results are returned.

Our CARE (Comprehensive Assessment Risk and Education) program, leveraging Artificial Intelligence (AI) technology, aims to bring preventative precision medicine to routine medical care appointments. Patients receive a questionnaire ahead of their regular appointment, such as a mammogram screening, which collects information about the patient's personal and family history of cancer. This information is used to provide personalized care for the patient by determining if genetic testing is indicated and by calculating the patient's estimated lifetime risk of breast cancer using a computer modeling tool. For those who report a history suspicious for a hereditary cancer condition, this tool also provides education about genetic testing and allows patients to undergo expedited genetic testing through our Walk-In Clinics. This testing is overseen by a genetic counselor, with the option for a post-test genetic counseling appointment to review the results and formal risk assessment.

As part of our services, the Clinical Genetics and Genomics Program screens pathology reports of patients who undergo a procedure at our Providence hospitals in Orange County to assess if they meet criteria for and may benefit from genetic counseling and genetic testing. Our genetic counselors review multiple factors including anatomic and molecular pathology reports as well as any personal and family history from the medical record, to determine if a patient meets national guideline recommendations for a genetic evaluation. If eligible, their doctor will be notified of the benefit for genetic services and the individual may be referred to the Clinical Genetics Program and offered an appointment or Walk-In visit.

Our genetic counselors explore local, regional, and national studies to identify meaningful genetic research opportunities that may benefit our patients and their families. Research participation is completely voluntary and is typically offered when specific personal and/or family history meets study criteria and, therefore, provides the most meaningful patient participation.

The Genetics Program at the Leonard Cancer Institute at Mission Hospital helps patients and families to better understand and manage their disease risks. While our focus is hereditary cancer and inherited cardiovascular disease, our genetic counselors are qualified genetics professionals who act as a resource for all types of inherited risks and are prepared to discuss the risk(s) of other familial conditions including adult-onset neurological diseases. Genetics is a dynamic and quickly evolving field that supports individualized wellness and disease prevention.

Any person who is concerned about their personal and/or family history of cancer may benefit from genetic counseling, consideration of genetic testing and receiving a genetic risk assessment.

Our cancer genetics services are beneficial for individuals who have a personal and/or family history that include:

• Cancer (especially breast, colon, or uterine) diagnosed at an unusually young age, typically before age 50
• Ovarian, pancreatic, or metastatic or aggressive prostate cancer diagnosed at any age
• Close family members diagnosed with a combination of same or related types of cancer. For example: breast, uterine, ovarian, pancreatic, prostate, melanoma, colon or other gastrointestinal cancers
• A rare or unusual type of cancer. For example: medullary thyroid cancer, pheochromocytoma/paraganglioma, or childhood sarcoma
• Multiple separate cancers diagnosed in the same person (not metastatic cancer spreading to other parts of the body). For example: breast cancer in both breasts or a person with a history of breast cancer and a new diagnosis of colon cancer
• A total lifetime history of 10 or more colon polyps
• Breast cancer or prostate cancer diagnosed in an individual of Ashkenazi Jewish ancestry

Any person who is concerned about their personal and/or family history of heart disease will benefit from genetic counseling, consideration of genetic testing and receiving a personalized genetic risk assessment.

Our cardiovascular genetics services are especially helpful for individuals who have a personal and/or family history that include:

• Heart disease at a young age, especially before age 50, or multiple affected relatives on the same side of the family.
• Untreated LDL cholesterol >190 mg/dL or history or familial hyperlipidemia
• Heart attack or coronary artery disease prior to age 50 or in multiple family members
• Aortic disease including aortic aneurysms, dissections, Marfan syndrome and other related disorders
• Cardiomyopathies or “enlarged heart” such as hypertrophic (HCM), dilated (DCM), arrhythmogenic right ventricular dysplasia (ARVC), left ventricular non-compaction (LVNC), familial ATTR amyloidosis
• Arrhythmias or “heart rhythm issues” such as Brugada syndrome, Long QT syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT)
• Unexplained sudden cardiac arrest or death 

An initial genetic consultation typically takes an hour. During the consultation, the genetic counselor will review your personal medical history and three-generation family history. With this information, the genetic counselor will:

• Create a tailored risk assessment regarding the chance you or your relatives may have inherited a genetic syndrome.
• Assess your risk of developing cancer or heart disease based on your personal and family history.
• Assess your risk of developing additional primary cancers and your relatives’ risks of developing cancer.
• Provide an explanation of inherited syndromes and familial disease risk.
• Recommend and review the best genetic testing options and identify the most informative individual(s) to test within the family. If you elect to proceed with genetic testing, a blood or salvia sample can be collected during your initial consultation.
• Support you in family communication, coping with results, psychological and social guidance.
• Document a detailed consultation report with recommendations.

A physician referral is required for all services. A brief telephone interview is completed at the time of scheduling to obtain initial personal and family history, and to answer questions about our genetic counseling services. All new patients are sent a detailed personal and family history questionnaire to complete in preparation for their consultation.

To schedule an appointment call: 949-573-9492 ext 4033.

To fax records or a physician referral: 949-365-2271

Learn more about preparing for your visit

Most appointments are provided onsite at our clinics; however, virtual telegenetics appointments with a licensed, board-certified genetic counselor are also available. For more information please call 949-573-9492 ext 4033.

If a patient elects to pursue genetic testing during their genetic counseling appointment, the genetic counselor and patient will discuss the best test selection including the amount and types of genes to be tested. The process of genetic testing involves obtaining a DNA sample (either a small blood or saliva sample), which is sent to a genetic laboratory to analyze a specified set of genes which look for any "errors" or mutations that cause genes to fail to work properly. The positive identification of this type of gene mutation indicates that a patient and/or their close family members may be at increased risk of developing certain types of cancers or other health conditions. Fasting is not required for a DNA sample collection. We ask that patients do not eat or drink 30 minutes prior to a saliva sample collection only.

Genetic test results are typically received within about 2-3 weeks from sample collection. Once results are available, the genetic counselor will call the patient to review the results and offer a post-test consultation (typically a 30 minute appointment), when appropriate. During the results phone call and/or post-test visit, the genetic test results are reviewed, and individualized screening and prevention recommendations are provided for the patient and their family members.

Genetic testing is billed by the third-party genetic testing laboratory directly. For most, the cost of genetic testing does not exceed $250. If the cost of the test is a barrier to you, your genetic counselor can discuss laboratory patient assistance programs and help you apply for them.

Genetic counseling consultation reports and genetic test results are provided to the patient, the referring physician, and to any additional patient-requested healthcare providers or relatives. All personal and family information and genetic test results are confidential and are not released without the patient's prior written or verbal consent.

Some patients have expressed concerns that insurance companies may use genetic information to discriminate against them. There are federal and state laws including HIPAA that protect patient privacy and provide protection against genetic discrimination and there are no documented cases of genetic discrimination following genetic counseling or testing for disease risk. The Genetic Information Nondiscrimination Act (GINA) of 2008 is a federal law that protects patients from health insurance eligibility and cost discrimination as well as from employment discrimination. Our genetic counselors can provide more information about this during the consultation.