Becoming a cancer genetic counselor isn't for the faint of heart. As certified specialists, cancer genetic counselors help people understand their inherited cancer risk and determine what treatments will be most effective after a cancer diagnosis. They may also give patients information about cancer prevention, screening, and treatment options while providing psychosocial support. Cancer genetic counselors must have the sharp mind of a scientist as well as the empathy of a priest and the objectivity of a judge. The job is demanding, and a good bedside manner is essential.
If you become a cancer genetic counselor, you’ll regularly work with people who are facing down their own mortality or coping with the possibility of having to say goodbye to a loved one too soon. You'll comfort people in what can be their darkest hours. And sometimes you'll deliver good—no, make that extraordinary—news that someone does not carry a deleterious gene. But, even when the news isn't so good, you'll empower patients with the knowledge they need to make the best choices they can.
In this article, we'll cover:
As noted, cancer genetic counseling is a career that melds science and psychology.
A solid understanding of biology, the human genome, inheritability, and medicine is top of the list for the skills that cancer genetic counselors need—along with knowing the statistics and probabilities of various patient outcomes.
Strong communication skills are necessary as cancer genetic counselors need to explain the science behind cancer and inheritable risk to patients who may not be scientifically minded themselves. Most of all, certified genetic counselors have to be able to communicate all of that information with sensitivity and patience. When discussing risk factors or treatment options with patients, a cancer genetic counselor may need to explain concepts several times or in several ways to a patient or family member who is distraught. They must be able to do this respectfully and with a great deal of compassion, but also with impartiality. A lot of genetic counseling involves conveying facts and helping patients make the decisions that are right for them—choices that may be very different from those a genetic counselor would make for himself.
As an entry-level genetic counselor, you’ll probably work with patients under supervision, and as you progress to more advanced positions, you’ll begin working independently. Wherever you are in your career, however, chances are that you’ll find plenty of work. Genetic counseling is a fast-growing field, and counselors are in high demand. Plus, new genome-based advancements in cancer care are being developed all the time, making for interesting work.
According to the Bureau of Labor Statistics, genetic counselors earn an average annual salary of $80,360; the highest paying jobs are in outpatient care centers, where genetic counselors can earn over $100,000 a year.
Then again, most genetic counselors don’t get into the field for the money. There are certainly less stressful ways to earn as much, if not more. But if helping people understand their genetic risk for cancer and planning accordingly sounds like a rewarding way to make a living, a career in cancer genetic counseling could be for you.
Specializing in cancer means doing your job on the cutting edge of research. While cancer genetic counselors have been making a difference in the care and quality of life for cancer patients and those at risk for some time, it’s only fairly recently that genetics has become a standard of care in oncology.
“It used to be that this process would tell you if you were at risk but wouldn’t change treatment, but now we’re getting into an area where these changes in genes are tailoring what therapy we give to patients," Rebecca Nagy, MS, CGC, a certified genetic counselor at the Ohio State University Comprehensive Cancer Center and president-elect of the National Society of Genetic Counselors, told Oncology Nursing News.
Today, genetic counselors aren’t just doing cancer risk assessments based on family trees; they're also helping patients discover via genetic tests whether they themselves are more likely to get certain cancers because of their genes. Genetic counselors can test for when someone has a higher than average risk of developing hereditary cancer syndromes, including colorectal cancer, uterine cancer, pancreatic cancer, and ovarian cancer.
The genetic testing ordered by counselors not only lets patients know their cancer risk but also helps counselors and their patients create strategies for preventing certain cancers, catching cancer early, and treating it more effectively.
The first step toward becoming a cancer-focused genetic counselor is earning a bachelor’s degree—usually in biology or a healthcare-related subject, though some people choose to major in chemistry, psychology, or social work instead.
During your bachelor's degree program, it’s a good idea to take elective coursework in genetics, statistics, and biochemistry in addition to the science and math that’s generally part of the core curriculum. If you choose a university that offers summer programs or internships specifically for students interested in genetics or genetic counseling, take advantage of them.
The experience you gain working in a clinical setting—whether you’re doing paid or volunteer work—will make you a more attractive candidate when you’re applying to genetic counseling master’s programs.
Next, you’ll earn a master of science in genetic counseling degree from an American Board of Genetic Counselors (ABGC) accredited school.
There are about 40 such degree programs in the US, including:
In some cases, applicants are required to have performed counseling work prior to applying.
Master's degree in genetic counseling programs are interdisciplinary and can include coursework in genetics, medicine, risk assessment, and lab work, as well as counseling, communication, psychology, and patient education. At the University of Michigan, students not only learn alongside Ph.D. scientists and practicing genetic counselors; they also take classes in the university’s School of Social Work and in the School of Public Health.
Generally, bachelor’s degree programs will take four years for full-time students and master’s degree programs will take two. However, Northwestern University has an 18-month Master of Science in Genetic Counseling program. None of the ABGC-accredited programs can be completed entirely online, but Indiana State University’s genetic counselor degree has a limited online component and much of the clinical training takes place at off-campus hospitals and medical centers.
After earning a master’s degree, genetic counselors must become licensed in their state to work. All states require counselors to have completed an ABGC-accredited graduate program; most have counselors take a written exam, and some states also require counselors to have earned the ABGC certification.
Employers tend to prefer ABGC-certified candidates, so if you’re thinking about working your way up the typical advancement path for cancer genetic counselors, it makes sense to get certified. The National Society of Genetic Counselors (NSGC) also offers continuing education resources.
"I was only 30 when I received my breast cancer diagnosis, and several of my cousins were diagnosed with cancer in their 30s," writes Mariana Torrado on the University of TexasMD Anderson Center blog. Because of this early-onset and her family history, Torrado's doctor recommended she see a cancer genetic counselor, who explained to her that she might carry a mutation in the BRCA1 and BRCA2 genes; this mutation can cause breast cancer and also increases the risk of ovarian cancer.
Subsequent testing revealed that Torrado did indeed have the BRCA1 mutation, meaning that she had a 50/50 chance of passing the mutation on to her children. Sobering but essential news, she says: "Knowing that I have a BRCA1 mutation has given me the power to make decisions, get screened and be proactive," Torrado explains. "With the help and guidance of my genetic counselors and great doctors, I've been able to see it as a win/win situation."
As Mariana Torrado puts it, the pros of becoming a cancer genetic counselor can be especially compelling.
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