A study underway at Denver Health has big implications for cancer patients in Colorado.
Thanks to a grant from the National Institutes of Health, Denver Health is offering genetic testing to all breast cancer patients and plans to expand the study to all cancer patients within a couple of years.
Inga Watford was among the first patients to participate. She returned from a vacation in Hawaii last February to learn she had Stage 4 breast cancer.
"It had metastasized into my armpit, up into my clavicle and my neck, and I was terrified," she said.
After five months of chemotherapy, surgery, and radiation, she is now cancer-free. But she can't help but wonder what caused the cancer.
"I feel great. Very positive and optimistic about my future," she said. "Why did this happen to me?"
She has no family history, which is why when Denver Health nurse practitioner Pam Crawford offered to test her genetic makeup, Watford agreed.
She's one of 50 breast cancer patients to undergo screening at Denver Health since August as part of a research project by Dr. Sonia Okuyama, Denver Health's chief of Oncology.
"A lot of our patients should be getting genetic counseling and testing," she said.
While the cost of testing has come down in recent years and runs about $250, Okuyama says many patients don't get screened because most clinics require them to see a genetic counselor first and there are only 700 genetic counselors in the country.
She is now flipping that and offering any patient diagnosed with breast cancer testing upfront.
Among the advantages, she says, is doctors can tailor treatments.
"So, for example, there might be medications -- chemo pills or IV medications -- that only work if you have this genetic abnormality. So, knowing up front will help you pick the best medicine to help the patient."
The study is also aimed at improving the tracking of high-risk patients and their families.
Crawford, who underwent training in genetic testing, works with patients' primary care providers on a high-risk screening plan.
"You would do a mammogram, alternating with the MRI. You'd do something every six months and the hope if something starts growing, we see it," she said.
Okuyama says Denver Health's study is the first of its kind.
"That coordination, that hand holding, that support to the patient and to the primary care provider? That's lacking. That doesn't exist," she said.
It is especially unique, she says, for lower-income patients at safety-net hospitals like Denver Health.
"It's generational implications and the equity, you know component of that is huge," she said.
Okuyama says the goal is to expand access to genetic testing for those who otherwise might not get it due to a lack of money or lack of genetic counselors.
While not everyone will want to know their risk, Watford is glad she does. Her test came back negative.
"Relief, for sure, just to know that I did not have that mutation," she expressed.
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