A study being conducted at Denver Health has big implications for cancer patients in Colorado.
Thanks to a grant from the National Institutes of Health, Denver Health offers genetic testing to all breast cancer patients and plans to expand the study to all cancer patients within a few 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.
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“It had metastasized in my armpit, up my collarbone 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, so when Denver Health nurse practitioner Pam Crawford offered to test her genetic makeup, Watford agreed.
She is one of 50 breast cancer patients being screened at Denver Health since August as part of a research project by Dr. Sonia Okuyama, Denver Health’s chief of oncology.
“Many of our patients need to get genetic counseling and testing,” she said.
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Although the cost of the tests has come down in recent years to about $250, Okuyama says many patients don’t get tested because most clinics require seeing a genetic counselor first, and there are only 700 genetic counselors in the country.
Now she’s reversing that and offering every patient diagnosed with breast cancer pre-screening.
Among the benefits, she says, doctors can tailor treatments.
“So, for example, there may be drugs — chemotherapy pills or IVs — that only work if you have that genetic abnormality. So knowing beforehand will help you choose the best drug to help the patient.”
The study also aims to improve follow-up of high-risk patients and their families.
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Crawford, who is trained in genetic testing, works with patients’ primary care providers on a high-risk screening plan.
“You would … talk about doing a mammogram alternating with an MRI, you do something every six months and the hope that something starts to grow, we see it,” she said.
Okuyama says the Denver Health study is the first of its kind.
“That coordination, that hand-holding, that support for the patient and for the primary care provider that … is missing, that doesn’t exist,” she said.
That’s especially unique, she says, for lower-income patients at protected-network hospitals like Denver Health.
“It’s generational implications and equity, you know … the component of it is huge,” she said.
Okuyama says the goal is to expand access to genetic testing for those who might not otherwise receive it due to lack of money or lack of genetic counselors.
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While not everyone will want to know what the risk is, Watford are happy to know. Her test came back negative.
“Relief, for sure, just to know that I don’t have this mutation,” she expressed.