#311 Cancer Mock Genetic Counseling Session
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Hi, I'm Arielle Modest and I'm a second year student at Sarah Lawrence and I'm doing my rotation with DNA Today and we're doing mock genetic counseling sessions. This is the first of a series of mock sessions just to give people insight into what a genetic counseling session is like

There are not that many resources out there that show what an actual session is like, and this is going to be a great tool for either aspiring genetic counseling students, current genetic counseling students, and even interested potential patients.

And this session is going to be a cancer session and I'll be doing it with Katherine. Hi everyone, my name is Katherine. I'm a genetic counselor. I'm a Sarah Lawrence alum and before, I currently work at a genetic testing lab, but before I worked at a clinical breast center. So this will be a bit of a recreation of our genetic counseling sessions that took place in real life.

Well thanks for coming in today Estelle, how are you? I'm doing well, thank you. How are you doing? I'm good. My name's Katherine, I'm one of the genetic counselors here at the Breast Center. I know you were referred by Dr. Smith, is that right? Yes, I had gone for like a regular checkup and I had mentioned my family history and he said to come here.

Okay, so family history, nothing else going on with you personally, but thought it might be a good idea to talk to a genetic counselor. Yes. He had mentioned it made sense based off of my family history, but I'm perfectly healthy. Okay, awesome. So I definitely want to ask a few more questions about that family history. That's a big part of what I do.

I work closely with Dr. Smith and I'll speak with people in your situation who have a family history and maybe want to learn more about genetic testing. So we'll talk about that. But like I said, first, I want to ask more about your personal history, your family history.

I will ask you questions about those cancers and kind of how old people were, who in the family, and kind of their treatment. Whatever you know is fine. If there's stuff that you don't remember, not a big deal. Just let me know what you are comfortable sharing. Okay. Okay. Sounds good. And before I get launched into everything, were there any other questions that you had coming into today's session that you were hoping I would answer?

Not really. I was just starting to get a little bit worried since I had a referral to another doctor after my primary care surgery.

Yeah, that's fair. And you know, you can see genetics and sometimes that can be scary, especially it's not so well known. So hopefully you'll walk out of here with more information and then we can decide and see what makes sense for you today. Okay, sounds good. Awesome. Okay, great. So I'm going to start with you. Like I said, I have your current age is 26 years old. Correct. Awesome. How old were you when you first started getting your period? I believe 11 years old. 11. Okay. Okay.

And then let me see here, are you getting regular periods? Any complaints or concerns there? Nope, all regular still. Awesome. Okay. Are you on any birth control? The pill. The pill, okay. And how many years were you taking the pill for or have you been on it? Since 18. Since 18? Okay, perfect.

Okay, and then I'll get your height and weight from the chart. Any other health concerns? You said you're healthy, but any surgeries, anything else for me to know about for you? Just a bone break when I was younger, nothing serious. Okay, okay.

How old were you for that? Four years old. Oh, ouch. Did you fall? From a bed. Oh, ouch, ouch. Okay, well, hopefully it's all healed up now. All good. Okay, good. All right. So if there's nothing else for your personal history, that was all my questions I had. Again, I looked in your medical record and I saw Dr. Smith's notes. So it seems like you're doing your checkups regularly, which is great.

And let me ask you, first, do you have any brothers and sisters? Yes. One sister, three brothers. One sister, three brothers. And does everybody have the same mom and dad? No. My two older brothers are my half-brothers. Okay. On which side? Moms or dads? Father's side. Okay, perfect. Two older brothers on dad's side. And then a brother and sister from the same mom and dad? Yes. Okay, awesome.

And then in just a second, I'm going to ask for how old everybody is and how they're doing. So let's start with your brothers, your older brothers. How old are they? How are they doing? They're doing well, healthy, no problems, especially no cancer. Okay. They are 32 and 29. 32, 29. Do they have any kids? No kids for them. No kids. Okay. Okay.

Right. And then your other siblings, how old is your, is it your younger brother? Yes. Okay. How old is he? He is 19. 19. And your sister? She is 21. 21. And then I should have asked you this as well. Any children for you? No, no children for me. No children for my younger siblings either. Okay. Perfect. So let's talk about that family history. I'm going to start with your mom. Is she still living? Yes, she is. She is 40.

54. 54. Okay. And how's she doing? She's doing well. Healthy. Good. No cancer for her. No concerns. No cancer for her. No health concerns. Awesome. Okay. And does she have brothers and sisters? She has one sister. One sister. Same mom and dad for them? Okay. Perfect. Let me see. How old is her sister? 47. 47. Younger? Yes. Younger sister. Okay. Does she have kids? She

She has two kids. Two kids. Boy and girl? Boy and girl. Your cousins? Yes. Are they around your age? Yes. Okay. And do they have kids, either of them? No kids for them. Okay. Let me see here. And your aunt, any health concerns for her? For the aunt? No. No. Okay.

And your mom's parents, are they living? If so, how old are they? My grandfather is not living. Okay. He passed at 80. 80, okay. And my grandmother is still living and she's 82. 82. Awesome.

Do you know what your grandfather passed away from by chance? Not really sure. Okay. Maybe old age? Yeah, he was 80. He otherwise was healthy. Okay. And then your grandmother, doing well, I presume? Yes, doing well, healthy. Awesome. Awesome. And where is this side of the family from in the world or ethnicity-wise? What would you say for that side? I'd say St. Lucia, so the Caribbean for that side of the family. Okay. Okay.

Anyone else on this side of the family? Cousins or anyone that you comes to mind for a cancer diagnosis or? Actually, my cousin on that side, Jessica, had leukemia when she was really young, like 13. Okay. And how do you know how she's related to your mom? Is she through your mom's mom, your mom's dad? Do you know? Mom's mom. Mom's mom. Okay. Okay.

So maybe a sibling of your grandma? Something like that. Okay. And then this is your cousin. So let me see here. She was 13, you said, with a leukemia diagnosis? That's pretty young. Let me see. Is she still living? Yes. Okay. She's on treatment. She's in her late 20s, like me. Okay. Okay.

Doing well now. Yes. Okay, good. Any idea what kind of leukemia? It's okay if you don't know. I was also young at that time. I have no idea what kind. Okay, but I'm so glad to hear she's doing well. Does she live in the US or is she in the Caribbean? Caribbean, yes. Okay, okay. So good. And then she's in her 20s. Any children for her? No children that I know of. Okay, all right. Anyone else on that side? No one else. Okay. Okay.

Alright, so let's go to your dad and his side. Tell me about your father's health. So my father, he is older than my mother. I believe he's 57. Okay. Recently diagnosed with prostate cancer.

So far, they haven't done any treatment. I think they said they're just watching right now. Okay. Recently diagnosed with prostate, so probably around the age of 56, 57. How's he doing? He's doing well, grappling with the cancer diagnosis right now, of course. Yeah, yeah. That's a lot to take in, but you may know prostate cancer is pretty common for men. Really? Yeah. There are some providers who might even say that...

I've heard them say if men live long enough, they'll all go on to develop an early stage prostate cancer. That might be a bit of an exaggeration, but it is quite common. So I hope he's in a good treatment center and he feels okay about his options. Do you know what stage it was when it was diagnosed? Is it early? Early, I believe. Good. Okay. Okay.

Okay. And then not sure about what treatment he's doing, but maybe more decisions to come on that front. I believe so. Okay. All right. Well, hopefully he's in good hands with his support team at home as well. Who else in his family has had cancer? Any of his brothers and sisters? Yes.

All his brothers and sisters. All of them have had cancer? Yes. Okay, so let me first start with, do all of those siblings share the same mom and dad? Yes. Okay, so let's start with an aunt. You said there were sisters. Tell me about his sister.

- So his sister, he has one sister. She is, I believe she's 48 right now. She's younger than him. - Okay. - She was diagnosed with breast cancer really young, I believe 37 or something around there. - Oh my goodness.

Breast cancer, also a pretty common cancer. We say one in eight women will go on to develop a breast cancer in the general population. But that was quite young. You know, for me, anything under the age of 50 is pretty young. So I'm curious about this for sure. She's 48. Do you know what kind of treatment she had or what stage it was when it was diagnosed? Whatever you know.

Vaguely, I remember her losing her hair, so I think she did chemo. Okay. And maybe, do you know if she did surgery? Maybe surgery, but not too sure on everything else. Okay, that's all right. And is she doing okay now? Yes, she's recovered now. Good. Does she have children? She has two sons. Two sons. Any health concerns for them? No. Okay. Around your age, both of them?

Okay. What other brothers and sisters for your dad? And he has two more brothers. Okay. Older? One older, one younger. Okay. Tell me about his older brother. His older brother is 63. Okay.

And also has or had prostate cancer, unsure, but I remember that being a conversation. And you know, sometimes families don't clearly talk about this. Sometimes cancer is like the C word and people are really avoidant of it. So totally okay to not have all the details there. But maybe prostate cancer, not sure. Any idea when that was, like how old he would have been if he's 63 now? Maybe...

Five years ago. Okay, so late 50s, early 60s, kind of a... Okay. And how's he doing? He's still alive. He's still alive. Okay. But maybe you don't know exactly the health details there. Does he have children? Yes. A son and a daughter. Son and a daughter. How are they doing? They're doing well. No health concerns for them. And they're a bit older than me, maybe in their 30s or 40s. Okay. Do they have kids? Yes. Yes.

Who has kids? Both of them have kids, but they're both healthy. Okay. Excellent. Okay. And that was the older brother. Tell me about your dad's younger brother. His younger brother is in his early 50s. Okay. And no health concerns as far as I know. Good. Does he have kids? Yes. One son. One son. How's he doing? Also healthy. Good. In his 20s or 30s? Yes. About? Okay. Okay.

Awesome. And does he have kids? Yes, he has one daughter. One daughter. Also healthy. Excellent. Thank you. You knew my next question. Perfect. Is she under, like, how old is she? She is 10. 10? Okay. Young. Yeah. Okay. Anything else as far as your dad's, his siblings' health, anything else for that, you know, generation on that side?

Not for that generation. I believe that's it. Okay, let's talk about your dad's parents. How old or well are they still living? My grandfather's not and my grandmother is. All right. Do you know how old your grandfather was when he passed? I believe he was late 60s early 70s. Okay, and do you know what he passed from? Yes, he had passed of prostate cancer and lung cancer. Okay.

He had both. And do you know when he was diagnosed with those cancers? Maybe a year or two before he passed. Okay. Okay. So older than the age of 50. Yes. All right.

And that was what your understanding was as he was diagnosed and he ended up passing away from those cancers. Yes. Do you know if the lung cancer, if you happen to know, if they mentioned it being metastatic or related to the prostate cancer, do you think he was diagnosed separately with those two cancers? Metastatic sounds familiar. Okay. And your dad's mom, is she still living? Yes, still living. She's 80. 80.

How's her health? Still good. Good. Good. And where is this side of the family from in the world or ethnicity, what do you say? Ethnicity, I'd say African American. Okay. Anyone that we missed that you want to talk about in the family?

No, that's all I can think of right now for my family members. Okay. Well, thank you for sharing all of that. It does really help me when I think about the next part of our conversation, which is I'll tell you a little more about what we understand for how cancer develops and what we know about what family history has to do with that. So knowing the ages of folks and knowing what types of cancer are in the family is really helpful for me so that I can talk to you about it today. Yeah.

So I appreciate you sharing all of that. Thank you. Yeah. So what I will say is the next thing I want to talk about is genetic testing. And before we get into that, blood or saliva tests, which we could do today. Mm-hmm.

I like to always tell people that first and foremost, we think most of the time cancer happens by chance or sporadic. So we expect that sporadic cancer, we don't expect to see a lot in the family history for that person, and those cancers are typically diagnosed over the age of 50, right?

So later in life, we know that we're being exposed to things throughout our life, whether that's smoking, whether that's just our environment. Also, just our cells are growing and dividing over time. And sometimes, quite normally, there are mistakes that happen. And that's usually how a tumor will develop.

So, like I said, most of the time cancer happens sporadically or by chance, and it doesn't really have to do with our genes or things that are running in the family. Really, that's a rarer type of cancer. Oh, really? Yeah. And I know it can be kind of surprising. We sometimes think, oh, I have it in my family, so I'm definitely going to get it. But really, a lot of the time, that's certainly not the case.

even if it is hereditary. And so I'll talk about that. So taking us back a little bit, maybe to biology class, you may remember, we have two sets of every gene. Genes are instructions. This is how the body knows what to do, knows how eye cells should be eye cells, skin cells should be skin cells, etc., etc. And we have two copies. We have one from our mother and one from our father, both of our biological parents.

And the genes that we're going to talk about today are good genes. They're cancer protection genes. They sometimes get a bad rep when we're talking about things, but these genes, their role is to tell the body how to fight off a cancer if it starts to develop. Like I said, mistakes happen all the time in our biology.

And so with hereditary cancer, what we're talking about is someone is born with one copy of those two genes, either from their mom or from their dad, that isn't functioning properly, right? And so with sporadic cancer, you go from having two healthy copies that you're born with in all of your cells, and over time, something happens to those, and that's usually how a tumor can start.

Okay. With hereditary cancer, someone is born with what we call in the cancer field a mutation. It means that that cancer protection gene copy isn't working so well. So you can imagine all that needs to happen is one thing to take out your other healthy copy, and then that leaves someone less protected from cancer.

: Okay. You don't need to memorize that part so much. I just want you to understand that those are the genes that we're looking into. And what that means for people is if they're born with one of these mutations, overall, we see a higher chance to develop a cancer.

So I've told you today, prostate cancer is relatively common for men. Breast cancer is also relatively common. That's why we wear pink for October breast cancer awareness. There's great screening that we can do because it affects so many people. We want to make sure that everyone is doing the screening that they can.

for individuals who have these hereditary conditions where there's this higher chance passing in the family, we're talking about a much higher chance for breast cancer to develop. So instead of a one in eight or 12 and a half percent lifetime risk, some of these individuals, depending on the gene, might have closer to over a 50% lifetime risk for breast cancer. - But not 100. - Not 100, that's a great point. Yeah, so I want folks to know that we don't expect

Well, I should say the vast majority of the time, like I said, cancer is not hereditary. It's rare for us to find these syndromes. And when we do, it's a really important point that it doesn't mean that you're going to develop a cancer. It just means that there's a higher chance compared to the average person. Does that all make sense? Any questions on any of that? No, it's starting to make a lot of sense to me. Okay, great.

Our family history is still important, so we can do genetic testing and it can all come back negative. But still, it's important to share this information with your providers because there may be different screening that they can offer you and say, you know what? Knowing you had an early breast cancer in your family like your aunt, we'll talk about the genetic testing, but...

Even putting that aside, it might mean that you would benefit from doing more screening or starting earlier than the average person. - Okay. - Okay? So I'll talk about the genetic testing, like I said, we can do that today. That is done via a blood draw. So we have phlebotomists here at the clinic.

What that test is looking for is it's basically a spell check for those cancer protection genes. It looks at a whole bunch of them depending on what you're interested in. And of course, knowing your family history, I would want to make sure we're looking at the prostate cancer genes, the genes that relate to breast cancer. And you have the option to include others, including, for example, leukemia. We know that that's in your family.

A lot of the time, leukemia, especially in children, is not inherited. And on that side of the family, we didn't see a whole bunch of other cancers that are related. So I'm not super suspicious for that, so you're aware. But there's three ways that the genetic testing can come back. So most of the time, it's negative.

And in that situation, like I just told you, we say, great, we did this spell check for the cancer protection genes. We didn't find any known problems in any of them.

Science isn't perfect, and it doesn't change the fact that you have that family history, like I said. So we say, okay, we got a negative result. We're going to keep treating you based on your personal and family history. Okay. Okay. That would be the conversation we would have at that point. Rarely, it comes back positive. Positive is what I described where we found a mutation.

When that happens, we often have guidelines from the national cancer experts that say, "Okay, somebody who has a mutation in this gene, this is how often they should do screening. This is how old they should start. This is how frequently they should do it." So there's really good guidance that says, "Okay, we know that this person has a different risk than the average person. Here's what we do about it." Okay. That's relieving to hear. Good. That's the one that can be, I think, kind of scary.

And so we would talk through any of that. If it were to come back positive, I will be following up with you no matter what, but we would have a much longer conversation just to make sure that you understand what that means for you.

The other important thing to know with genetic testing and a mutation being identified is it's obviously we share a lot with our family. And so this is important information not just for you, but for any of your family members. If we found a mutation, your first degree relatives, so your mom and dad and your siblings, you don't have children, all of them would have a 50% chance to have the same mutation.

So that would be a conversation that might need to happen at that point. I like to give folks a heads up about that. And so that would be the positive, again, rare result type, not always something we're expecting, but if it does, that's what it means. Any other questions on positive versus negative?

No, since you said that we'd have a longer conversation if I do come back positive. I don't have any questions right now. Okay, excellent. So there is one other kind of result that I have to tell people about, which is a common one. So like I said, we're doing a spell check. There are different ways to spell my name, Catherine. You can spell it with a C, you can spell it with a K.

Technically, they're both Catherine. But if you put like an L instead of an A in my name, I don't even know how you would pronounce that. Probably you would have a hard time. So there are some spelling changes in these genes, which are made up of letters that we basically don't know the impact that they're having. So these are called variants of uncertain significance. Again,

Pretty common result type. And what I want folks to know about these is it's a spelling change. We don't know if it's increasing the risk for cancer or not. The vast majority of the time when we figure these out, we have enough evidence and science is able to definitively say, hey, this is causing cancer or it's not. It's benign. So it's not increasing the risk for cancer. Not all the time, but most of the time.

And for that reason, because it's a little unknown and uncertain, we keep going based on the personal and family history. So same as a negative result. Okay. And I like folks to know this upfront because if it comes back uncertain, it is not the same thing as a positive. And we wouldn't have that same conversation about,

screening and you need to do this and do that, we're actually going to do the same conversation as a negative. So negative in VUS, that's how most of it comes back. We keep going based on the personal and family history. And if it's positive, we have guidance as to what to do. Got it. Okay. Thank you. You're welcome. So I just want folks to understand that. We can do the testing today, I will say, based on your family history. I want to make a couple of comments here. So

Number one, we like to try to test the people in the family who have had the cancer diagnosis. I like to think of this as like the needle in the haystack. We're looking for, these are rare syndromes, right?

Cancer is relatively common, as we've talked about. So testing the people in the family who especially were more suspicious, if you will, like that early onset breast cancer, I would love to know if your dad, your aunt, anyone on that side has been offered genetic testing. Do you happen to know? Unsure about the aunt. Okay. And I don't believe my father has been offered or he hasn't mentioned it to me that he's been offered genetic testing. Okay.

And that's helpful to know. We can certainly test you today. We just say, you know, if you come back negative, I don't know if there's still something in the family. And so this might still be an important conversation to have with them. Because if you come back negative, that is great.

But I would really love to make sure we've tested all of the people who are at risk for a hereditary cancer mutation. And then let's say they test positive. I now know that you are truly negative for something going on in the family. Does that make sense? That makes a lot of sense. Yeah. So how are you feeling about that right now? Right now? Well, my father has a lot of decisions to be making right now. So I don't want to add another thing to his plate. Absolutely.

So I'd rather still get the testing for myself and if I happen to come back positive, I can

help, like, get the rest of my family maybe considering testing without having to go through my father. Well, that's really thoughtful of you. I know your dad probably does have a lot going on, and his providers will likely talk to him about genetic testing if it would be helpful for his treatment. But for now, I think it's a great idea to still do genetic testing for you if you're interested. How are you feeling about it for yourself? Absolutely. I'm really interested in it. Awesome. So we have some options. Like I said, there's different genes that relate to different cancers.

We have what I like to call the small, medium, and large options. Small would be we focus on the breast cancer genes, and there's about 13 of those that we could look at.

Medium is pretty commonly ordered and it's the common hereditary cancers. So that would be breast, ovarian, prostate, pancreatic cancer, and colon as well. And that's more like 48-ish genes. And then there is the large one, which is going to include rarer cancer syndromes. So think like brain tumors, maybe some of the leukemia genes.

That's more like 70-something genes. So the exact number doesn't necessarily matter. It's more that the more genes that we test, the more there's a chance for that uncertain result, the variant of uncertain significance. And so it totally is up to the person I'm speaking with as to their preferences, if they feel comfortable with that possibility and they say no.

I just want to know as much as I possibly can if I'm going to do this testing. They might go for the large one. And then for other people who say, oh, I'd rather focus on just what's in my family, maybe we do the medium or a smaller. What do you think about that? Would the price be the same for all the panels? Great question. Yes. Yes. So especially because we're hoping this is going to get covered by insurance, doesn't matter what size panel you pick.

We're going to go based off of your family history anyway. Right, right. I think I'd just go for the bigger one. I'd want to know more information. Yeah, you're not alone in that. I think a lot of people feel similarly. So that's wonderful. So I will put that into your order that we'll do the big one today. And

And I wanted to mention a couple other things. So we talked about, or we'll talk about billing, but there's also a law called the Genetic Information Non-Discrimination Act, or GINA, much shorter. And what GINA means is that

Legally, there are protections so that you can't be discriminated based on your genetic information for employment, for health insurance. There are some limitations to that, but it's not protective at this point for life insurance, long-term care, or disability. Those are things that I will say a lot of my patients who have kids are thinking more about life insurance.

It's another personal preference. We don't have any data or evidence showing that these companies are discriminating based on genetic information. It's possible even that someday they would say, "Oh, this is very proactive and it's going to take care of this person over time." But we can't guarantee anything. So I do like folks to understand

Some individuals might say, you know what, I'm gonna go get a life insurance policy in place first before I do this testing. And others say, I haven't decided necessarily on life insurance or that's coming down the road and I really want this information now. How are you feeling hearing that? - Definitely in that last camp for sure. I'd rather just get this information now

when life insurance isn't on my mind right now. - That makes sense, that makes sense. Like this is more top of mind, we'll get this information in the next few weeks and then you can deal with life insurance someday if you want to at that point. Awesome, so I've got the test selected that we wanna do.

I have a consent form here, which goes over everything we talked about, the different types of test results, Gina, the tests that we're going to do for you, and a little bit about billing. So I'll have you sign here, and then I will send you over to the phlebotomy clinic in just a second. All right. Sounds good. Thank you. Thanks. We can absolutely do the testing today. Like I said, it's a blood draw. The results usually take two to three weeks to come back. I would be giving you a phone call.

Like I said, if it comes back positive, we could have a longer conversation. And if that phone call needs to be turned into an appointment, we can absolutely do that. And then otherwise, I can email you the results when they come back.

I want you to know that most of the time this testing is covered by insurance. So especially when, like in your family, you actually meet criteria for genetic testing based on the National Comprehensive Cancer Network guidelines. Fancy way to say I would expect this to get covered

by insurance. So I will send your insurance information to the lab. The lab that I work with though, if there's an expected out of pocket cost for this test, they're going to text you. And so if you get that text message, they list their billing information, give them a call.

And then they have patient assistance options. They have ways to make it affordable if there's an expected out-of-pocket, like you have a high deductible or something like that. But any concerns about billing or questions there? About billing?

Hopefully it gets covered by the insurance, but I'm able to respond to the text when it comes if I need to. Excellent. So look out for the text. I don't expect you to get one, but keep that in mind. And then so you're aware, one other option with the patient assistance is there's also a self-pay cost of $249. So...

Worst case, if that text comes through and it's a number that isn't feasible for you, know that you can always switch to the self-pay cost of $249. Okay. That's a relief to know. Yeah. Excellent. So I don't want any unexpected bills. I don't expect them at all. And that's something we can take care of today. I let you know that the results will be back in a few weeks. I will give you a call. What other questions do you have for me at this point?

No other questions at this point. Thank you. You've answered all of my questions and I feel much better now than I did when I came into the office. Excellent. I'm really glad to hear that. It was so nice meeting you. I'll send you off to the phlebotomy clinic and then I'll be giving you a call in a few weeks. Sounds good. Thank you. Yeah, thank you.

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Here's a bonus. If you do and send us a screenshot, I'll give you a shout out on the show. DNA Today is created, hosted, and produced by myself, Kira Deneen. Our team includes communications lead, Corinne Merlino, video lead, Amanda Andreoli, outreach intern, Sonia Tanaykar, social media intern, Kajal Patel, and graphic designer, Ashlyn Anokian. Thanks for listening and join us next time to discover new advances in the world of genetics.

All made of DNA.

Looking to jumpstart your career as a genetic assistant? These essential roles involve patient communication, data management, genetic testing coordination, and admin tasks, making proper training a must. The Genetic Assistant Online Training Program at Johns Hopkins University School of Medicine is a top choice. DNA Today listeners rave about how this course boosted their genetic counseling skills and prepared them for grad school.

The spring cohort starts soon on January 27th, so apply now before it's too late. The program includes two 10-week instructor-led courses. Armed with a basic science background, you'll earn a certificate from the Johns Hopkins School of Medicine upon completion. You'll also gain practical skills and insights from leading instructors that will give you a competitive edge in genetic counseling and related fields.

Learn more at dnapodcast.com slash sponsors or simply search Genetic Assistant Online Training Program, Johns Hopkins.

When it comes to your health, knowledge is power. I've always believed that the more we understand about our bodies, the better decisions we can make, whether it's about the food we eat, the exercise we choose, or how we plan for the future. But traditional healthcare often feels reactive and not proactive. That's why I'm so excited about 23andMe Plus Total Health, a longevity platform that puts you in the driver's seat of your health journey.

Again,

Again, that's 23andMe.com slash DNA Today. You can also find this link at DNAToday.com. Take charge of your future health with 23andMe Plus Total Health because your health deserves a personalized approach.