Genetic counselor shows patients the options

Neighbors

December 21, 2007|By Janene Holzberg

Just before Christmas two years ago, a patient at Mercy Medical Center in Baltimore was waiting to hear whether she carried a gene mutation for breast and ovarian cancer.

"I was so certain everything would be fine that I went to my appointment alone," recalled Abigail Glassberg of Clarksville. Though there was no history of cancer being passed down through the generations of her family, she had opted for genetic counseling after her older sister had survived late-stage breast cancer.

"When I entered [counselor] Jessica Scott's office, she gently placed her hand on the small of my back and ushered me to a chair," she said. "I knew right then that I had it. Through my tears I could see that she was crying, too."

FOR THE RECORD - In an article on genetic counseling that appeared in the Dec. 21 edition of The Sun in Howard County, Dr. Robert Atlas of Mercy Medical Center was incorrectly quoted when he explained why some patients opt against testing for the Huntington's chorea gene. The quote should have read: "If a parent carries it, you have a 50-50 chance of inheriting it." Further, an individual who inherits the gene will develop the disease.
The Sun regrets the error.

Glassberg, then 45, listened to Scott describe available choices and later underwent a double mastectomy and hysterectomy on the same day.

"What Jessica gives patients isn't just knowledge, but power," the commercial real estate broker explained. "She leaves it up to the individual how to use the knowledge she gives them. For me, as a mother of twin daughters in middle school, I did what I felt I had to do."

Scott, a Howard County native and a Lutherville resident, underscored what Glassberg had discovered, saying that the mantra of genetic counselors is "be nondirective."

"My job is to present options to patients with a family history of cancer or who are pregnant and want to investigate prenatal testing," said Scott, 27. "But it isn't my job to tell them what to do -- it's not my cancer or my pregnancy. I help patients think about things they may not have thought about, so they are empowered to make informed choices."

Scott's passion for her job in the relatively new field of genetic counseling was initially ignited as a freshman at Glenelg High School in 1994.

"I always thought genetics was a fascinating topic," said Scott, whose parents, H. Lee and Dorothy Schultz, live in Glenwood. "I took biology I and II and then the Advanced Placement class -- it was my favorite subject."

Her parents helped foster her love of science early, she said. Her mother is a chemistry teacher, and her father is an environmental scientist who harvests methane gas produced during coal mining for use as natural gas.

Several years after graduating from Glenelg in 1998, Scott took a course in advanced genetics as a senior majoring in biology at Radford University in Virginia.

"When we got to the unit on genetic counseling, I thought, `That's it! That's what I want to do,'" she said. "I had already learned during summer internships that I could not spend 30 years staring into a lab microscope. Finding out about this career was a huge moment for me."

After receiving her undergraduate degree in 2002, Scott spent a year shadowing three genetic counselors in the Baltimore area. She used that experience as a springboard into the two-year master's program at the University of Maryland, Baltimore, where she was one of five students plucked from a field of 80 applicants. She graduated in May 2005 and a month later became Mercy Medical Center's genetic counselor, making her one of 2,200 nationwide, she said.

Shannan Dixon, director of the UMB program, described Scott as "a very, very, bright and kind woman who is a great role model for students coming up through the pipeline."

"Our program is a highly competitive one that relies heavily on clinical rotations in the second year," Dixon added. "That's what limits us to five students; there aren't that many counselors out there to work with -- yet."

Dr. Robert Atlas, head of the hospital's Center for Advanced Fetal Care, where Scott spends half her time, said: "The field of genetic counseling is growing rapidly, just as the landscape of genetics is changing almost daily due to all the breakthroughs in gene identification."

Atlas, of Glenelg, said: "Jessica is an energetic, smart and very caring person -- just what we wanted in a genetic counselor. There is a huge push in society for individuals to check into their family histories, and physicians refer patients to her."

But there are instances when patients would rather not look into a genetic crystal ball, he said.

"One problem is the impact genetic testing results may have on insurance coverage or availability," Atlas said. "Medical insurance is great until you actually need it.

"Another dilemma is whether to find out if you have a defective gene for a disease that you can't do anything about. One gene for which patients often do not opt to be tested is that of Huntington's chorea, a degenerative disease which causes patients to lose control of thought and bodily functions. If you carry it, you have a 50-50 chance of getting it -- so there's a high incidence of suicide associated with that test. It's worse for most people to know that it's coming."

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