Cancer may be caused by abnormal gene changes known as mutations. Mutations accumulate over time, leading to sporadic cancer. Sometimes environmental factors influence the accumulation of mutations. In a small percentage of families, a gene mutation can be passed on from generation to generation. Inherited mutations may predispose those who are carriers to develop particular types of cancer. Not everyone with an inherited mutation will develop cancer, although the risks are increased.
If you or a close relative has had:
Genetic counseling and testing for hereditary cancer is available through St. Vincent Health. Knowing your risk for cancer can help you make informed choices about your medical management, including enhanced surveillance, taking potential medications to lower the risk of developing certain cancers, and other optional preventive measures, such as risk-reducing surgery.
Our board-certified genetic counselors work closely with your physician to help communicate findings that may be important to cancer surveillance and your medical care.
For more information or to schedule a genetic counseling appointment call
Genetic counseling services are available in-person at our Indianapolis campus, and via telegenetics (video consultation) from several locations around the state. To see a map of all telegenetic locations, click here.
In-person genetic counseling services are available at:
Cancer Genetics Risk Assessment Program
At St. Vincent Indianapolis
Professional Office Building, Suite 324
8402 Harcourt Rd.
Indianapolis, IN, 46260
A free parking garage is conveniently located at this location.
Dawn (McIlvried) Nixon is a certified and licensed Genetic Counselor who holds a Master’s degree in genetic counseling. After graduating from the Indiana University Genetic Counseling Program in 2004, she practiced genetic counseling at the University of Alabama at Birmingham (UAB) in preconception, prenatal, pediatric, and cancer genetics. She also was involved in the education of medical students and residents at UAB. Dawn began working at St.Vincent Cancer Care’s Genetic Risk Assessment Program in January 2008. She is involved in several clinical research and professional projects through the Cancer Genetics Program at St. Vincent Cancer Care. She also offers educational presentations for the medical staff and community and is involved with the National Society of Genetic Counselors (NSGC). Dawn is an Adjunct Assistant Professor of Medical and Molecular Genetics at Indiana University School of Medicine, where she teaches a course on Cancer Genetic Counseling and is involved in supervision of genetic counseling students from the Indiana University Genetic Counseling Program. She is also a co-author on several publications related to service delivery in genetic counseling.
Cohen, S.A., and Nixon, D.M. A collaborative approach to risk assessment services using genetic counselor extenders in a multi-system community hospital. Breast Cancer Res Treat 2016; 158(3)
Cohen, S.A., Nixon, D.M., and Scherr, C.L. Development of an iPhone Application to Support Tracking and Adherence to Recommended Guidelines for Women with a BRCA Mutation. Poster presentation at the St. Vincent Hospital Research Symposium in Indianapolis, IN (June 15th, 2016).
Cohen, S.A. and McIlvried, D.E. Do BRCA Positive Women Need Better Follow-Up? Gaining Perspective from a Midwest BRCA Population. Poster presentation at the National Society of Genetic Counselors annual education meeting at Boston MA (October 23-27, 2012).
Cohen, S.A. and McIlvried, D.E. Genetic Counselor Review of Gynecologic Pathology Reports Improves Quality of a Lynch Screening Program. Poster Presentation at the Collaborative Group of the Americas Inherited Colorectal Cancer annual education meeting at Boston MA (October 27-28, 2012)
Cohen, S.A. and McIlvried, D.E. Impact of computer-assisted data collection, evaluation and management on the cancer genetic counselor’s time providing patient care. Familial Cancer 2011; 10(2): 381-9.
McIlvried, D.E., Birhiray, R. and Lu, J. Z. Atypical identification of Lynch syndrome by immunohistochemistry and microsatellite instability testing on jejunal adenocarcinoma. Familial Cancer 2010; 9(3): 377-81. Also presented as a poster at the Collaborative Group of the Americas Inherited Colorectal Cancer (CGA-ICC) national annual education meeting at Dallas TX (October 12-13, 2010)
Cohen, S.A., McIlvried, D. E. and Schnieders, J. A collaborative approach to genetic testing: A community hospital’s experience. Journal of Genetic Counseling 2009; 18: 530-33.
Cohen, S. A. and McIlvried, D. E. Evaluating patient understanding and satisfaction of the genetic testing process for hereditary cancer: Does ordering provider make a difference? Poster presentation at the St. Vincent Annual Research Symposium, May 2009, and at the National Society of Genetic Counselors Annual Education Conference, November 2009.
McIlvried D.E., Prucka S.K., Herbst M., Barger, C. and Robin, N.H. The use of role-play to enhance medical student understanding of genetic counseling. Genetics In Medicine 2008; (10) 10: 739-44.
Prucka S.K., McIlvried D.E., Korf, B.R. Cancer risk assessment and the genetic counseling process: Using hereditary breast and ovarian cancer as an example. Invited review paper, submitted to Medical Principles and Practices, October 2007.
McIlvried D.E., Robin N., Holt R.L., Prucka S., Herbst M. and Barger, C. Medical student understanding of the genetic counseling process: Use of role-play as a unique teaching tool. National Society of Genetic Counselors Annual Education Meeting Platform Presentation and Abstract Publication in Journal of Genetic Counseling, Fall 2007.
Stephanie Cohen is a board-certified and licensed Genetic Counselor. She earned her MS degree in Genetic Counseling at the University of Michigan. She has provided cancer genetic counseling since 1998 and was instrumental in developing the Cancer Genetics Risk Assessment Program at St. Vincent Hospital. Stephanie has been very involved in the field of genetic counseling at a local and national level. She has a special interest in identifying and evaluating service delivery models to expand access to genetic counseling. She has co-authored numerous publications and given presentations across the country on the topic. She also is active in training genetic counseling students as an Adjunct Assistant Professor in the Department of Medical and Molecular Genetics at the Indiana University School of Medicine.
Goedde LN, Stupiansky NW, Lah M, Quaid KA, Cohen S. (2017). Cancer Genetic Counselors’ Current Practices and Attitudes Related to the Use of Tumor Profiling. Journal of Genetic Counseling, doi:10.1007/s10897-017-0065-z
Cohen, SA, Tucker, ME and Delk, P (2016). Genetic Counselor Workforce Issues: a Survey of Genetic Counselors Licensed in the State of Indiana. Journal of Genetic Counseling, doi:10.1007/s10897-016-0026-y.
Cohen, SA, Nixon, DM (2016). A collaborative approach to cancer risk assessment services using genetic counselor extenders in a multi-system community hospital. Breast Cancer Research Treatment, Volume 159, Issue 3, pp 527–534, DOI: 10.1007/s10549-016-3964-z.
Cohen, S. A., Tan, C. A., & Bisson, R. (2016). An individual with both MUTYH-associated polyposis and Lynch syndrome identified by multi-gene hereditary cancer panel testing: a case report. [Case Report]. Front. Genet., Volume 7, Issue 6, doi:10.3389/fgene.2016.00036.
Cohen, SA, Huziak, RC, Gustafson, S and Grubs, RE (2015). Analysis of Advantages, Limitations, and Barriers of Genetic Counseling Service Delivery Models. Journal of Genetic Counseling, Volume 25, Issue 5, pp 1010–1018, DOI: 10.1007/s10897-016-9932-2.
Redlinger-Grosse, K., Veach, P., Cohen, S., LeRoy, B., MacFarlane, I., & Zierhut, H. (2015). Defining Our Clinical Practice: The Identification of Genetic Counseling Outcomes Utilizing the Reciprocal Engagement Model. Journal of Genetic Counseling, 1-19, doi:10.1007/s10897-015-9864-2.
Trepanier, AM, Cohen, SA and Allain, DM (2015). Thinking Differently About Genetic Counseling Service. Current Genetic Medicine Reports, April 2015.
Cohen, S. & Leininger, A. (2014). The genetic basis of Lynch syndrome and its implications for clinical practice and risk management. The Application of Clinical Genetics, 2014:7, pp 147-158, http://dx.doi.org/10.2147/TACG.S51483.
Cohen, S. & Mcilvried, D. (2013). Improving Access with a Collaborative Approach to Cancer Genetic Counseling Services: A Pilot Study. Community Oncology, August 2013.
Cohen, S. (2013). Current Lynch Syndrome Tumor Screening Practices: A Survey of Genetic Counselors. Journal of Genetic Counseling, doi 10.1007/s10897-013-9603-5.
Cohen, S., Marvin, M., Riley, B., Vig, H., Rousseau, J., & Gustafson, S. (2013). Identification of Genetic Counseling Service Delivery Models in Practice: A Report from the NSGC Service Delivery Model Task Force. Journal of Genetic Counseling, 1-11, doi 10.1007/s10897-013-9588-0.
Cohen, S., Gustafson, S., Marvin, M., Riley, B., Uhlmann, W., Liebers, S., et al. (2012). Report from the National Society of Genetic Counselors Service Delivery Model Task Force: A Proposal to Define Models, Components, and Modes of Referral. Journal of Genetic Counseling, 21(5), 645-651.
Cohen, S., & McIlvried, D. (2011). Impact of computer-assisted data collection, evaluation and management on the cancer genetic counselor’s time providing patient care. Familial Cancer, 10(2), 381-389.
Cohen, S. A., McIlvried, D., & Schnieders, J. (2009). A collaborative approach to genetic testing: a community hospital's experience. J Genet Couns, 18(6), 530-533
Cohen, SA. (2009) Muir-Torre syndrome associated with a mutation in MSH6: multiple sebaceous carcinomas as the presenting feature. Community Oncology 6(9), 418-421.
Young SR, Pilarski RT, Donenberg T, Shapiro C, Hammond LS, Miller J, Brooks KA, Cohen S, Tenenholz B, DeSai D, Zandvakili I, Royer R, Li S and Narod SA (2009) The prevalence of BRCA1 mutations among young women with triple-negative breast cancer. BMC Cancer 9:86.
Claire Harwood is a board-certified licensed genetic counselor. She graduated from the University of Pittsburgh in 2013 with a Master of Science degree in Genetic Counseling. After graduation, she worked as a genetic counselor at Levine Cancer Institute in Charlotte, NC, and specialized in adult and pediatric cancer genetics. Claire joined the St. Vincent Cancer Genetics Risk Assessment Program in January 2016. She is involved in research projects and is an Adjunct Assistant Professor of Medical and Molecular Genetics at the Indiana University School of Medicine, where she is involved in teaching and supervising genetic counseling graduate students.
We are now offering genetic counseling services through telegenetics (online video calls) from several St. Vincent Hospitals in Indiana. This telegenetics service will provide access to genetic counseling from designated remote locations with the assistance of a genetic counselor extender.
Telegenetics is available in the following St. Vincent hospitals locations:
Evansville, IN (Vanderburgh county)
St. Vincent Evansville Breast Center
100 St. Mary’s Epworth Crossing
Newburgh, IN 47630
812-469-7001 TEL | 812-485-6890 FAX
Anderson, IN (Madison county)
Address: 2020 Meridian St, Suite 100, Anderson, IN 46016
Kokomo, IN (Howard county)
Address: 1907 West Sycamore Street, Kokomo, IN 46901
Phone number: (765) 456-5687
Telegenetics is a service that provides genetic counseling via online video appointments. Telegenetics allows for increased access to genetic counseling services. These services include, but are not limited to:
If you are identified as an individual who may have a genetic predisposition to developing cancer, a local genetic counselor extender will arrange an appointment with a board-certified genetic counselor. These appointments are conducted at one of several local hospitals. A licensed, certified genetic counselor from St. Vincent Indianapolis will talk to you through an online video call. Appointments incorporate risk assessment of personal and family history, pre- and post-test genetic counseling.
A genetic counselor extender is usually a nurse navigator working in a breast and/or oncology center at your local hospital. Their duty is to receive referrals, triage and coordinate appointments, perform straightforward cancer risk assessment, and sometimes arrange for some basic genetic testing. Genetic counselor extenders undergo training and work very closely with licensed, board-certified genetic counselors to ensure that you receive high quality care.
A genetic counselor is a Masters and board-certified healthcare professional, trained to assess risk based on personal and family medical history of a genetic predisposition to developing cancer present in a family, explain the risks, benefits and limitations of genetic testing, as well as explain results of genetic testing including a review of evidence-based medical management guidelines, if available. Genetic counselors in the state of Indiana are required to be licensed.
An order for genetic testing from your doctor is required. The genetic counselor extender will work with your physician to be sure we have the appropriate paperwork. The genetic counselor extender will also send you a link to a family history collection tool to help triage you to the best type of appointment (in-person risk assessment with the genetic counselor extender or telegenetics session with the certified genetic counselor). If you have questions, concerns, or are interested in telegenetics, please contact a genetic counselor extender at one of our locations.
Telegenetic appointments are typically 45-60 minutes. A genetic counselor extender will set up the telegenetic session and will facilitate any technology needs you may have. The pre-test counseling session is used for risk assessment and to discuss testing options. A sample for testing can be collected by the genetic counselor extender the day of the appointment. Most testing results are returned via phone call; a post-test telegenetics appointment can be arranged to review results when needed. This follow-up appointment typically takes 30-60 minutes.
Genetic counseling involves reviewing your personal medical and family history, discussing your risk for developing cancer, and the risk there is a hereditary cause for cancer in your family. We will discuss genetic testing options that may be available, including the risks, benefits and limitations of testing, as well as how the information may impact medical management for you and your family members.
Prior to your appointment, you will be sent a secure link via email to complete your medical and family history online. This information is used during the appointment to determine your personal risk for developing cancer as well as the likelihood that there is a genetic predisposition for cancer in your family. Completing this on-line ahead of time allows for more time during the genetic counseling session to discuss personalized risk, surveillance and testing options. Additionally, it allows the Genetic Counselor the opportunity to review your history before the appointment and prepare.
We will discuss the benefits, limitations, and potential outcomes of genetic testing during your visit and how they may have an impact on medical management for you and your family. Genetic testing may not be appropriate for everyone, and many factors need to be considered. Currently, genetic tests are available to detect a variety of hereditary cancer syndromes. These include (but are not limited to) cancers that involve the breast, colon, ovary, thyroid, kidney and prostate.
Genetic testing may be done using saliva or blood. If you would like the option for testing with saliva, you should not eat or drink for 30 minutes prior to your appointment. In most cases, results take approximately 3 weeks to be completed. We usually contact you by phone with the results. If a mutation is identified with genetic testing, we will schedule a follow-up visit to discuss the test results and their implications.
Genetic testing is usually covered by insurance companies. We cannot establish coverage for genetic testing until we assess medical and family history during our initial genetic counseling session, as this information is important to determine which laboratory will be used, what test will be ordered and if you meet medical criteria for testing. We will work with the laboratory that provides genetic testing to ensure the best coverage possible. How much you have to pay out of pocket is determined by your insurance plan and deductible. The good news is that in most cases, the out-of-pocket cost is $100 or less. There are also options for financial assistance for those who have no insurance, and payment plans that may be investigated if testing is not fully covered by those with insurance.
The genetic counseling session is covered by many insurance companies. Genetic counseling is billed under the CPT code for genetic counseling (96040). The doctor who referred you should determine if a pre-certification is necessary for your visit, but if you are concerned, you should call your insurance to determine if this CPT code is covered by your particular plan. Genetic counseling is not a covered benefit for those on Medicare, although Medicare frequently covers the cost of genetic testing and there is a financial discount for individuals who do not have coverage for the session. St. Vincent Health also offers a sliding scale for those who need financial assistance. You can call 1-800-582-8258, or email firstname.lastname@example.org for more information.
See the website, St. Vincent Billing Services for financial assistance information, contact numbers and applications.
There are state and Federal laws in place to protect against health insurance and employment discrimination with respect to genetic test results. Please note that there are no such protections in place for life insurance and long-term disability. Therefore, if you have no personal history of cancer, you may want to make sure you have your preferred life insurance in place prior to genetic testing. For more information on Genetic Discrimination/Public Policy, please see these resources:
For more information or to refer a patient, please call 317-338-RISK (7475).
After an appointment is made, please complete and sign our Fax Order Form (see below), and send along with medical records to 317-583-2436. Please remember to pre-certify your patient’s genetic counseling visit.
During a genetic counseling visit, our licensed, board-certified genetic counselor will review your health history and your family history to look for any risk factors. If there is a family history of a birth defect or genetic disorder, the genetic counselor will discuss the chance that the condition will occur again in your family. The genetic counselor will also provide up-to-date information about available screening and diagnostic tests, treatments, research options, support groups and community resources.
We will help you to sort through and understand your risks and to understand the variety of testing, screening and treatment options available. Our goal is to ensure that you and your family are comfortable with the decision you make and that you feel you make an informed choice.
The Genetic Counselor works in concert with St. Vincent Maternal Fetal Medicine physicians.