The Role of the Oncology Nurse in Cancer Genetic Counseling

The identification of genes that, when mutated, are associated with cancer development has transformed cancer detection and cancer management. The genetic revolution, spawned by the Human Genome Project (National Institutes of Health, 2009) has resulted in a shift in focus from genetics (hereditary transmission and the variation of inherited characteristics) to genomics, which refers to the study of multiple genes, DNA sequences, and proteins and their interaction with one another. Genetic and genomic information now can be used to describe the biology of disease, characterize malignancies, develop new therapeutic modalities, and identify individuals at increased risk of developing cancer. As genetic and genomic technology evolves and knowledge of cancer genomics expands, healthcare providers must respond by informing people with cancer, their families, and the public about the implications of these developments for cancer prevention and risk reduction, early detection, and treatment (American Nurses Association & International Society of Nurses in Genetics, 2007). Oncology nurses in all settings have a role in educating patients, families, and the public about cancer-related genetics and genomics. Advanced practice nurses with specialized training in clinical cancer genetics and genomics and cancer predisposition testing may be involved in the clinical application of cancer genetics, including genetic counseling and education. Oncology nurses are able to provide comprehensive care in the area of clinical cancer genetics to meet the needs of the increased number of individuals requesting this service.

It Is the Position of ONS That

  • Further advances in the science of clinical cancer genetics and genomics will increase the need for professional nurses trained in genetics and genomics and cancer care (Calzone & Masny, 2004).
  • Cancer genomic information is integrated into relevant curriculum content and taught at all levels of nursing education (National Human Genome Research Institute, 2009).
  • Oncology nurses at the general and advanced practice levels have educational preparation in the principles of human genetics and genomics and in the critical evaluation of ethical, legal, and social implications of the use of genetic and genomic technology in cancer care (Calzone & Tranin, 2003). Oncology nursing practice related to cancer genetics includes three levels:
    • The general oncology nurse
    • The advanced practice oncology nurse
    • The advanced practice oncology nurse with specialty training in cancer genetics and genomics.
  • Nurses who provide comprehensive cancer genetic risk counseling are advanced practice oncology nurses with specialized education in cancer genetics and hereditary cancer predisposition syndromes.
  • Continuing education and specialized educational programs are developed and provided to practicing oncology nurses.
  • Collaborative relationships between healthcare providers and specialty organizations with a focus in genetics are essential to provide comprehensive care to high-risk individuals.
  • Comprehensive cancer genetic risk counseling includes cancer risk assessment and education, facilitation of genetic testing, pre- and post-test counseling and follow-up, provision of personally tailored cancer risk management options and recommendations, and psychosocial counseling and support services. Practice is consistent with guidelines defined by an individual's state nurse practice act, the nurse’s educational preparation, the scope of the nurse’s role, and standards of oncology nursing practice (National Coalition for Health Professional Education in Genetics, 2007).

References

  • American Nurses Association & International Society of Nurses in Genetics. (2007). Genetics/Genomics nursing: Scope and standards of practice. Silver Spring, MD: American Nurses Association.
  • Calzone, K.A., & Masny, A. (2004). Genetics and oncology nursing. Seminars in Oncology Nursing, 20, 178-185.
  • Calzone, K.A., & Tranin, A.S. (2003). The scope of cancer genetics nursing practice. In A.S. Tranin, A. Masny, & J. Jenkins (Eds.), (pp. 13-22). Pittsburgh, PA: Oncology Nursing Society.
  • National Coalition for Health Professional Education in Genetics. (2007). Core competencies in genetics for health professionals (3rd ed.). Retrieved February 25, 2009, from http://www .nchpeg.org/core/core_comps_English_2007.pdf
  • National Human Genome Research Institute. (2009). Essential nursing competencies and curricula guidelines for genetics and genomics. Retrieved February 25, 2009, from http://www .genome.gov/17517037
  • National Institutes of Health. (2009). All about the Human Genome Project. Retrieved February 25, 2009, from http://www.genome .gov/10001772

Approved by the ONS Board of Directors, 1997; revised 2000, 10/06, 3/09.

To obtain copies of this or any ONS position, contact the Customer Service Center at the ONS National Office at 125 Enterprise Drive, Pittsburgh, PA 15275-1214 (866-257-4ONS; customer.service@ons.org).