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. Genetic 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 technology evolves further and knowledge of cancer genetics expands, healthcare providers must respond by informing patients, families, and the public about the implications of these developments for cancer prevention and risk reduction, early detection, and treatment. The genetic revolution has impacted the specialty of oncology nursing, and oncology nurses in all settings have a role in educating patients, families, and the public about genetics related psychosocial support, counseling, and referrals related to hereditary cancer. Additionally, advanced practice nurses, with specialized training in clinical cancer genetics and cancer predisposition testing, may be involved in the clinical application of cancer genetics, including counseling and education. Oncology nurses with appropriate education and training now 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 will increase the need for professional nurses trained in genetics and cancer care.
• Cancer genetics information must be integrated into relevant curriculum content and taught at all levels of nursing education. Oncology nurses at the general and advanced practice levels must have educational preparation in the principles of human genetics and in the critical evaluation of ethical, legal, and social implications of the use of genetic technology in cancer care.
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
• Nurses who provide comprehensive cancer genetic risk counseling must be advanced practice oncology nurses with specialized education in hereditary cancer genetics.
• Continuing education and specialized educational programs must be 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 highrisk 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 must be 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.

Bibliography

Calzone, K.A., Jenkins, J., & Masny, A. (2002). Core competencies in cancer genetics for advanced practice oncology nurses. Oncology Nursing Forum, 29, 1327-1333.

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.), Genetics in oncology Practice: Cancer risk assessment (pp. 13-22). Pittsburgh, PA: Oncology Nursing Society.

International Society of Nurses in Genetics, Inc. (1998). Statement on the scope and standards of genetics clinical nursing practice. Washington, DC: American Nurses Publishing.

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

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