An eighth-grade biology lesson is where a young Jenny Geurts, now a certified genetic counselor at the Medical College of Wisconsin (MCW), discovered what would become her life’s work.
“The lesson on the Punnett square is where it clicked for me,” she recalls. “Since then, I have always found genetics fascinating. Genetics is always changing and it affects everyone’s lives. I found genetic counseling is the perfect harmony of using science to help patients and communities.
Today, Geurts is part of a team of genetic experts at the MCW Genomic Sciences and Precision Medicine Center (GSPMC) and the Institute for Health & Equity (IHE) leading the way in genetic research, patient care, community engagement and education with the goal of helping guide early detection and prevention of disease. Genetic counseling is part of the burgeoning field of precision medicine, where health professionals can tailor patient screenings, treatment and interventions based on a person’s genetics, lifestyle and environment.
“Genetic counselors can provide patients and their providers with information they need to understand what conditions a patient is at risk for developing,” Geurts explains. “Ultimately, this information is valuable for providers so they are better prepared for delivering personalized care, and for patients who can play a role in prevention by reducing modifiable risk factors.”
Some inherited gene mutations and their link to certain cancers are well known, like the BRCA1 and BRCA2 genes linked with increased risk for breast and ovarian cancers. But genetic experts at MCW are also looking beyond these common links and researching inherited gene mutations in other types of cancers including melanoma, prostate cancer and pancreatic cancer.
“Our main focus at the Cancer Center is prevention and early detection of cancer. We work to try to understand the cause of the disease and try to prevent it from affecting future generations,” Geurts explains. She says her role allows her to provide services beyond just genetic testing.
“In the last 10 years, genetic testing has become a very hot topic with the popularization of direct-to-consumer tests people can buy at the store. High-profile cases of people who have had genetic testing are featured on magazine covers and very visible in the media,” Geurts says. “Understandably, people have some fears about ways their results can be used against them. I encourage people with a family history concerning for a genetic disease to talk through those fears and opportunities with a certified genetic counselor.”
She notes that genetic testing may not be right for everyone. Rather, the purpose of genetic counseling is to equip people with information they need to make an informed decision about whether genetic testing is right for them and their family. Part of a genetic counselor’s role is to help people understand what types of genetic tests are available to them.
“What we are doing with genetic testing is reading a person’s DNA, the body’s blueprint. Scientists believe there are between 20,000-25,000 genes which act as instruction manuals for how our bodies should develop and function. Because of the Human Genome Project, we know how the DNA code should read. When we perform genetic testing, we are searching for any errors or mutations which might cause disease. ,” Geurts explains. “If we find a causative gene mutation, we help people understand their options for what to do with the information and walk them through what the results mean for them and their family.”
Geurts and other genetic counselors at MCW are working to make this level of care more accessible to patients through community education and research. By engaging in listening sessions with community members and participating in research programs like the All of Us Wisconsin project, she says her team hopes genetic repositories will become more representative of populations in Wisconsin and across the U.S.
"Genetic samples should be representative of the communities we serve, but there are underrepresented populations in genetics research,” she notes. “We are working to engage communities to understand the different genetics that happen in different populations, and make sure populations that have not had access to genetic counseling in the past receive that access. Today, Medicaid and Medicare do not reimburse genetic counselors for their services. We are working in policy areas on the federal, state and local levels to make systems more equitable and inclusive for healthier populations in Wisconsin and beyond.”
MCW’s genetics experts are also participating in recruiting a diverse workforce that is representative of the patients they see. Geurts says that while the need for genetic counselors is growing exponentially, many students are not aware of the field as a career option.
“People who want to work in health care may think becoming a physician or nurse is the only way to work with patients,” she says. “But we are working to create pathways for students to learn more about becoming a genetic counselor, as well as teaching the various student bodies already here at MCW about the resources genetic counselors on their team can provide.”
Wisconsin has only about half of the genetic counselors it needs to serve the population. MCW is in the beginning stages of developing a program for genetic counseling training, something Geurts is hopeful will fill the growing need for genetic counseling as research strides open more possibilities for prevention and treatment.
“Today, genetic testing is regularly utilized in oncology; however, more advances are coming for other conditions like neurological diseases, cardiology and certain rare childhood illnesses. We are working to provide therapeutics to extend their lifespans considerably,” she says. “We are always looking at new ways to help patients through genetic counseling. The future is exciting, and more discoveries are coming, so we are keeping our eyes on the horizon.”