by Darrin S. Joy and Alicia Di Rado

In the arid plains of southern Texas, where Gary Unzeitig, M.D., resides, desert heat is the order of the day. Few would identify the area as a major center for specialized cancer care, but his newly honed, prized expertise — gained through City of Hope — is changing the lives of his patients.

Jeffrey Weitzel, right, and Gloria Nunez discuss the intensive course in cancer genetics counseling. (Photo by Darrin S. Joy)

Unzeitig is a breast surgeon in Laredo, where Latinos make up about 95 percent of the more than 226,000 residents. Despite the prevalence of hereditary breast and ovarian cancers among Latinas, no genetic counselors work in the area. So Unzeitig sought help in expanding his knowledge of cancer genetics so he could provide those services to the Laredo community.

He recently completed City of Hope’s Community Cancer Genetics and Research Intensive Course, offered by the Division of Clinical Cancer Genetics to train health professionals in cancer risk counseling and assessment services.

“If I don’t provide the service, patients will not have access to any genetic counseling,” Unzeitig said. “I’m better able to influence and impact my patients’ care as a result of this course, and my patients are also getting an opportunity to participate in national research efforts through City of Hope.”

Supported by grant funding from the National Cancer Institute, the course includes 10 weeks of Web-based learning and five days of interactive cancer genetics workshops at City of Hope. Core training is followed by a full year of Web-based activities, hosted by the Division of Clinical Cancer Genetics, that support course alumni as they integrate cancer risk assessment into their community practices.

Class participants include physicians, genetic counselors, nurses and physician assistants, according to Jeffrey Weitzel, M.D., chief of the Division of Clinical Cancer Genetics and director of the Cancer Genetics Education Program at City of Hope. Reflecting its national and international impact, 225 clinicians from 47 states and seven countries outside the U.S. have completed the course to date.

“We’ve designed the course to provide comprehensive cancer risk assessment training to participants with varied training backgrounds and practice settings,” Weitzel said. He noted that the course, developed in 2001, is the first of its kind.

“The ultimate goals of the course are to help clinicians achieve practitioner-level competence in genetic cancer risk assessment at the community level, and to promote cancer genetics research collaboration to communities with little or no access to them,” he added.

“Like Dr. Unzeitig, many of our participants take what they’ve learned through the course and apply it in underserved communities, where these services are helping us identify and prescribe effective preventive care for high-risk families,” explained Kathleen Blazer, Ed.D., M.S., course co-director and assistant director of the City of Hope Cancer Genetics Education Program. Blazer, a board-certified cancer risk genetic counselor, spoke from personal experience; she regularly provides pro-bono bilingual cancer risk assessment services to uninsured Latino families through an underserved outreach program provided through the Division of Clinical Cancer Genetics.

“Despite stretching our resources to more than triple our initial training goals, ongoing genomic discoveries and direct-to-consumer marketing of genetic tests is fueling increasing demands for cancer genetics training,” Blazer added. “To help meet these demands, we’re redesigning the course with more distance learning features to make it accessible to more health-care professionals across the U.S. and abroad.”

Unzeitig is convinced the course is changing Laredo cancer care for the better. Already, many of the women in his community who tested positive for cancer-predisposing mutations have undergone surgery to reduce their risk — and none have developed cancer.

“Being part of the course, and staying connected to the experts at City of Hope through their Web-based case conferencing and research registry has really made a change not only in my practice, but also in the whole community, which was extremely underserved,” he said. “I think in a year from now we’ll have even more things in place and more success stories to relate.”