Some years back, one of my cousins was diagnosed with cancer. In a small village like ours in India, it was rare. And that I believe was the first time I have ever heard of the term ‘cancer’. With her strong will and determination, she overcame the challenge and beat cancer. I still remember the way she would smile with that face tired with having to ingest so many medicines and without much hair to decorate the head. But even with the pain and fear, the first question she asked the doctor was whether her kids were at risk of getting cancer as well. Finding an answer to that question was kind of difficult at the time, but it isn’t now. The answer is in a word, well two words are ‘Genetic counselling’.
Genetic counselling is the process of advising individuals and families affected by or at risk of genetic disorders to help them understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. For eg; almost 5 to 10 per cent of ovarian cancer has an underlying genetic factor that is hereditary. People, with the help of genetic counselling, can make an informed decision on the basis of the details provided.
Genetic counsellors are involved in the education about inheritance, testing, management, prevention, etc, interpretation of family and medical histories to assess the chance of disease occurrence or recurrence, and counselling to promote informed choices and adaptation to the risk or condition. A genetic counsellor is in many ways, an integral part of our health care system today. With a lot of genetic disorders and hereditary diseases going on around, we need clarity and genetic counselling can provide that clarity. A lot of these diseases, if diagnosed at an early stage, can be controlled to a big extend. This is especially true for psychiatric disorders.
A major portion of beneficiaries of this system are couples who are expecting. With proper testing and medication, pregnancy can be the first step to a healthy life. In the case of psychiatric and neurological disease, there is a high risk of heritability. And it is always better to know beforehand of the risk and implications. But this isn’t aimed at discarding the weak genes and promoting the stronger ones, rather this is based on the notion that humans aren’t just a combination of genes.
You might have heard of Eugenics and the controversy behind. It was Francis Galton who came up with the idea of an intelligence test to identify the people in the lower strata in terms of intelligence (the intelligence test he proposed was a total disaster, which we will discuss at another time). Adolf Hitler supported this venture and promoted selective breeding, by sterilizing the people below the average intellect level. Well, this could have been the dark history of genetic counselling. But the field has since been sanitized and is now one of the most trusted departments in healthcare.
With the coronavirus pandemic hesitating to leave the world stage, it is time we start rethinking our health care decisions. What we need now is a holistic approach. If experts from all fields can join hands with the authorities and the public (metaphorically that is) we sure can achieve higher feats in the health status of our respective countries.
