Nursing in The Genomic Era
An Evolving Role for the
Oncology Nurse
HASSAN ZAHREDDINE, BSN, RN, OCN, DIP.EDU
KING FAISAL SPECIALIST HOSPITAL AND RESEARCH CENTRE-RIYADH
BURDEN OF CANCER IN THE GULF REGION: BRIDGING THE GAPS
21-23 OCTOBER 2014
Genetics Vs Genomics

Genetics


Is the study of single genes and their effects
Genomics

Is the study of the functions and interactions
of all the genetic material in the genome,
including interactions with environmental
factors.
Old Genetics

Single chromosomal and gene
abnormalities (e.g. Down’s
Syndrome, Turner Syndrome)

Genetics care could be supplied
primarily by medical geneticists
and genetic counselors, with
occasional involvement of
primary care providers and other
specialists
From Old Genetics to New Genetics

The Human Genome Project

Completed on April 2003

A landmark event in the history
of mankind
Human Genome Project (HGP)

Project Identified all the approximately 20,000-25,000
genes in human DNA.

Determined the sequences of the 3 billion chemical
base pairs that make up human DNA.

Stored the information in databases and made
available online.

Addressed the ethical, legal, and social issues (ELSI) that
arised from the project.
From Old Genetics to New Genetics

Individualized screening

Individualized behavior changes

Presymptomatic medical therapies.

Individualized pharmacogenomics

Individualized nutrigenomics
Contribution of the HGP to Cancer

Describe the biology of disease at the molecular
level.

Characterize malignancies according to the
biomarkers.

Develop new therapeutic modalities that target
specific cancer molecular biomarkers

Identify individuals at increased risk of developing
cancer
Some Hereditary Cancers with
Available Genetic Screening Tests
Cancer Type
Genes
Breast and ovarian cancer
syndromes
BRCA1, BRCA2
Li-Fraumeni syndrome
TP53
Cowden syndrome (PTEN
PTEN
hamartoma tumor syndrome)
Lynch syndrome (hereditary
nonpolyposis colorectal
cancer)
MSH2, MLH1, MSH6, PMS2,
EPCAM
Familial adenomatous
polyposis
APC
Retinoblastoma
RB1
Multiple endocrine neoplasia
type 1 (Wermer syndrome)
MEN1
Multiple endocrine neoplasia
type 2
RET
Von Hippel-Lindau syndrome
VHL
Why Should Nurses be Interested in
Genomics?

To meet the challenges of the genomic healthcare.

Understand genetic terminology

Identifying genetic contribution to disease and drug
response.

Understand new technologies.

Nurses are a primary resource for patients

Philosophy of holistic patient care is basic principle in
nursing

Advocacy
Why Should Nurses be Interested in
Genomics?

Transforming healthcare from diagnosis and treatment to
prediction and prevention (ICN 2005).

Nurses facilitate communication among family member,
the healthcare system and the community resources

Medical and biotechnology companies are moving quickly
toward new genetic tests and new therapies based on
genomic information

Genetic-testing gatekeepers
A Multitude of Roles for Nurses in
the Genomic Era

Clinical care

Individual and family counseling

Patient education

Policy making

Ethics

Research
Genomics for Nurses Across the Nation

Multiple agency, organization and academic
collaboration.

Consensus and endorsement of competencies
required for nursing

Strategic plan for implementation

Integration of genetic/genomic information into
curricula, board exams, specialty certifications tests,
continuing education programs, and accreditation
standards
Integrating Genomics into Clinical
Practice
Useful Genetic Web Sites for Professional Information

American Board of Genetic Counseling

http://www.abgc.net

American Board of Medical Genetics
http://gslc.genetics.utah.edu

http://www.abmg.org

American College of Medical Genetics
American Society of Human Genetics

Association of Professors of Human and Medical Genetics

Centers for Disease Control and Prevention, Office of Genomics
and Disease Prevention

Genetic Alliance

Genetics Education Center at the University of Kansas Medical
Center
http://www.kumc.edu/gec

Genetics Education Partnership
http://genetics-education-partnership.mbt.
washington.edu
National Organization of Rare Disorders (NORD)
http://www.rarediseases.org

http://www.geneticalliance.org

National Human Genome Research Institute, National Institutes
of Health
http://www.nhgri.nih.gov/
http://www.cdc.gov/genomics/

National Coalition for Health Professional Education in Genetics
http://www.nchpeg.org
http://www.faseb.org/genetics/aphmg/aphmgl.htm

International Society of Nurses in Genetics
http://www.isong.org
http://www.faseb.org/genetics/ashg/ashgmenu.htm

HumGen
http://www.humgen.umontreal.ca/en/
http://www.acmg.net

Genetic Science Learning Center
National Society of Genetic Counselors
http://www.nsgc.org

Online Mendelian Inheritance in Man (OMIM), National Center
for Biotechnology Information
http://www.ncbi.nim.nih.gov/omim
Biotechnology: The Future is Now
A “digitally native” generation
Social Media and Public
Access to Information
Number of Genome Wide Association
Studies (GWAS) 2005 – Q4 2007
Courtesy of:
Number of Genome Wide Association
Studies (GWAS) 2005 – Q2 2013
Courtesy of:
Number of Genome Wide Association
Studies (GWAS) on Cancer 2005 – Q2 2013
Courtesy of:
Cancer Early Detection -Miroculus
Phone
MicroRNA
detection
platform
Conclusion
For our patients and the public to
benefit from the emerging trends in
healthcare technology in cancer
care, we have to be ready to jump
the curve of the exponential growth