Shobana Kubendran loves putting together family trees. From them, she helps people tease out the answers to questions that often begin, "What are my chances of having ... ?" Kubendran, 32, is a certified genetic counselor, the first one Wichita has had in seven years.
That means she helps people look for patterns that could indicate an increased risk for disease and disorders, and she counsels them about their options.
Kubendran is one of five certified genetic counselors in Kansas; there's one in Topeka and three in Kansas City.
Her work is the result of a partnership between the University of Kansas School of Medicine-Wichita and Wesley Medical Center. She's on the staff of the medical school's pediatrics clinic but she isn't limited to pediatrics questions.
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Kubendran says her clients fall into three core groups:
* Pregnant women, who want to know whether their baby might be affected by a genetic condition such as cystic fibrosis or Down syndrome.
* Parents of children with developmental delays or birth defects, who want to know whether it could happen again and how best to help their children.
* People who have cancer or whose relatives do, who want to know how to prevent it in themselves or others.
Many of Kubendran's clients come to her through referrals from their physicians, but that's not necessary — people can call on their own.
Often, a call is enough to reassure people.
"Most of the time, my job is telling them, 'Your risk is not as great as you thought it was,' " she says.
For example, many women know that a mutation in the BRCA1 or BRCA2 gene increases the risk of breast cancer.
But only 5 to 10 percent of women have the mutation, and the test costs $3,000, so it's not practical to give it to every woman.
Instead, Kubendran would ask a woman about a history of breast cancer in her family, looking for at least two close relatives who'd had breast cancer, especially at a young age, or for other evidence.
And if a woman does have the mutation, Kubendran could help assess her risk and options to prevent breast cancer.
Assessing risks is always a matter of probabilities, she says. As a patient, "you want that reassurance that what you're doing is appropriate."
Kubendran fell in love with genetics in her native India, where she received her medical training. After getting her degree, she went on to do research in neuropsychiatry. She was put in charge of assessing families with schizophrenia or bipolar disorder, to look for genetic links.
"I loved the fact that you could combine the two fields," she said.
She decided to become a certified genetic counselor, but India didn't offer the training she was looking for. Kubendran got her master's from the University of South Carolina in 2007 and her certification earlier this year.
"My long-term goal is to settle down here and build up a good genetics service," she says.
Not everyone wants to know their chances of developing an inheritable disease or condition, she says. "We are here for the people who do."
And of those who find out, not all will change their lives because of it.
"They just want to know," Kubendran says. "It's OK to want to know for the sake of knowing."
Some insurance covers genetic counseling, some doesn't, Kubendran says. The genetics clinic is willing to work with those whose costs aren't covered by insurance.
Kubendran says a personal medical and family history is the best way to get started to assess risks.
Family gatherings during the holidays are a good time to draw a family tree to look for a pattern of birth defects, heart defects, autism, cancer or similar issues, she says.
Kubendran will be drawing a new family tree for herself in the spring — she and her fiancee, a first-year psychiatry residents, are getting married. They'll return to India for the wedding.
"Trying to plan a wedding in another country — my relatives are having a field day," she says with a laugh.