When Dana arrived at her Cancer Fight Party, Kelly Teed was already there, answering questions about genetic testing in her quiet Canadian voice. At age 34, Dana Thomas had been diagnosed with breast cancer. She’d tested negative, though, for variations in the BRCA1 and BRCA2 genes, the best-known gene mutations that increase breast cancer risk. So after she received the diagnosis at such a young age, she decided to get more testing. This time, she met Kelly.
“The appointment was so much fun,” Dana says, choosing a word most people wouldn’t associate with sitting in a hospital and learning how their family history could contribute to the development of various cancers. But if “fun” seems like an odd adjective, you haven’t met Kelly.
“She had little quirks,” Dana continues. “I was so nervous. I was like, ‘My mouth is dry. I don’t know what to do,’ and she was like, ‘Think of lemons.’”
Dana was relieved that genetic testing, these days, requires a vial of spit rather than a sample of blood, but avoiding a needle wasn’t the only reason her visit with Kelly felt breezier than she’d expected. Dana learned she did have a mutation in another cancer-connected gene, but knowing she can call Kelly to learn about new recommendations for the gene has given her peace.
At Dana’s Cancer Fight Party, Kelly spoke to her friends and family about genetic testing, what it can do, and why it’s not to be feared. Dana recalls the soft-spoken Canadian wearing a skirt (“she never looked medicine-y”) and sticking around to visit with her even though she had somewhere else to be that day.
As a genetic counselor, Kelly may keep a head full of information on genes and mutations and research and insurance policies, but she says the personal connections are her favorite part of the job.
“Genetic counseling lets you talk one-on-one with people,” Kelly says. “It’s not purely lab-based, so you can have that human connection along with the interesting science part.”
Kelly Teed is the certified genetic counselor at Piedmont Fayette Hospital’s Cancer Center, where she’s worked for three years. The growing genetic counseling program within Piedmont Healthcare now includes five counselors—besides Kelly, there are three in Atlanta and one in Henry County. Kelly also helps patients at Piedmont Newnan, visiting twice a month.
After getting a masters in human genetics and genetic counseling at Emory University, Kelly moved to Utah for a year to research genetic causes in children with developmental delay. Her boyfriend (now fiancé), Matthew Lacer, stayed in metro Atlanta, so Kelly moved back to the South, choosing Fayette County for its tight-knit community.
Because she works in oncology services at Piedmont, Kelly’s role as genetic counselor involves looking for answers after cancer diagnoses and helping patients with family histories of cancer determine what their next steps should be.
“People say to me all the time: ’Okay, I have this mutation. Let’s fix it.’ And it’s hard to say that we can’t fix it. We can just deal with it,” she says.
Kelly describes her position as a hybrid between doctor and therapist. First, she’s got to understand what a particular genetic mutation means. Then she counsels patients through the process of discovery.
When new patients arrive, they sit for an hour in her office, discussing options for testing. Like her sense of style, Kelly’s office has a muted but classic feel: Light shines through the window opposite her desk, where she keeps a fishbowl housing a paper fish.
Facing her desk is a painting of several birds, which prompted her colleagues at Piedmont to nickname Kelly “the bird lady.” One of them even drew her a little sketch of a bird, which sits on her desk.
“I’m always gravitating toward bird-themed things,” she says. “I think being in Fayette has made me like birds. I tried to buy a bird feeder, but the birds don’t even eat from it. I think I got the wrong seeds.”
Between her desk and the window sits a small round table surrounded by a few chairs, where she has sessions with patients. Kelly says she likes the therapist aspect, the “very personal” side of the job.
“Things come up that aren’t related to genetics,” she says.
She helps patients process their experiences, but she says she’s learned she can’t fix everything in one hour. She sometimes refers patients to Piedmont Fayette’s social worker, Mark Flanagan, or Elaine Harbin and Karen Bouwman, the cancer navigators.
“She’s very in tune to the patients,” Karen says. “If something else is going on emotionally, and she knows they would benefit from talking to us, she [sends them in].”
After meeting with new patients, Kelly spends the rest of her day fighting with insurance companies or going through results with established patients. Once a patient decides to get genetic testing, a saliva sample goes to a lab, which sends back a report about the patient’s genes. Kelly says if there are mutations, she schedules a results session to explain what they mean and whether family members should get testing as well.
Because the field of genetics is constantly evolving, Kelly says it’s a challenge to keep up with the research. Recommendations for handling a gene mutation can change within months. For high-risk breast cancer genes, for example, Kelly says genetic counselors now recognize the importance of examining more than the mutation.
“One thing that’s changing is we’re learning that one size doesn’t fit all. Just because someone has a BRCA2 mutation, we can’t just look at that. We have to look at how old they are, what their other family history is. The risk could be different based on those other factors, and we can’t see it in such a black-and-white way,” she says. “That’s just the world of genetics. It’s always changing, and we do have to stay on top of it.”
Not every part of Kelly’s day, though, is dictated by her job description.
“She’ll take a call from someone in the community who just has a question, not even particularly for her,” Elaine says. “She goes above and beyond.”
Kelly’s fiancé, Matthew, says he watches her go above and beyond as well.
“I have seen her work for hours over weeks to ensure that patients who need testing but cannot afford laboratory tests get what they need, either by working for insurance exceptions or procuring reduced or free testing from the labs themselves through negotiation,” Matthew says.
As genetic counseling becomes more popular nationwide, Kelly focuses not just on patients within the hospital system, but also on outreach and education.
“She is very passionate about bringing her message of genetic health and understanding your genetic risks to the community,” Oncology Operations Manager Catherine Hoffman says.
Catherine says Kelly may be young, at age 30, but she’s done exceptional work building the genetics program at Piedmont and beyond.
At Piedmont, Kelly helped start a pilot program for patients at high risk for breast cancer. The high-risk breast clinic, which Kelly has worked on for two years, filters patients who visit Piedmont’s imaging centers through a high-risk questionnaire Kelly helped create. Denise George, the high-risk coordinator, reviews the questionnaires and communicates with patients who may benefit from meeting with either Kelly or a Breast Specialist. The program, sponsored by the Faye Hendrix-Ware grant, will focus on patients with a 20 percent or greater lifetime risk for breast cancer.
“It’s all her doing, bringing it forth and working with our oncology team to advocate for its birth,” Catherine says.
For women considering genetic testing, Kelly says there are a variety of factors to keep in mind. Anyone with three or more people on the same side of the family with the same cancer, a personal or family history of a cancer diagnosis before age 50, or personal or family history of a rare cancer, such as ovarian cancer or male breast cancer, should consider testing. Women tend to focus on breast cancer, but genetic mutations can also cause other cancers like colon, pancreatic, or ovarian cancer.
“I would say if someone is concerned, they can call me and I can just run through their family history and see if they would be a fit to come in,” she says. “That’s probably easier than trying to list all the criteria. But if they’re worried, then just call me or talk to their doctor.”
Kelly says legal changes over the past decade have encouraged the growth of genetic testing. Thanks to the Genetic Information Nondiscrimination Act (GINA) passed in 2008, insurance companies can’t discriminate against their customers based on genetic testing; they’re not allowed to increase premiums or drop clients. Many insurance companies are also more willing to cover the cost of testing, which Dana says helped her.
Kelly has been interested in both genetics and community education since high school. She decided to pursue genetic counseling because she was interested in medicine but also wanted the one-on-one connection with patients. Although she liked teaching, she decided against it because talking genetics with a patient seemed less intimidating than facing a classroom of students.
“I like teaching a lot, but I like it a lot better on the one-on-one level, in a way that is really personal to someone,” Kelly says. “And your health is the most personal thing.”
In her free time, Kelly finds other ways to engage with her local community. She joined a swim team, eats at local restaurants with vegan offerings (she’s a fan of The Beirut), and acted in Flowers for Algernon at Southside Theatre Guild in July.
“She did great,” Michael Boylan, Piedmont Fayette’s communications specialist, says. “She had come to see me in a play in the spring and decided to try out for the next one.”
Matthew says Kelly volunteers to speak at patients’ community centers and church events. Together, he and Kelly attend gatherings across the county, including Balloons Over Fayette and concerts at Southern Ground Amphitheater. Sometimes, they just take walks around town.
“We love enjoying the little things and soaking up the community,” Matthew says.
As she’s stretched herself to reach out in the community, acting on a stage facing an audience even though she decided to skip the classroom, Kelly has pushed outside her comfort zone at work, too. She wouldn’t share information about herself with her patients at first, but she says if she senses it can help, she will now.
“It’s about normalizing uncertainty,” she says. “There’s uncertainty in my health and my life, too. And none of us know what might happen to us throughout our life or what illnesses we might get. Genetics is trying to help clarify that uncertainty, but being human there’s always going to be some level of uncertainty.”
She’s also started hugging.
“Where I’m from in Canada is a pretty big city. It’s more reserved, I would say. Coming down here, people are a little more friendly in an outgoing way,” she says. “People are more huggy here, and I’m not a huggy type of person. I am more now. I just worry about not fitting in, but I think after being here for three years it’s rubbing off on me and my accent is kind of a mix of Canadian and Southern. I say a mix of ‘you guys’ and ‘y’all.’ I’m just a weird hybrid person right now—who hugs more.”
Dana recalls Kelly giving her a hug at her Cancer Fight Party. Now two years cancer free, Dana says Kelly is everything she wanted, and didn’t know to expect, in a genetic counselor.
“When you’re going through a process like that, it’s so nice to meet someone who has a very warm and approachable sense, knowledgeable without it being overwhelming ‘cause you’re already overwhelmed in the process. The unknown is the biggest fear,” Dana says. “She makes it seem like you’re just walking through a garden. You get to the end and she’s like, ‘Okay well, I’m going to stay here and watch this [gene], and you just come back and visit me whenever you want.’ I definitely feel like having [genetic testing] done is a way to secure your future and your family’s future. I feel like it’s safe.”
Kelly may have found little success feeding her backyard birds, but she’s been busy walking people through the garden. If you catch her in her office, she’ll be sitting across from her bird painting, counseling visitors and guiding them through an unknown path.