Should You Get Genetic Counseling About Cancer Risk?

Articles On Screening for Cancer

If cancer runs in your family, you may be considering genetic counseling as a way to learn how likely it is to affect you, too. Genetic counselors can help you figure out if you’re at risk for cancer or other diseases, and whether it makes sense to get genetic testing.

You may be surprised to learn that only about 5% to 10% of all cancers are linked to genes that you’re born with. Family risk can also include shared lifestyle habits or environment, as well as genes handed down from parent to child. For this reason, most people don’t need genetic testing. It’s usually done when certain types of cancer run in a family and a problem with a gene is thought to be the cause.

Some genetic tests for cancer are for people who have a hereditary (inherited) condition that puts them at risk for cancer. Other genetic tests check on mutations such as BRCA1 and BRCA2 (linked to breast and ovarian cancers), BRIP1 (ovarian cancer), CHEK2 (breast and colorectal cancers), PALB2 (breast and pancreatic cancers), and RAD51C and RAD51D (ovarian cancer).

How to Find Genetic Counseling for Cancer

If you think a genetic counselor might help you, your doctor can refer you to one in your area. Or you can search on the website of the National Society of Genetic Counselors.

At your first appointment, the counselor will ask you about your family’s health history and your concerns. They will talk to you about what tests are out there and what they can show, and help you decide whether you want to get genetic testing.

You might consider genetic testing if:

• You have several close relatives (mother, father, sisters, brothers, or children) with cancer.
• Many people on one side of your family have had the same type of cancer.
• Different cancers in your family have been linked to a problem with a single gene (such as some types of breast, ovarian, colorectal, and pancreatic cancers).
• A family member has more than one type of cancer.
• Family members have had cancer at a younger age than normal for that type of cancer.
• Close relatives have cancers that are linked to hereditary cancer syndromes.
• A family member has a rare cancer.
• You’re from an ethnic group at a higher risk. (For example, Ashkenazi Jewish heritage is linked to ovarian and breast cancers.)
• A medical finding is linked to an inherited cancer (such as having many colon polyps).
• One or more family members have already had genetic testing that found a problem.

What a Genetic Counselor Does

If you decide to get genetic testing to check on a cancer risk, a genetic counselor can help you understand the results. Tests often give limited answers about the risk of certain cancers.

Even if genetic testing shows a risk of a certain type of cancer, it can’t predict whether you will definitely get that cancer. Genetic counseling will help you understand the results. Then you can take action to lower your cancer risk as much as possible.

Genetic counselors have specific training and often graduate degrees in their field. Some doctors, advanced practice oncology nurses, social workers, and psychologists with special training may also do genetic counseling.

A genetic counselor can also let you know how your results might apply to other family members who share your genes, including your parents, siblings, and children. Some people might want to know if they’re at higher risk, but others may not. You’ll want to make a decision that’s best for you, and be sensitive to how you manage the information: whom you tell, when, and how.

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