Genetic Counselling for Hereditary Cancer
What does hereditary mean?
Hereditary means something that is passed down to you by your ancestors or
family members. In a medical sense, hereditary refers to the passing of a
medical condition, or perhaps even an increased risk for developing certain
medical conditions.
What is genetic counselling for hereditary cancer?
At a genetic counselling appointment, a genetic counsellor will review your personal medical history and your family’s medical history to determine if you are at risk for developing hereditary cancer. If you are at a higher risk, the genetic counsellor will be able to offer recommendations on screening (to detect cancers earlier when they are more treatable) or prevention (ways to reduce your chance of developing cancer).
Some families who are considered high risk will be offered genetic
testing to try to find a genetic cause for cancer in their family, or they
may be offered referrals to other specialists to discuss further screening
or prevention options. Genetic testing, which is completed by collecting and
analyzing a blood sample, is not offered to everyone who receives genetic
counselling.
Are all cancers hereditary?
No, most cancers are not hereditary. Non-hereditary cancers occur for many reasons including:
- Age (our risk of developing cancer increases as we age)
- Lifestyle (certain lifestyle habits can increase our risk of cancer, such as high fat/low fibre diet, smoking/use of tobacco products, excessive alcohol, exposing skin to the sun’s rays without protection, being inactive or overweight)
- Environment (we may be exposed to harmful substances in our living and working environments, many of which are unknown to us)
- Chance (many cancers happen for unknown reasons, or chance)
- Genes that play a very weak role in who develops or does not develop cancer
- Other health problems we may develop that can make us more prone to certain types of cancer
Most cancers happen for a combination of reasons. Only a very small
number of cancers (less than 1 in 10) are actually hereditary, or due to a
single gene, inherited from a parent, that can play a strong role in who
develops or does not develop cancer.
Who should receive genetic counselling?
If you think your family history of cancer may run in your family, ask your doctor for a referral to a genetic counsellor. Before receiving an appointment, a genetic counsellor may phone you to get more details about your family history and decide if an appointment is needed.
Some factors that may suggest hereditary cancer include:
- Multiple family members with cancer on one side of the family (especially breast/ovarian or colon/uterine{endometrial}/other abdominal cancer)
- Cancer at a young age, i.e., breast or colon cancer diagnosed before age 35
- Any invasive serous ovarian cancer (a specific type of ovarian cancer)
- Breast or ovarian cancer in Jewish families
- A family member who has had cancer more than once (a new primary cancer)
- A family member with multiple colon polyps (more than 10) or "polyposis"
- Rare cancers, such as male breast cancer
- A family member who is a carrier of a cancer gene mutation. A mutation is an alteration in a normal healthy gene that can prevent it from working properly.
If you have questions or are not sure if a referral is right for you,
please ask your physician, oncologist or supportive care coordinator, or
contact the genetics clinic at 519-749-4300 ext. 5988..
How much does genetic counselling/testing cost?
Genetic counselling appointments are covered by the Ontario Health
Insurance Plan (OHIP). (If you do not qualify for OHIP, you may be required
to pay for these appointments.) Most genetic tests are also covered by OHIP
but are only available when certain rules in the family history or personal
medical history are met. Your genetic counsellor will tell you if there is a
genetic test that you qualify for.
Do I have to do a genetic test?
No. Genetic testing is optional. If your genetic counsellor suggests a
genetic test for you, he or she will discuss with you all of the pros and
cons for having that genetic test. You will decide whether or not to have
the test.
How do I learn about my family health history?
If you would like to learn how to construct your family health history to discuss with your health care provider, click on the links below:
- NSGC Family History Tool: http://www.nsgc.org/consumer/familytree/index.asp
- US Surgeon General’s “My Family Health Portrait” free download software: http://www.hhs.gov/familyhistory/download.html
Does it matter which side of the family the cancer is on?
No. Cancer (or other health problems) on your father’s side or mother’s
side can be just as important to your health and your own chances of
developing a similar health problem. We inherit our genes from both parents
equally, whether we are male or female. We also often share many of the same
lifestyle habits and environment with both sides of the family. When you
review your family history with your doctor, you should remember to mention
health problems on both sides of your family.
I don’t have a doctor. Can I still receive genetic counselling?
Yes. If you do not have a family doctor or other primary health care
provider, you may contact the cancer genetics clinic at 519-749-4300 ext.
5988. A genetic counsellor will take your personal information and family
history over the phone, and let you know if a genetic counselling
appointment is needed for you. If needed, the genetic counsellor will
discuss setting up an appointment and give you instructions on how to
prepare for this appointment.
I am a doctor. How do I make a referral for cancer genetic counselling?
For health care providers, click here for the Ministry of Health and Long
Term Care guidelines for referral to cancer genetics services, and our
referral form. Certain referrals for rare inherited cancer syndromes may be
redirected to one of the larger provincial genetics programs.
How can I learn more about a career in genetic counselling?
If you are interested in a career in genetic counselling or would like to learn more about genetic counselling in general, click on the useful links below:
- Canadian Association of Genetic Counsellors: www.cagc-accg.ca
- American Board of Genetic Counseling: www.abgc.net/genetics/abgc/abgcmenu.shtml
- National Society of Genetic Counsellors:
www.nsgc.org
What if I am worried about a genetic problem in my family other than cancer? / I am a doctor. Can I refer patients for other genetic reasons to Grand River Hospital??
Grand River Hospital is not currently offering other genetics services such as prenatal, pediatric genetics consults or Huntington’s disease. Please continue to direct these referrals in the usual manner to the Regional Genetics Programs at McMaster University Medical Centre – Hamilton (905-521-5085 / fax 905-521-2651) or Medical Genetics of Southwestern Ontario at London Health Sciences Centre – London (519-685-8140 / fax 519-685-8214).
We will update this website as new genetics services are available at
Grand River Hospital. In the meantime, if you have a referral for a
pediatric, adult or general genetics case, you may continue to direct these
referrals in the usual manner to Hamilton or London, or you may contact the
GRH genetics clinic directly at 519-749-4300 ext. 5988 to see if your
referral can be handled at this time.