This page has been written by : Neena Bhatnagar
"I am already suffering from cancer; how will genetic counseling benefit me?"
You may have developed the cancer due to a genetic risk factor that made you more susceptible to developing the disease. Sometimes a cancer-predisposing change, or mutation, in the genetic material (called DNA) has been passed down through the family for generations. Genetic risk assessment and testing helps to better define cancer risks in the family. For those who carry the familial genetic risk factor for the development of cancer, increased screening may help to catch cancer early when treatment is most effective, and preventive measures may help to reduce the risk or prevent the cancer from developing at all. It can help establish cancer risks in family members who may benefit from cancer screening or preventive measures.
"There are so many cancers in my family that it is not a matter of IF I will get cancer, but WHEN!"
A strong family history of cancer could impact your risk for developing the disease. However, if there is a genetic mutation in the family that is the reason for increased the risk of cancer, based on genetic patterns of inheritance; it may be possible that you do not inherit that mutation. In this scenario, your cancer risks are similar to those of the general population. Importantly, if you did not inherit the familial mutation, you cannot pass it down to your children.
Even if you have inherited the familial mutation, it is not inevitable that you will develop cancer. Diet and lifestyle modification, preventive medicine (known as chemoprevention) or preventive surgery may help lower the risk of cancer, or prevent cancer altogether. You may also benefit from beginning cancer screening at an earlier age, screening more frequently, or screening by other methods that are not recommended for someone at average risk. This way, even if you do develop cancer, it is more likely to be caught at an earlier stage, when treatment is more effective and outcomes, better.
Sometimes the cancers in a family are caused by genetic factors that cannot be detected with current testing methods or by a mix of genetic and environmental factors. For this reason, a negative genetic test result does not always mean that there isn't an inherited risk in the family. At times, increased screening, preventive medicine or surgery may be considered even if genetic testing is not done, or is uninformative (meaning that no genetic mutation was found).
"The breast cancer (and/or ovarian cancer) in my family is on my father's side, so it does not matter!"
This is not true. Having a cancer history in your fathers' side of breast and/or ovarian cancer can have a significant impact on your risk. Both mothers' and fathers' family cancer histories are very important for determining your personal cancer risks. Having a mutation in one of the breast and ovarian cancer genes has a larger impact on cancer risks for women than for men. It is not uncommon for a man to carry a mutation in one of the breast and ovarian cancer genes and never develop cancer himself. However, he can pass this mutation on to his children, including his daughters.
"The cancer in my family only affects the men (or the cancer in my family only affects the women), so I am not at risk!"
If the cancers in the family have only affected men (or only affected women), it is possible that this is due to chance alone. The genetic mutation could be carried by either father or mother, and are cancer risks for both males and females who carry the genetic mutation