What Does a Family History of Cancer Mean for Me?
Kristin Gunderson, MS, is a Clinical Genetic Counselor with the UW Carbone Cancer Center. She provides some insights into what a cancer genetics risk means.
Most cancers happen by chance and are caused by random errors that accumulate in a cell of the body over time. Because of this, most cancers occur as we age. Some cancers are also influenced by environmental and/or lifestyle factors. Less often, cancers are hereditary. Although hereditary cancer is rare, it is important to identify families with inherited cancer risk so they may receive the best type of medical care. As a result, cancers can often be prevented in families with hereditary cancer risk.
Genetic counselors are trained to evaluate family histories of cancer and can help determine if the cancers in a family are random or influenced by inherited factors. At UW Health, cancer genetic counselors work out of the UW Carbone Cancer Center, the UW Breast Center and the Digestive Health Center.
Genetic testing is a personal choice. In order to ensure individuals are appropriately informed, it is essential to understand the implications for medical care and family members before undergoing any testing. Genetic counselors help patients navigate difficult information in order to make informed choices. In addition, they also provide emotional support and/or refer to additional supportive resources if necessary. You should consider a cancer genetics risk assessment if:
- You or a close relative were diagnosed with:
- cancer at an early age (generally under age 50)
- more than one type of cancer
- a rare type of cancer (i.e. ovarian cancer or male breast cancer)
- There is a known cancer gene mutation in your family; and/or
- You are concerned your family history of cancer places you at increased risk for cancer
Family histories are the key to an accurate and complete cancer genetics risk assessment. Therefore, patients are usually sent a family history questionnaire prior to a consultation. This family history questionnaire helps a genetic counselor gather information about the size of the family, the types of cancer seen, and the ages at which cancer was diagnosed among relatives.
A genetic counselor will review your personal and family medical history looking for clues that could suggest hereditary risk for cancer in your family. If indicated, the genetic counselor will discuss the option of genetic testing and will recommend tests that are appropriate based on your situation. Genetic test results may help clarify the cause of the cancer(s) in you and/or your family. If genetic testing is performed, a blood sample is most often needed. The genetic counselor may make personalized recommendations for cancer screening and prevention based on your personal/family history of cancer and genetic test results.
Is genetic testing covered by my insurance?
Fortunately, a cancer genetic counseling appointment is covered by most insurance plans. A referral is required by some health plans. If you have questions about coverage, please call your insurance carrier directly.
Can I do at-home genetic testing?
Over the last couple of years, at-home genetic testing (also known as direct-to-consumer genetic testing) has become available. For this type of testing, a person sends a DNA sample directly to a genetic testing company, without the involvement of his/her physician and/or genetic counselor. Companies such as 23andMe and Color Genomics can analyze a person's DNA to learn about his/her health risks, including the risk for certain cancers. However, many genetics experts caution against using at-home genetic testing. These test results can be confusing and may not accurately reflect a person's risk for cancer or other health problems. If you have used an at-home genetic test, contact your local genetic counselor to discuss your results and your risk for cancer.
I previously had genetic testing and my results were negative. Do I have more testing options?
If you or a close relative have previously undergone genetic testing and those test results were negative, you and/or your family may consider contacting your genetic counselor to discuss additional genetic testing options. Recently, "newer" genes have been discovered that may provide an explanation for families who have a strong personal/family history of cancer. Contact your local genetic counselor to learn if you are an appropriate candidate for additional genetic testing.
To find out more about our program and a list of our genetic counselors, visit us online at: uwhealth.org/genetics