Cancer Genetics Consultation
Who Would Benefit from a Cancer Genetics Consultation?
Below is a list of considerations in a personal and family history that would suggest that there may be an inherited susceptibility to cancer in the family. By no means is this list all inclusive, but it will hopefully assist you in deciding whether or not a genetics consultation would be beneficial.
Risks of Inherited Cancer in Families
- Multiple family members with either the same type of cancer or related cancers (such as breast and ovarian cancer). More details regarding cancers that may be genetically related to one another can be found below.
- Family members diagnosed at younger ages than are typically seen in the general population.
- Family members with more than one cancer or bilateral cancer.
- Having more than one cancer means having two or more separate cancer diagnoses. The recurrence of a previously diagnosed cancer or the spread of a cancer from its original site to another organ is not the same as having two separate cancer diagnoses. For example, cancer may start in the breast and spread (metastasize) to other organs such as the brain, lungs, liver or bone. Even though cancer was found in more than one organ, it is considered one cancer diagnosis.
- Bilateral cancer is cancer affecting both organs in a pair (paired organs include the breasts, ovaries, kidneys, etc.) and, as above, is two separate cancer diagnoses as opposed to cancer that spread from one organ to the other. For example, bilateral breast cancer means that breast cancer did not spread from one breast to the other, but developed in both breasts, independent of one another. The two breast cancers may be diagnosed at the same time, or many years may separate the two cancer diagnoses.
- Multiple generations with cancer.
Hereditary breast cancer, ovarian cancer and hereditary colon cancer conditions are the most common reasons for referral. However, we also see patients with other genetic conditions that increase the risk of cancer. Other genetic conditions for which we provide genetic counseling and testing include, but are not limited to:
- Cowden syndrome: This condition increases the risk of breast and uterine cancer, thyroid cancer, central nervous system tumors and gastrointestinal polyps (hamartomas). Individuals with Cowden syndrome sometimes have fatty tumors (lipomas) and other skin or mouth lesions.
- Li-Fraumeni syndrome (LFS): Individuals with LFS have up to a 90 percent lifetime risk of cancer and many are diagnosed with two or more cancers during their lifetime. The main feature of LFS is a sarcoma; however, this condition predisposes to many different types of cancer. Childhood cancers are common (25 percent of cancers are diagnosed before age 18).
- Multiple endocrine neoplasia, type 1 (MEN1): This condition is characterized by multiple tumors of the parathyroid glands, pancreatic islets and pituitary glands.
- Multiple endocrine neoplasia, type 2 (MEN2): This condition is characterized by medullary thyroid cancer, pheochromocytomas (a tumor of the adrenal gland) and benign parathyroid tumors.
- Von Hippel-Lindau syndrome (VHL): Individuals with VHL have a variety of tumors which are usually benign. Tumors in VHL include tumors of the adrenal gland (pheochromocytomas), retina/lung/central nervous system (hemangiomas/hemangioblastomas), and cysts and adenomas of the kidney and pancreas. There is also an increased risk for kidney cancer (clear cell renal cell carcinoma).