It is important to share family history with your physician. This is especially true if you have been diagnosed with cancer. In this article, Our Health Matters talks about why finding out about a possible family history of cancer is important and how to do it.
What is Hereditary Cancer?
Hereditary cancer means that a person was born with a genetic change (mutation), that makes it more likely than usual to get cancer. This genetic mutation could have come from either the mother or father or both. Hereditary cancer may also be called familial cancer or cancer in the family. A small percentage (5-10%) of all cancers are hereditary, so how can you tell whether a cancer runs in the family?
Consider these clues:
• Having multiple relatives with cancer on the same side
of the family, especially if they were diagnosed at a
younger age; or
• Having a single person in the family with multiple
tumors, especially in the same organ.
Testing for Hereditary Cancer
Hereditary cancer is found through genetic testing. It is done by taking a sample of blood or tissue that contains genetic material, such as the cells inside a person’s cheek.
Testing results can:
• Help predict the risk that someone will get a disease.
• Identify “carriers” of a disease. (People who do not have
the disease, but have a copy of the disease gene)
• Diagnose a disease.
• Find out the likely progression of a disease.
More than 900 genetic tests are available for many diseases, including breast, ovarian, colon, thyroid and other cancers.
What Family History Can Show
Information from your cancer family history can help the doctor to determine whether:
• You and your family may benefit from genetic counseling,
which explains the risks of an inherited cancer and the
benefits, risks and limitations of genetic testing.
• You or others in your family may benefit from genetic testing.
• You require more intensive follow-up care than patients
with non-hereditary cancer, even if you do not need
genetic testing.
Information to Collect
Your doctor will want information on the cancer history of your first-degree relatives (parents, children and siblings) and second-degree relatives (grandparents, aunts/uncles, nieces/nephews, grandchildren, and half siblings). Collect as much of this information as possible for each relative who has had cancer:
• Type of cancer(s)
• Age at diagnosis
• Lineage, meaning is it on the mother’s side (maternal) or
on the father’s side (paternal)
• Ethnicity (some ethnicities, such as the Ashkenazi Jewish
population, are at greater risk for certain cancers)
• Results of any previous cancer-related genetic testing
Keep in mind that it might be difficult for some of your family members to discuss their health with you. You may want to send your questions ahead of time and emphasize that even a little information is helpful. Try to find a time to talk that is free of distractions.
Sharing Family Cancer History With Your Doctor
Provide your cancer family history to your doctor soon after your diagnosis and before you begin treatment, if possible. It is also important to let your doctor know of any new information you gather or changes to your family history. Sometimes, medical advances may change how your doctor evaluates your history. Good opportunities to review your cancer family history are after your first phase of treatment, during your post-treatment summary, and as part of your post-treatment survivorship appointment.
Collecting Your Cancer Family History
One way to gather information is to use the ASCO* Cancer Family History questionnaire. After completing the form to the best of your ability, bring it with you to your next doctor’s appointment and ask to discuss it. Also send the form to your close relatives so they have the information to share with their doctors. Remember to take into account that some relatives may not want or value this information in this same way you do.
Questions to Ask Your Doctor
If, after reviewing your cancer family history, your doctor suspects that you may have a hereditary cancer, you should understand what this means and what next steps are
available. Consider asking the following questions:
• Does my family history put me at risk for other cancers?
• Do you advise that I receive genetic counseling and/or
genetic testing?
• Can you recommend a genetic counselor or a way
to find one?
• What is the purpose of genetic testing?
• Will information from genetic testing change your
treatment plan for me?
• Is genetic counseling and testing covered by my insurance?
• Is my genetic information protected?
• Which of my family members are at risk?
• Does someone who inherits a genetic mutation always
develop cancer?
• What information do I need to share with family members?
• Do you have any suggestions for helping me communicate this information?
