People want to know their cancer risk for many different reasons. The most common reasons are to:
Cancer risk consultation provides information on how inherited and environmental factors may cause cancer in a family or an individual. This information may play a role in maintaining good health. Cancer risk consultation can provide accurate information about cancer risk, cancer screening and genetic testing that can relieve anxiety and provide a sense of control.
At the initial visit, which generally takes 1 to 1 ½ hours, you will meet with a physician who is a medical geneticist and with a genetic counselor to completely review your family and medical histories. After identifying your primary concern, the consultation team will discuss the following information:
A few weeks after the consultation we will mail a written summary of the information discussed at the session and a copy of your family tree.
In most cases, one visit will be sufficient to allow us to give you information on the role genetics plays in your family's cancer and what your risk of cancer may be. However, we may find during your first visit that additional information on your relatives is needed before a complete risk assessment can be given. If you need a second visit to discuss risk assessment, we will recommend that you schedule it once the additional information has been gathered.
In cases where genetic testing seems reasonable, a follow-up visit will be scheduled after your complete risk assessment. This will allow you sufficient time to make your decision about whether or not to proceed with testing. During the follow-up visit, the risks, benefits and limitations of genetic testing will be discussed again. We will obtain your informed consent before drawing any blood for genetic testing. Genetic test results will be discussed only in person at a later visit.
Once you are seen through the Cancer Genetics Program for consultation, you may find it helpful to be seen by other specialists to learn about preventive surgery or to seek counseling to help cope with the anxiety cancer risk may cause. We work very closely with all cancer specialists, including surgeons, oncologists, radiologists, pathologists, gastroenterologists, nurses, ethicists and psychologists to provide the most advanced information on cancer screening and management of people at high risk for cancer.
We encourage you to bring a support person, such as your spouse or a significant other, with you. We welcome having one close family member accompany you on your initial visit, as this visit concentrates on reviewing the family history and your medical history in great detail. However, if some issues in your medical history are highly private and not known to your relatives, you may want to come alone. In addition, the decision to have a genetic test for cancer predisposition is an extremely personal, highly confidential one that you may not wish to share with other members of your family.
People who are concerned about their family or personal history of cancer can benefit from consultation. However, cancer risk consultation is specifically recommended for:
A complete family tree is one of the most important pieces of information that allows us to determine if the cancer in your family is due to an inherited tendency and to determine your risk of cancer. When you make an appointment for cancer risk consultation, you will be asked who in your family has had cancer and whether you would feel comfortable asking for written consent from your relatives to have their medical records reviewed by us. Before your visit, we will fill out and send you a medical records release form with instructions for each of your relatives for whom records are requested.
During the first visit, we will ask you many questions about all of your relatives, including those who have passed away, those who have had cancer and those who have not. We would like information about three to four generations of family members, reaching as far back as great-grandparents and forward to include children and later generations. We will want to know who had cancer, how old he or she was when cancer was diagnosed, in which organ the cancer started and if the relative is living or deceased.
For relatives who have not had cancer, we will want to know if they are living, their current ages, their health conditions and if they have had any surgeries. For relatives who did not have cancer and are deceased, we will want to know how old they were when they died, their cause of death and if they had serious health problems during their lifetimes. We realize that many people may not have all the answers to these questions. It may be a good idea to talk to an older family member. Please know that, although this information is of great use to us in assessing your family history of cancer, we will still see you for a consultation even if you have limited knowledge of your relatives and their health status or are unable to have medical records released to us.
All of the records generated by your visit to the Program are confidential and will not be shared with anyone without your written consent. Your records will be maintained in a private, locked office and will not become part of the institution's general medical records. However, your records are accessible by insurance companies to which the consultation bill is submitted.
For those patients who are referred by their physician, one copy each of the consultation summary and family tree is sent to the referring physician. Genetic testing results are not released to anyone without prior written consent by the patient.
Some insurance companies will cover all or part of the cost of consultation as an outpatient visit. Many insurance companies will require that you have a referral from your primary care provider before the consultation is authorized. Because each insurance company differs and may change coverage terms over time, we recommend that you check with your plan directly. We are happy to assist you in gathering the necessary information, such as procedure codes, so that you can find out if your carrier will cover your visit. We do accept medical assistance. If you are self-paying, we can arrange a financially comfortable payment plan for you.
You can be self-referred or referred by any health care provider for consultation. However, if you carry health insurance through an HMO or preferred provider plan and you intend to submit the fee for consultation to your insurance plan for payment, you will need a referral from your primary care provider. If you do not intend to submit the bill to your insurance carrier, a referral is not necessary; the Cancer Genetics Program will bill you directly.
To schedule an appointment, call the Cancer Genetics Program at 1-800-454-8156 between 8:30 a.m. and 5 p.m., Monday through Friday. During evenings and weekends you can leave a message. You can either call directly or have your physician call to make the referral.
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