Cancer Genetic Testing & Counseling
Genetic tests for cancer to assess your risk
Cancer Genetic Screenings
If you have a personal or family history of cancer, certified genetic counselors in our Familial Cancer Risk Assessment Center at Lahey Clinic can help. We’ll assess your risk and interpret testing results. We can recommend screenings and other ways to manage your risk of developing cancer.
The first step is to talk with your primary care provider if think you have an inherited cancer risk. Your doctor can give you a referral for genetic testing or counseling.
What Causes Cancer?
About 1 out of every 3 Americans will develop cancer sometime during their lifetime. It’s hard to know the exact cause of cancer in a person. But scientists believe that most cancer is caused by a combination of factors such as chance events, the aging process or environmental exposures. About 5–10% of all diagnosed cancers are caused by a hereditary predisposition that is passed on in a family.
Hereditary Cancers
The genes we inherit play an important role in many cancers. We know of several genes that are linked to an increased chance of developing certain types of cancer. These include breast, ovarian, colon and uterine cancer.
Features that suggest you could be predisposed to inherit a cancer gene include:
- Multiple family members are affected with the same cancer (such as breast cancer) or related cancers (such as breast and ovarian cancer, or colon and uterine cancer)
- Earlier than average ages of diagnosis
- Multiple primary cancers in the same person (such as cancer in both breasts)
- Family members in multiple generations have been diagnosed with cancer
There also are rare hereditary syndromes that could predispose you to other types of cancer, such as thyroid cancer and stomach cancer.
Our genetic counselors can help evaluate your personal and family history. We can offer advice about whether or not a risk assessment appointment is a good idea for you. If you complete genetic testing, such as cancer DNA testing, you’ll have a follow-up visit so we can explain the results. These visits typically last about 30 minutes.
More About Genetic Testing and Counseling for Cancer
Genes are units of inheritance that code for traits and conditions, such as eye color or hair texture. Genes are located on structures called chromosomes. Most people have 46 chromosomes that come in 23 pairs. One copy of each chromosome pair (and therefore each gene) comes from our mother and the other from our father. In the same way, we pass on one copy of each chromosome pair to our children.
Genes make proteins that are needed for proper growth and development of the body. Each gene is made up of a code of information called DNA. When a gene is altered (called a mutation), it can’t function properly.
Alterations in certain genes (called cancer predisposition genes) may increase a person’s chance to develop specific types of cancer. Gene testing for cancer is a way to learn if you carry a particular gene. Details about some of the more common hereditary cancer predisposition syndromes are outlined below.
The guidelines below can help you decide if you should schedule cancer genetic counseling services.
Breast Cancer and Ovarian Cancer
There are several features of a personal or family history that should raise the suspicion of a hereditary ovarian or breast cancer syndrome:
- Early-onset breast cancer (<45)
- Ovarian cancer at any age
- Two or more breast cancers
- Breast and ovarian cancer
- Breast cancer at any age and at least one close family member with breast or ovarian cancer
- Two or more close family members with breast or ovarian cancer
Colon Cancer
There are several features of a personal or family history that should raise the suspicion of a hereditary colon cancer syndrome:
- Colon cancer diagnosed at an unusually young age (<50 years)
- Colonic polyps diagnosed at an unusually young age (<45 years) or in large numbers (>10 polyps)
- The presence of distinctive extra-colonic cancers, such as uterine cancer and colon cancer, in a family
Lahey provides counseling and genetic testing for these and other syndromes:
- Hereditary breast and ovarian cancer syndrome (including the BRCA1 and BRCA2 mutations)
- Cowden syndrome
- Li-Fraumeni syndrome
- Hereditary non-polyposis colorectal cancer syndrome (Lynch syndrome)
- Colon polyp syndromes: familial adenomatous polyposis, MYH-associated polyposis and juvenile polyposis
- Hereditary diffuse gastric cancer syndrome
- Peutz-Jeghers syndrome
- Von Hippel-Lindau syndrome
- Birt-Hogg-Dubé syndrome
- Hereditary paraganglioma syndrome
- Multiple endocrine neoplasia, Type 1 and Type 2 syndrome
- Hereditary leiomyomatosis and renal cell cancer syndrome
- Hereditary papillary renal cell cancer syndrome
- Familial atypical multiple mole melanoma syndrome
An accurate family medical history is an important tool for genetic counselors. If certain diseases affect one generation, it can be more likely that the next generation will be affected. A health care practitioner can use your family history to provide more accurate risk assessments. It also helps guide screening and prevention recommendations. A family history is often recorded by drawing a “pedigree.” A pedigree uses symbols to represent family members and relationships.
Learn more about how to document your family history by using these interactive tools:
- Your Family History – Your Future: Learn how to gather and record your family history from the National Society of Genetic Counselors.
- My Generations: An interactive tool created by Evanston Northwestern Healthcare to document your family history of cancer.
Meet the Team
Genetic Counselors
- Taryn Rourke
- Rhonda Feinbaum
- Punitha Kannan
- Gabriella Raffaele
