A thorough personal and family history is the key to determining which patients are candidates for genetic counseling and testing.
Ellen T. Matloff, MS, CGC
Cancer geneticists from around the globe will agree on one thing: A thorough personal and family history is the key to determining which patients are candidates for genetic counseling and testing. This information can unlock the secret of why a particular family has been afflicted with many cancer diagnoses, often at young ages. Having this information may make it possible for many other family members to finally know their own cancer risks, have the cancer surveillance they need, and reduce their risks of ever developing the cancers seen in the family. There is no greater gift to give a family.
Oncology nurses are perfectly poised to elicit a thorough cancer family history. They know their patients well, see them for multiple visits over an extended period of time, and often hear about their family members and fears that other loved ones will someday develop cancer.
These are the secrets to taking a thorough family history:
The family medical pedigree is one of the most valuable gifts a parent can leave for children and grandchildren.
Far too many patients (and providers) still believe that you can only inherit breast and ovarian cancer risk from your mother, or prostate cancer risk from your father. Both men and women can carry mutations in these genes, and we can all pass these mutations on to both sons and daughters.
Ask your patient to research for each family member with cancer:
For example, in a family with multiple cases of breast cancer, be sure to ask if anyone has had ovarian, pancreatic, thyroid, or gastric cancer. In a family with a history of colon cancer, ask if anyone has had multiple polyposis, ovarian or uterine cancer, or sebaceous adenomas or carcinomas. Each of these findings can lead to a different genetic syndrome.
What about the patient who says she doesn’t know her family history? Advise the patient to do some research:
More often than not, this research will yield a more useful family history.
This family medical pedigree is one of the most valuable gifts a parent can leave for children and grandchildren. A copy of this pedigree should go in a safe deposit box with other essential family documents and is an investment in the health of future generations.
The oncology nurse can make a huge difference by encouraging patients to do the research necessary to pull this family history together.
Ellen T. Matloff, MS, CGC, is a certified genetic counselor and director of Cancer Genetic Counseling at Yale Cancer Center, New Haven, Connecticut.