Genetics Program

Genetic Counseling Introduction Letter

Family History Questionnaire for Cancer Genetic Evaluation

What is the Cancer Genetics Program?
A family history of cancer has long been known as a strong risk factor for the development of cancer. This has been confirmed by recent discoveries of genes that can significantly increase an individual's risk to develop cancer.

Individuals are often confused about their genetic risks. They want to know if they are at increased risk, what steps they can take to reduce those risks, and whether they are candidates for genetic testing.

The Cancer Genetics Program was created to answer these questions. We provide comprehensive cancer risk assessment, genetic counseling, personalized cancer screening recommendations and, if appropriate, genetic testing.

What is genetic counseling?
Genetic counselors are healthcare professionals with specialized graduate degrees and experience in the areas of medical genetics and counseling. Cancer genetic counseling involves a discussion of your personal and/or family history of cancer.

What is discussed during a genetic counseling appointment?
The initial 1.5 to 2-hour meeting with a genetic counselor will focus on any questions and concerns you have about your and your family's risk of cancer, what steps may be taken to reduce your risk of cancer and if any genetic testing may be appropriate to determine if you have a change in a cancer susceptibility gene.

To provide you with the most comprehensive information regarding your cancer risk assessment and available genetic testing, the genetic counselor will be asking about your personal and family history.

It is important to gather information about your family prior to the meeting so that during the consultation the genetic counselor can give you an accurate risk assessment based on your personal and family history. We will be asking you about your FIRST-DEGREE RELATIVES (parents, siblings, children), your SECOND-DEGREE RELATIVES (nieces, nephews, aunts, uncles, grandparents, half-siblings), and your THIRD-DEGREE RELATIVES (first-cousins, great-aunts, great-uncles, great-grandparents, half-aunts, half-uncles). It is important to obtain information about both your maternal and paternal relatives. To help in gathering this information, please see The Family History Questionnaire for Cancer Genetic Evaluation worksheet.

We realize it may be difficult to obtain all of this information; gather as much as you can. Please come to the meeting regardless of the detail of knowledge of your family history. The counselor can work with you and any information you have and you will still benefit from the meeting.

Does genetic counseling require genetic testing?
No. Genetic testing may not be useful for everyone receiving genetic counseling. The decision to pursue testing is a personal one and entirely up to you. During the session the risks, benefits and limitations of genetic testing will be discussed to help you make that decision. For individuals who wish to proceed with genetic testing a small blood sample will be required.

Who will benefit from the Cancer Genetics Program?
The Cancer Genetic Program is appropriate for men and women who are concerned about their risk to develop cancer, regardless of family history. The program is especially important for individuals with a personal and/or family history of:

• a cancer diagnosis at an early age, especially breast, ovarian, colon, or uterine diagnosed under age 50
• several relatives with cancer
• more than one cancer diagnosis
• a rare or unusual cancer diagnosis
• breast and/or ovarian cancer at any age and are of Ashkenazi Jewish ancestry

To make an appointment, please contact us at:

Cancer Genetic Program	Cancer Genetic Program
Beth Israel Medical Center Phillips Ambulatory Care Center 10 Union Square East, Suite 4E New York, NY 10003 Tel: 212-844-6285 Fax: 212-844-8399	St. Luke's-Roosevelt Hospital Center 425 West 59th Street, Suite 7A New York, NY 10019 Tel: 212-523-7092 Fax: 212-523-7012

Genetic Discrimination
As more and more people see the value of genetic testing for cancer risk some people worry that their health insurance and/or employers might use the results of these tests to discriminate against them. Recognizing the value of genetic information to patients and doctors, governments both at the federal and state levels have specific legal protections in place preventing genetic discrimination.

GINA – Genetic Information Nondiscrimination Act 2008

• Prohibits group and individual health insurers from using a person’s genetic information in determining eligibility or premiums
• Prohibits an insurer from requesting or requiring that a person undergo a genetic test
• Prohibits employers from using a person’s genetic information in making employment decision such as hiring, firing, job assignments, or any other terms of employment
• Prohibits employers from requesting, requiring, or purchasing genetic information about persons or their family members

What GINA does not do:

•  Does not cover life, disability, or long-term-care insurance
•  Does not mandate coverage for any particular test or treatment
•  Does not prevent healthcare providers from recommending genetic testing to their patients
•  Does not prohibit medical underwriting based on current health status
•  Does not apply to members of the military

In New York State, results of genetic tests are not to be given to any physician or family member without the written informed consent of the person to whom such genetics test relates, per N.Y. Civil Rights Law § 79-I.