General Information
Paul R. Duncan, M.D. FACP

Screening of family history:  During the initial familial cancer consultation, a  determination is made as to whether there is within the family tree an increased risk of individual cancer types. Prior to the initial consultation, a handout will be mailed to the prospective patient regarding their family history. Careful review of the family history and completion of this handout is very helpful in making the familial cancer determination.   

Education:  It is important initially to introduce very specific information regarding cancer, patterns of genetic transmission, genetic testing and its limitations, the potential benefits and risks to testing and other topics which we have learned are important for patients seeking genetic risk assessment.

Individual risk assessment:   Once the individual patient history relative to cancer and the family history are outlined, it is often possible to identify the probability of a malignancy developing in an individual person over a given time frame.  There are certain family history characteristics which, when present, suggest a specific genetic cause.  In that setting, genetic testing might be recommended.  Before genetic testing is undertaken, a consent form is drawn up and given to the patient. 

Follow up:  If a specific mutation is found, specific recommendations regarding prevention of the cancer in question can be made.  In families where a genetic abnormality has been identified, there will be information available for other family members.  

It may be necessary to gather further information before specific testing recommendations can be made. 

In general:  Familial breast cancer and familial colon cancer are the most common of the familial cancers that we see in this clinic.  However, many other cancers have a familial aggregation, and although less common, are still evaluated in the clinic.

Genetic testing is very specialized and is performed at reference laboratories.  An attempt is made in each case to obtain prior authorization per the individual requirements of individual health plans.  It is understood that the patient and/or the patient's insurance will be responsible for all lab and other services associated with genetic evaluations (including those for family members).

For further information, please visit our Cancer Info Links page.