| Ch 2 | Page 11 / 13 | |
| Cancer prevention |
Genetic counselling | |
Genetic counselling is a new approach in cancer treatment. Many different aspects should be contemplated in order to adopt a practical attitude. The following recommendations originate from a working group of onco-geneticians from the French Federation of Comprehensive Cancer Centres (Standards, Options and Recommendations ).
The goals of the onco-genetic consultations are:
- evaluating a possible hereditary cancer risk with an aim to either confirm or invalidate it,,
- offering, when possible, a realistic screening policy adapted to the cancer risk,
- offering, when indicated and feasible, molecular research on predisposing genes, whilst explaining the interest and limits of such research,
- taking charge of the psychological consequences of a presumed or demonstrated hereditary risk,
- providing long term follow-up for individuals and families.
As a general rule, families for which a onco-genetic study is indicated are those with one of the following clinical presentations:
- presence of at least three cases of cancer (for instance: breast, colon) in first or second degree related family members, in the same parental lineage,
- presence of two cases of cancer in first degree related family, associated with at least one of the following criterion:
- early occurrence of one of these cancers, in comparison with the mean age of occurrence (for instance breast cancer before 40 years, colon before 50 years),
- bilateral occurrence (for breast cancers),
- multifocal occurrence ,
- occurrence of several cases of cancer in the same person (multiple primitive tumour syndromes), apart from evident iatrogenic contexts (such as tobacco-related cancers),
- cancer associated with a predisposing disease (like familial colic polypomatosis, Recklinghausen disease, and so on…) or with a dysmorphic syndrome.
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