Complexities in Cancer Risk Counseling: Presentation of Three Cases

Abstract

Complexities abound in the identification and management of families at increased risk for inherited forms of cancer. One of the ways to learn as a profession how best to provide cancer risk counseling (CRC) is to share counseling experiences. Such cases can provide insight into the issues raised by families and ways in which genetic counselors have handled complex situations. Here we describe three CRC cases initially presented at the 1995 American College of Medical Genetics meeting. The first case involves balancing the importance of informing a family of the presence of an inherited cancer syndrome with the family's right "not to know." The second case illustrates the difficulties in assisting an individual to make medical management decisions in the face of uncertain risk information. The third case describes the complex interactions with a woman before and after her decision to have prophylactic surgery.

The genetic self: The Human Genome Project, genetic counseling and family therapy.

“…Finally, because some persons may not want specific risk information, there is a strong appreciation within genetic counseling of “the right not to know” about one’s genetic risk for a specific genetic diagnosis (Schneider, et al, 1997). The optimal timing of referrals for cancer risk assessment, counseling, and testing has yet to be determined.…”