Genetic Counseling and Risk Assessment

Genetics CounselingAt the Knight Cancer Institute, we’re committed to helping you lower your cancer risk.

For some patients, this involves genetic counseling and testing. Our medical geneticists and genetic counselors can guide you through options and help you decide next steps.

Understanding genetic risk

Some cancers run in families because members pass a gene that has a defect, or mutation, from one generation to the next. These genes play a role in about 5 percent to 10 percent of cancers.

If you have such a gene, it doesn't mean you will definitely get cancer. It means only that your risk is higher. Once you know, you can take steps to lower your risk and to increase screening for early detection.

It’s also important to understand that cancer can run in families because of environmental factors -- such as smoking or too much sun exposure -- that have nothing to do with inherited traits.

Family history

A genetic mutation might be suspected in a family:

  • With several members having the same cancer.
  • With a member who has had more than one type of cancer.
  • With rare cancers, such as ovarian or male breast cancer.
  • With cancer in people younger than 50.
  • In an ethnic group associated with a mutation.

Inherited cancers

Researchers have identified more than 50 “hereditary cancer syndromes.” Types include:

Hereditary breast and ovarian cancer syndrome

In this syndrome, also called HBOC, the BRCA1 and BRCA2 genes are linked to an increased risk of breast, ovarian, prostate and pancreatic cancers.

Lynch syndrome

This syndrome increases the risk of colorectal and uterine cancer. Other associated cancers include liver, kidney, stomach, small intestine, pancreatic, urinary tract, bile ducts, ovarian and brain. This syndrome is also called hereditary nonpolyposis colorectal cancer, or HNPCC.

Familial adenomatous polyposis

This syndrome, also called FAP, can cause polyps to develop in the colon and rectum, significantly increasing the risk of colorectal cancer. A milder form is called attenuated familial adenomatous polyposis, or AFAP.

Cowden syndrome

People with Cowden syndrome are likely to develop noncancerous growths called hamartomas on the skin or inside the body. They also have a higher risk of breast, thyroid and uterine cancer.

Li-Fraumeni syndrome

Li-Fraumeni syndrome is a rare condition that increases the risk of cancer, especially at a young age. Cancer types associated with this syndrome include a type of bone cancer called osteosarcoma, as well as sarcoma, breast cancer, brain tumors, leukemias and adrenal cancer.

Von Hippel-Lindau syndrome

People with this syndrome can develop noncancerous tumors such as hemangioblastomas, which form from blood vessels in the brain, spinal cord and eye. They are also at higher risk of kidney, pancreatic and adrenal cancer.

Multiple endocrine neoplasia

This group of disorders involves tumors in glands that produce hormones, such as the thyroid and pituitary glands. Tumors can be noncancerous or cancerous.

What to expect

The OHSU Knight Cancer Institute is the only Oregon cancer center with board-certified medical geneticists specifically trained to determine the risk of hereditary cancer syndromes. Our medical  geneticists and genetic counselors will:

  • Review your family history and/or your history of cancer
  • Discuss cancer genetics and testing options
    • Coordinate testing, if needed
    • Review insurance, if needed
    • Arrange a follow-up visit to review results
  • Conduct an individual risk assessment
  • Talk with you about ways to lower your risk, such as:
    • Screening
    • Lifestyle changes such as getting exercise and stopping smoking
    • Preventive options, such as mastectomy for someone at high risk of breast cancer

Our team

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