My name is Kelly Kohut. I’m a genetic counsellor at the Royal Marsden hospital in London.

The decision to have a genetic testing is not an easy one

and the results will affect many aspects of a person’s life

Genetic counselling is a process that helps to support people through this

and to provide information and support along the way.

Genetic counselling may be appropriate for individuals who have a family history of cancer.

This could include multiple people in the family with the same type of cancer

or types that we know could be related due to genetics.

We also look at the ages at which people were diagnosed.

For most types of cancers, they are more common at older ages

so when we see them occurring at younger ages this could be an indication of a possible genetic link.

Most cancers are not due to a strong hereditary predisposition

that we can find through genetic testing.

It’s a small percentage of families where we can actually pinpoint a genetic cause at this point,

although research is ongoing.

The most common referrals that we get are for hereditary breast cancer.

Some families also have a predisposition to ovarian cancer alongside breast cancer.

The advantages of having genetic testing could be to provide information for that person.

For example, with the BRCA genes a woman may wish to know about her risk for breast cancer in the future

and if she finds she is a gene mutation carrier

she could have access to a high-risk screening programme,

including mammogram and breast MRI.

On the other side, her ovarian cancer risk may also be increased

if she is a carrier of the BRCA gene mutation.

In that setting we would discuss the option of risk-reducing surgery

to address the ovarian cancer risk later in life after she’s finished having her children.

When people are referred to us for genetic counselling they are sent a family history questionnaire in advance.

hey can complete this, noting the people in the family who have been diagnosed with cancer

and the ages at diagnosis.

When we see the person in clinic we will go through the family history.

This could also be done over the telephone if they have an initial telephone counselling appointment.

At some other centres, the family history may be collected for the first time with a genetic counsellor.

It’s important for us to get as much information as possible

about the exact types of cancer that people have had and how old they were when they were diagnosed,

in order for us to make an accurate assessment of risk.

Most of the genetic testing that we do involves a blood test.

This is a simple blood test like any other that people might have

but it’s the implications of the results that we spend a lot of time talking about.

The results can tell us about people’s risk for cancer in the future,

type of screening recommendations that would apply to them, possible risk-reducing options,

including risk-reducing surgery and information for other family members.

Some people take some time to get used to their genetic test results

and we’re there to support them with information, referrals to other specialties,

support groups and the opportunity to take part in research studies as well.

People will need to be referred by their doctor to a genetics centre.

There is a directory of all the genetic centres in the UK

on the British Society of Human Genetics website.*

For information, help, or if you just want to chat call

the Macmillan support line on 0808 808 00 00

or visit macmillan.org.uk