What a genetic counselor can do for you

By Sarah Mantia
Posted on August 25, 2023

Dear Mayo Clinic: My grandmother and mother, as well as an aunt and a cousin, have had breast cancer. Another cousin was diagnosed with colon cancer recently.

It has been suggested that I undergo genetic counseling to determine my cancer risk. As a young man, is genetic testing necessary for me? What benefit would I gain from visiting a genetic counselor?

A: Although it can be daunting to have a loved one diagnosed with cancer, having a family history does not mean that you will automatically get cancer. This is one of the reasons why having a discussion with a genetic counselor can be valuable.

A genetic counselor reviews your personal health history and your family’s health history to identify your risk for certain conditions. A genetic counselor can try to determine if there is a pattern or connection among family members’ diagnoses and how that may affect you.

If your grandmother, mom and cousin are on the same side of the family, that suggests a pattern that could potentially increase your risk, even as a man. Breast cancer affects men, too, though it occurs infrequently.

Only about 5% to 10% of breast cancers have a hereditary cause that can be identified. If a genetic counselor discovers a hereditary cause for breast cancer, however, this condition may increase the risk for other types of cancer, as well.

Other cancers that may have a hereditary connection include ovarian, colon, prostate, uterine and pancreatic cancers.

Concerns for hereditary cancer syndrome rise if people are diagnosed at younger ages, have a personal history of more than one cancer, or have multiple family members with the same or associated cancers.

Benefits and risks of testing

Meeting with a genetic counselor doesn’t immediately mean that you need genetic testing. Rather, the goal of the appointment is to have a discussion that can guide you toward making an informed decision regarding genetic testing.

Discussing the potential risks and limitations of genetic testing is just as important as reviewing the potential benefits of testing.

Another benefit of meeting with a genetic counselor is to learn more about your family risk for certain conditions, which could be valuable in the future.

For instance, understanding your risk for cancer is important, but learning about certain hereditary heart and neurologic conditions, as well as more rare genetic conditions like cystic fibrosis, might help relatives who are planning to have children.

Although it can be challenging to learn about the details of your family’s health tree, especially if prior generations didn’t share as much or document health concerns, it is important to talk with your family prior to meeting with a genetic counselor if you can.

Family history should be gathered for three or four generations on both sides, and include parents, grandparents, aunts, uncles, cousins and children.

Helpful information to gather includes:

Major medical conditions and the age they started
Cause and age of death
Birth defects
Family’s ethnic background, as some conditions can be more prevalent in certain ethnicities. For instance, if someone is of Ashkenazi Jewish descent, the risk for hereditary breast and ovarian cancer syndrome is greater than in the general population.

Free online tool

A good resource to help you get started is a free online tool called My Family Health Portrait. This tool is available through the surgeon general’s office. It allows you to collect the information and create a family pedigree that can be printed and shared with healthcare professionals and your family.

As you discuss your family history, don’t forget to talk about conditions that may not have a strictly genetic cause but may have a genetic link. Although there are conditions such as diabetes where a genetic test is not available, it’s important to document the patterns in your family and share them with your primary care provider.