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Complexities in Cancer Risk Counseling: Presentation of Three Cases
Authors:Katherine A Schneider  Jill E Stopfer  June A Peters  Ellen Knell  Gladys Rosenthal
Institution:(1) Division of Cancer Epidemiology and Control, Dana-Farber Cancer Institute, Boston, Massachusetts;(2) University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania;(3) National Human Genome Research Institute of the National Institute of Health and Johns Hopkins University School of Medicine, Bethesda, Maryland;(4) Los Angeles Oncologic Institute, Los Angeles, California;(5) Strang Cancer Prevention Center, New York, New York
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 ldquonot to know.rdquo 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. (affiliated with Long Beach Memorial Breast Center at the time of counseling)
Keywords:breast cancer  cancer risk counseling  cancer genetics  prophylactic mastectomy
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