I heard that my wife’s cancer may be genetically related. Do other family members have to be told? Should they be encouraged to be tested for cancer themselves?
The first thing your wife needs to do is to sit down with her doctor to clarify what is meant by “genetically related.” This term can mean many different things, and you and your wife need to understand exactly what the doctor means by this statement. If the doctor believes your wife’s cancer could indicate an increased risk factor for relatives or your children (or future children), you may consider seeking more information from a genetic counselor to discuss what is known about her cancer and its connection with genetics.
Based on her family history of cancer, or perhaps through further genetic testing, the counselor will be able to make recommendations regarding screening tests for the cancer, which member(s) of the family should undergo these tests, and when. Since the earlier a cancer is diagnosed, the better the chances for cure, this information can be of life-altering importance to other family members.
However, people at higher risk for cancer may avoid getting these tests based on the very powerful fear of finding out that they have the disease or that they have passed on a genetic predisposition for cancer to their children.
Similarly, the person with cancer may fear that telling other family members that they are at a higher risk for cancer will cause their loved ones emotional distress. Talking about personal fears with your spouse and a member of your medical team can help clarify the underlying beliefs causing your resistance. They als may help provide strategies for good communication. For many families informed about their risk of a cancer diagnosis, the bonds of support and love only strengthen.
Clearly, if there is someone in the family who is already extremely emotionally distressed or psychiatrically unstable, caution needs to be exercised in passing this information on to that individual. In any case, anyone contemplating testing should be made aware that there are genetic counselors and trained clinicians to help him or her understand the personal risk for developing cancer and how to cope with the psycho-logical challenges that this knowledge can bring. The Appendix contains information to help with issues related to genetic testing and counseling.