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Scientists have been able to identify certain sets of genetic mutations to be associated with particular cancers. This discovery opens up the opportunity for patients with certain cancers to receive genetic testing for specific mutations. If that mutation is found, a doctor may suggest additional counseling for the patient and family members. For instance, a woman with breast cancer might have a mutation in the BRCA1 gene, associated with a higher risk of breast cancer. A genetic counselor would discuss whether other healthy family members should know of the mutation’s presence, be counseled or potentially tested for the same mutation.

Genetic testing of healthy people is currently controversial. In many cases, insurance companies have not yet determined what they will do with information that indicates a person has a higher lifetime risk of developing cancer. Another concern is the potential of unnecessarily worrying a person about the possibilities of developing cancer. In support of testing, a negative test result may bring great peace of mind for those worried about a genetic mutation placing them at higher risk for cancer.

Only a few genetic mutations have been linked with certain cancers; however, reserach to identify new mutations is ongoing. If you feel you are at rick for developing cancer, we recommend discussing with your doctor whether genetic testing is appropriate for you.

The Familial Cancer Risk Assessment and Surveillance Program (FCP) of the Joe Arrington Cancer Research and Treatment Center (JACC) is a service for individuals and families whom appear to have increased hereditary cancer risks. The FCP is an integral part of JACC’s commitment to comprehensive cancer care. The goal of the FCP is to provide individuals and families with an analysis of their familial risk factors, education and counseling regarding genetic testing, emotional support and recommendations regarding options for risk reduction and surveillance. A multi-disciplinary team of experts staffs the FCP.

A full-time, board certified genetic counselor who has earned a master's degree coordinates the FCP. Medical oncologists with expertise in genetics and cancer are involved in each case. These physicians supervise the genetic counselor and provide medical recommendations. Nurse educators, social workers, chaplains, a nutritionist and psychologist are all available according to patient needs.

What is the purpose of FCP?
Through education, counseling, and support, the Familial Cancer Risk Assessment and Surveillance Program will empower individuals and families with increased hereditary cancer risk with the resources needed to make better life choices and to better deal with their cancer predisposition.

How can I access FCP?
Individuals may either be self-referred or referred by a physician to the FCP.

What makes an individual a candidate for the services FCP?
If an individual has a personal history of cancer, eligibility is determined by his/her age at diagnosis and family history of cancer. If he/she does not have a personal history of cancer, but has a family history of cancer, the affected family members’ relationship to the patient, the number of relatives with cancer, the types of cancer and ages of diagnoses determine a patient’s eligibility. Hereditary cancers tend to have an earlier age of onset, usually under fifty-five, with multiple family members affected with the same types of cancer. Ethnicity may also play a role in hereditary cancer risk. For instance, persons of Ashkenazi Jewish (Eastern European) heritage have a slightly higher predisposition to cancer, depending on family history of cancer. Hereditary cancers make up only about 10% of all cancers. Hereditary cancer means there is an inherited change in a cancer-predisposing gene that leads to increased cancer susceptibility. Having this gene change does not mean an individual will get cancer, but it does increase his/her chance over the general population for developing that type of cancer. Although certain families may appear to have a hereditary cancer, it may just be familial and not hereditary. Familial cancer means that the cancer does have a familial component, but no gene is known to be associated with the familial cancer. The FCP offers familial risk assessment and genetic susceptibility testing primarily for colorectal, breast, and ovarian cancers.

What services can I expect to receive from the FCP?
The FCP offers cancer risk assessment on the basis of family and personal medical history. Eligible patients are encouraged to discuss the FCP’s recommendations with their own primary care physician to determine the possible impact that lifestyle and environment may have on their cancer risk. In order for patients to gain maximum benefit from the Familial Cancer Program, they need to participate in as many of the FCP sessions as possible and provide the necessary family and personal history information. This does not mean patients are required to have genetic testing, which is a decision for each individual to make on his/her own, based on his/her individual circumstances.

In order to derive the maximum benefit from participation, patients may need to participate in as many as five counseling sessions. These sessions range from approximately 45-90 minutes in length and involve a genetic counselor and/or a physician associated with the FCP. If a patient is determined not to have increased hereditary cancer risk, he/she may only attend 1-2 counseling sessions. If a patient decides not to pursue cancer predisposition testing, his/her involvement in the FCP will be limited to 3-4 counseling sessions. If a patient decides to pursue genetic testing, involvement in the FCP will require him/her to attend 1-2 additional counseling sessions, to total 5-6 sessions. Additional sessions with the genetic counselor will be available as needed to help the patient and/or family members understand the relationship between heredity and cancer.

Information you should consider before participating in the FCP:
Involvement in the FCP requires significant time, and emotional and financial commitments from patients. All information obtained by the FCP will remain confidential. However, if a patient chooses to pay for physician services and/or testing using insurance, their insurance company may have the right to access risk evaluations and genetic testing results.

It is important for patients to realize health insurance may or may not cover risk assessment evaluations and/or genetic testing. However, the FCP is prepared to work with its patients to ensure coverage for the services of the FCP. Participation in FCP program may also result in additional testing, exams or screening practices that may or may not be covered by the patient’s insurance. Additionally, participation in and/or results obtained through the FCP could potentially affect a patient’s insurability and/or employability.

Participation in the FCP is completely voluntary and patients may withdraw at any time. If a patient has difficulty in arranging his/her schedule or travel, the FCP will try to accommodate him/her to the best of our ability.