Getting your genetic test results
Getting the results of a genetic test to find out whether you have an inherited faulty gene that increases the risk of cancer is likely to be an emotional time.
If your test is negative and no faulty gene is found, you will probably feel a huge sense of relief.
If you do have a faulty gene, you may feel very shocked, even though you knew that the test could be positive. You will probably be trying to work out what it all means and what to do next.
If your family has a known faulty gene, but your test is negative, it means that you aren't carrying the gene.
It doesn’t mean that you definitely won’t get cancer though. Your risk is the same as everyone else. You can still reduce your risk by choosing a healthy lifestyle.
If the test doesn’t find a faulty gene but you have a strong family history of cancer, it could be that you don’t have one of the known high risk genes. But you could still be at higher risk of particular cancers than other people in the general population.
If this happens, your genetic councsellor will explain how they will check on you with regular tests to find cancers early. The uncertainty of this can be very difficult to work with.Your counsellor will advise and support you.
Most people who have a positive result will feel a range of emotions including resentment, anger, worry, and anxiety. This is understandable. It can be difficult to find out that you have an increased risk of developing cancer. Some people find that it helps to talk to their family members about their feelings. Other people may prefer to talk to a counsellor.
You can talk to your doctor or genetic counsellor to find out about how much your risk of cancer is increased. They can tell you what check ups you need and how often you will need to have them. It is important to remember that not everyone who has a faulty gene goes on to develop cancer.
Whatever your situation, you can help to reduce your risk by choosing a healthy lifestyle.
You may be worried about which family members to tell and how to tell them. Your genetic counsellor can help you work out the best way to do this. Some clinics have prepared letters that you can send out to relatives but you may prefer to tell people face to face. Or you might want to do a mix of both, depending on which relative it is and your relationship with them.
Your relatives’ reactions may vary. It may be a shock to them if they hadn’t thought about having a family history of cancer. Some people may choose to ignore the result and may even find it difficult to talk to you afterwards. Others will be glad that you have warned them about the possibility that they may have a faulty gene and will then want to have a test themselves.
You might get test results at the same time as other family members. This can be very hard to cope with. You might feel guilty if you do not have a faulty gene, but your relatives do. You might also be trying to cope with their results.
Talking together as a family might be helpful. You can talk together at the genetic clinic, or with a counsellor. You could also try individual counselling. You can go back again if you dont want counselling straight away.
Depending on the type of faulty gene and the types of cancer you are at risk of developing, your doctor might recommend:
- risk reducing treatments such as surgery or medicines
Screening aims to catch cancer at its earliest stage, and for some types of cancer can even help to prevent the disease. The type of screening, when it starts, and how often you have it will depend on the type of cancer you are at risk of getting.
The following links take you information about screening for people at high risk of particular cancers:
- Screening for people at higher risk of bowel cancer
- Screening for people at higher risk of breast cancer
- Screening for people at higher risk of ovarian cancer
- Screening for people at higher risk of womb cancer
- Screening for people at higher risk of thyroid cancer
- Screening for men at higher risk of prostate cancer
- Screening for people at higher risk of kidney cancer
You may be able to have treatment to reduce your risk of getting cancer. This might include surgery or medicine to reduce cancer risk. This is possible for some types of cancer where there is a known faulty gene.
Timing of risk reducing treatments are affected by the type of cancer you are at risk of developing, and the type of faulty gene. For some cancers, your risk may not be significantly increased until you are in your 40's. For other types of cancer, you might need treatment earlier.
The main risk reducing treatment is surgery to remove the part of the body at risk of developing cancer.
Breast or ovarian cancer
For example, women who have one of the faulty BRCA genes may choose to have both breasts removed with breast reconstruction. This is called preventive mastectomy, risk reducing breast surgery, or prophylactic mastectomy. Or women may have their ovaries and
Treatment to reduce your risk of bowel cancer would be an operation to remove your large bowel (prophylactic colectomy).
Risk reducing surgery doesn’t necessarily stop you getting cancer completely. Nobody can guarantee that. But it will significantly reduce your risk of getting a particular type of cancer.
Surgery can change how you feel about yourself. For some people, knowing that they have reduced their risk makes them feel more confident and happier. For others the changes in their body, whether visible or not, are very difficult to cope with. It is important to try to think about how you will feel if you do have treatment and how you may feel if you don’t.
If you have an increased risk of breast cancer another option could be to take medicines to prevent breast cancer. This is called chemoprevention.
Find out about taking medicines to lower your risk.
Choosing to have treatment to reduce your risk of cancer is a very personal decision. Before you decide to have any treatment to reduce your risk, it is worth thinking about and finding out about the following questions:
- What treatment options are available to you?
- How much will treatment reduce your risk of developing cancer?
- How do you feel about having treatment?
- What does the treatment involve?
- What are the immediate and long term side effects?
- Can side effects be controlled?
- When should you have the treatment?
- Will the treatment affect your fertility?
- Can you time your preventative treatment so that you can have a family first?
Finding out that you have a gene fault may make you think about the choices you make in your life. For example:
- you may decide to have children earlier than you had planned, before having your ovaries removed
- you may want to have tests before or during pregnancy to avoid having a child with the faulty gene
- it may affect the choices you make about work and your career.
Your genetic counsellor or specialist nurse can talk through your options and help you decide what is right for you.