1. © 2001 Myriad Genetic Laboratories Northern Nevada Genetic Counseling Robbin Palmer Certified Genetic Counselor www.genesrus.net

2. © 2001 Myriad Genetic Laboratories

3. Genes Contain the Instructions for Making Proteins CellNucleusChromosomes Adapted from Understanding Gene Testing, National Institutes of Health, 1996. Gene DNA Molecule RNA Molecule Protein

4. © 2001 Myriad Genetic Laboratories All Cancer is Genetic

5. © 2001 Myriad Genetic Laboratories All Cancer is Genetic a normal cell undergoes a genetic mutation and begins to grow uncontrollably a normal cell undergoes a genetic mutation and begins to grow uncontrollably Genetic  Hereditary Genetic  Hereditary Hereditary IS Genetic Hereditary IS Genetic

6. © 2001 Myriad Genetic Laboratories Who Is at High Risk for Hereditary Cancer? Hereditary cancers account for only a small proportion of all cancer

7. © 2001 Myriad Genetic Laboratories 5-10% of all cancer is hereditary

8. © 2001 Myriad Genetic Laboratories The Cancer Family History Is the Key to: l Accurate risk assessment l Effective genetic counseling l Appropriate medical follow-up

9. © 2001 Myriad Genetic Laboratories RED Flags  Multiple family members with cancer  Multiple cancers in one individual  Early age of onset  Bilaterality  Rare types of cancer  Ancestry

10. © 2001 Myriad Genetic Laboratories The more red flags, the higher the suspicion of hereditary cancer in a family, but family history is the most important consideration. A red flag may be a red herring

11. © 2001 Myriad Genetic Laboratories A mutation in a cancer susceptibility gene does not mean cancer is inevitable.

12. © 2001 Myriad Genetic Laboratories Knowledge is Power