Cancer Genetics
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The Cancer Genetics team at the Southwest Thames Regional Genetics Service serves a population of approximately 3million people. The aim of the service is to identify people at increased risk of developing cancer because of any underlying genetic factors, so that we can offer screening and other treatments to reduce the risk of cancer, or to pick up cancers early at a treatable stage.
Who we see
We see people who already have a cancer diagnosis to try to identify if the cancer may have been due to an underlying genetic cause. Identifying a genetic cause for a cancer may give an explanation for a cancer diagnosis and guide cancer treatment. It also allows us to advise people with cancer, and their relatives, on their future cancer risk. We also see people who are concerned about their cancer risk because of their family history.
Clinic appointments
We accept NHS GP referrals, as well as referrals from other specialists, from across the Southwest region. We hold regular clinics at St George’s Hospital in Tooting, London, as well as monthly clinics in the following hospitals:
- Royal Surrey County Hospital
- Jarvis Breast Screening Centre
- Epsom Hospital
- Crawley Hospital
- Worthing Hospital
- Frimley Park Hospital
- St Peter’s Hospital, Chertsey
- St Richard’s Hospital, Chichester
- Kingston Hospital
- Haywards Heath Hospital
We also run the following specialised clinics:
- Endocrine genetics cancer clinic – in association with endocrinologists at St George’s Hospital
- Von Hippel Lindau screening clinic – in association with endocrinologists and ophthalmologists at St George’s Hospital
- Cancer genetics carrier clinics – for individuals who carry a high risk gene mutation at St George’s Hospital and Royal Surrey County Hospital (BRCA carrier clinic)
- Paediatric cancer clinic – at the Royal Marsden Hospital
Team
- Dr Helen Hanson – Joint Lead Consultant for Cancer Genetics
- Dr Katie Snape – Joint Lead Consultant for Cancer Genetics
- Ms Kelly Kohut – Lead Genetic Counsellor
- Ms Jessica Bailey – Principal Genetic Counsellor
- Ms Erin Baker – Principal Genetic Counsellor
- Ms Uruj Anjum – Research Genetic Counsellor
- Ms Virginia Attard – Genetic Counsellor
- Ms Heidy Brandon – Genetic Counsellor
- Ms Stephanie Burcher – Genetic Counsellor
- Ms Sharne Limb – Genetic Counsellor
- Ms Beth Coad – Genetic Counsellor
- Ms Elizabeth Winchester – Genetic Counsellor
- Ms Darshna Dudakia – Research Practitioner and Family History Coordinator
Laboratory testing services
The Southwest Thames Regional Genetics laboratory undertakes genetic testing for the high risk breast and ovarian cancers genes, BRCA1 and BRCA2, and the tp53 gene.
For patients
Cancer is sadly a common condition. 1 in 2 people will develop cancer in their lifetime. The majority of cancers (90-95%) are not caused by single high risk genes running through a family, but are likely to be due to lower risk genetic and environmental factors working in combination, or sometimes just down to chance. In a small minority of cancers (~ 5-10%), a single high risk faulty gene has increased the chance of a person developing cancer. When this is the case, we tend to see cancers occurring at younger ages than usual, we may see special subtypes of cancer known to be associated with faulty genes, multiple cases of the same cancer in one person or in close relatives, or certain patterns of cancers running through a family, for example breast cancer and ovarian cancer occurring together.
It is important to identify people who carry high risk cancer genes so we can offer them screening to pick cancers up early at a treatable stage, or offer them other treatments to reduce their cancer risk. We use the clues outlined above to offer genetic testing to people who have an increased chance of carrying a high risk cancer gene. Having a genetics appointment does not mean you will automatically be offered a genetic test, as this will depend on the chance of finding a single high risk faulty gene in the family. In some cases, whilst it is not likely that a single high risk faulty gene has caused the cancers in the family, there may still be an increased risk of people sharing lower risk genetic factors. Whilst we cannot test for these, we can offer people screening if we assess them as being at increased cancer risk because of their family history.
Referral to our service
If you are worried that you may be at increased risk of cancer because of your personal or family history of cancer, you should see your GP, oncologist or treating specialist. They can assess whether you are eligible for a referral to our service. In some cases, we will need more information to decide whether you are eligible for an appointment with us. In this case, we will send you a Family History Questionnaire (FHQ) to complete. It is important to fill this out as thoroughly as possible, including all unaffected, as well as affected relatives, so that we can give you the best advice.
Once we have reviewed the FHQ, the following may happen:
- We may write to you giving you advice on screening but not offer an appointment
- We may advise that your relative with cancer is seen by their local genetics service
- We may offer you a telephone appointment
- We may offer you a face to face appointment at one of our clinics
Genetic testing always gives most information when undertaken in a person who has had cancer. If you have not had cancer we may ask you to try to bring a relative who has had cancer to your appointment with you, or if we may offer an appointment to your affected relative.
We have patient information leaflets about hereditary cancer. These will be online in the near future.
Referrals to our service are reviewed by a senior member of the Cancer Genetics Service. Referrals which clearly meet our referral guidelines will be given an automatic appointment in either a telephone or face to face clinic. If we require further information to triage the patient, we will send out a Family History Questionnaire (FHQ) for the patient to complete. If the patient does not meet our referral guidelines, we will not offer an appointment and may ask for clarification of the family history.
Referrals should be made on our Cancer Genetics Referral form (Word) whenever possible
Referral guidelines
Breast and ovarian cancer referral criteria (PDF)
Colorectal cancer/bowel polyp referral criteria (PDF)
Skin cancer referral criteria (PDF)
Women with breast or ovarian cancer requiring urgent testing for BRCA1 and BRCA2 (please see BRCA Rapid Protocol) should be referred using the BRCA Rapid referral form, and blood sample sent with the BRCA Rapid Blood Form and emailed to cancergenetics.stg@nhs.net or by calling 020 8725 0957 or 07787 843 070. Please indicate this is a rapid test and the patient will be contacted within 2 working days of receipt of referral.
In addition, other cancer diagnoses may be associated with an inherited predisposition to cancer and may be appropriate for referral:
Other tumour referral critieria (Pdf)
Please also consider referring:
- families with childhood cancers (solid tumours), particularly if there are other cancer diagnoses in the family
- Or any family with more cases of cancer than expected, particularly if occurring at young ages
Screening Guidelines
We have specific screening guidelines for individulas with a family history of breast cancer and colorectal cancer. Patients will normally receive the screening recommendation following assessment of the family by our service, but they are available below for reference
- Surveillance guidelines for women with a family history of breast cancer (PDF)
- Surveillance guidelines for patients with a family history of bowel cancer (PDF)
Please note this list is not comprehensive. We are happy to receive requests for advice about referrals through our dedicated email service:
cancergenetics.stg@nhs.net or by contacting the dedicated Cancer Genetics phone line on 020 8725 0957 or 07787 843 070
