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What we do
Up to 1 in 2 people will get cancer in their lifetime. Most cancers happen when people get older, and are not due to anything running in the family. However, sometimes we see more cancer in a family than we would expect by chance. Conditions which run in a family are usually caused by genetic changes. Our genetic code is the instruction manual for how to make a person, and is present in every cell in our body. Genetic changes make us who we are.
For example, genetic changes will decide whether our eyes will be blue or green or brown. Genetic changes tell our body how tall to grow.
In some cases, a person can carry genetic changes which increase the chance of them getting cancer.
For these people we can offer extra screening or other ways to make it less likely that they will get an untreatable cancer.
To help us decide whether you have an increased chance of developing cancer in your lifetime, we use family history as a guide. We look at
• the number of people who have developed cancer in your family
• the ages the cancers developed
• the types of cancer in the family
• how closely related the relatives with cancer are
This information helps us decide whether any genetic testing is needed, or, more commonly, whether any extra screening is needed for you and your relatives.
To learn more about our Cancer Genetics service, click here.
The Clinical Genetics department organises a wide range of clinics at St George’s Hospital and throughout the South West Thames region.
Clinics are for anyone concerned about a known or suspected genetic condition in themselves or their family.
The department currently employs:
- 9 Genetic Consultants
- 8 Genetic Counsellors
- Several Trainee Doctors and Genetic Counsellors
The Clinical Department is closely integrated with the South West Thames Regional Genetics Laboratory which offers Molecular and Cytogenetic services.
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
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 firstname.lastname@example.org 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:
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
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:
email@example.com or by contacting the dedicated Cancer Genetics phone line on 020 8725 0957 or 07787 843 070