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Release: July 28, 1999

Familial Cancer Consultation Service aids in assessing cancer risk

IOWA CITY, Iowa -- History often repeats itself, but for individuals with a family history of cancer, early detection at the University of Iowa Cancer Center may be the fastest route to ensuring that it doesn't.

The Familial Cancer Consultation Service, offered by the UI Cancer Center, provides counseling and genetic diagnostic services for individuals with a predisposition for particular types of cancer. The service focuses its efforts to determine the risk of developing cancer and to discuss the testing and surveillance options available.

The Familial Cancer Consultation Service is staffed by Adam B. Kanis, M.D., Ph.D., associate in the department of pediatrics and the service's director, Joy Larsen Haidle, a board-certified genetic counselor, and Meg Eilers, a genetic counselor.

One of the service's primary goals is to establish a personalized cancer surveillance program that evaluates a patient's cancer risk. This task is accomplished with the cooperation of the individual's referring physician. UI Cancer Center counselors construct a family tree that spans four generations. In addition, medical records, pathology reports and other documents are used to assess a patient's chances of developing cancer. Patients also receive a physical exam by a physician, board-certified in clinical medical genetics, who looks for features of an underlying disorder that may have associated risks of cancer development.

This information-gathering stage occurs before and during a patient's first few visits with a genetic counselor and physician. Confidentiality is assured and no other family member is contacted for information without the permission of both the patient and his/her family members.

A genetic counseling session is the second phase in the consultation process. It is crucial because it allows UI Cancer Center specialists to communicate directly with patients about their cancer screening options and give them the ability to be proactive about their health care decisions.

"Our role is largely educational," Kanis said. "We analyze the information gathered about the family and give the patients our interpretation of the results so that they can make informed choices."

The duality of the service, through its counseling and educating, is part of an informed consent process that has shaped the Familial Cancer Consultation Service's approach. More than 1,200 patients in Iowa will have a new diagnosis of cancer caused by a genetic susceptibility. These individuals, and especially their relatives, would benefit from enlisting in its services, which began roughly two years ago.

Patients receive recommendations about DNA testing and learn of prophylactic treatments that may lower cancer risk. In addition, the service helps identify other family members who are at an increased cancer risk.

"The risks, benefits and limitations are discussed in each session, so that individuals are well-equipped when deciding to take the next step," Haidle said.

Those seeking genetic testing can work through the cancer consultation service, which sends patient blood samples to laboratories outside the hospital. The results are interpreted for patients by the service's genetic counselors and physicians.

Early detection is a good start when faced with a cancer predisposition, and the Familial Cancer Consultation Service staff wants that message spread.

"We would like to expand our clinical services so that we can help more people learn about their individual risk for cancer and potential surveillance options," Haidle said.

"Also, we want to educate the general population and health care providers about what we can provide," Kanis added. "Getting the word out to people is important."

To make an appointment, or to obtain more information, call the Familial Cancer Consultation Service at (319) 384-9645.