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Hereditary Cancer

The Hereditary Cancer Program (HCP) provides genetic counselling and genetic testing for BC/Yukon residents who may have inherited an increased risk for specific types of cancer. Similar services are available across Canada and in other countries.

This section provides direction about HCP referrals, information and resources for health professionals to use when discussing hereditary cancer assessment with your patients/families.

Referral
People are encouraged to review their personal and/or family history with a health care provider to clarify whether HCP referral is indicated. 

How to refer

To refer a patient, print the current HCP Referral form, complete all sections and fax it to the appropriate HCP office.

HCP referrals are accepted for BC/Yukon residents with: 

  • Personal history that suggests inherited cancer risk (click the "Syndromes" tab above to see specific syndromes)
  • Family history that suggests inherited cancer risk (click the "Syndromes" tab above to see specific syndromes)
  • A close relative who has a confirmed hereditary cancer gene mutation (refer for carrier testing)
  • A hereditary cancer gene mutation identified through private pay genetic testing or a research study (refer for review of clinical implications and carrier testing for family members)
  • A hereditary cancer gene mutation identified prior to moving to BC (refer with request for high-risk cancer screening)
Answers to some common questions are provided below. You are also welcome to contact  HCP staff with questions about whether to make a referral.

Frequently asked questions

Below are answers to commonly asked questions about HCP referrals:

The most informative approach to genetic testing is usually to offer the first test in a family to someone who has had a relevant cancer diagnosis. When that person’s short-term prognosis is poor, or their health is unstable, urgent storage of a blood sample may be prudent.

The goal of storing a blood sample is to allow for the possibility of hereditary cancer genetic testing in a family. No testing is done on a stored blood sample until the appropriate family member has had genetic counselling and completed an informed consent process. An adult family member who is aware of that blood sample is welcome to follow-up at an appropriate time in the future.  

Please print and use the Urgent DNA Storage Requisition, Consent and Family Info form  provided for this purpose. Contact HCP staff with any related questions. Call 604-877-6000 local 672198 (Vancouver office), 604-851-4710 local 645236 (Abbotsford office), or send an email.
Referrals that include a request for urgent assessment are reviewed promptly by HCP staff. Please provide a specific timeline and reason for expedited assessment (i.e. details about unstable/poor health or how genetic test results will impact specific immediate medical management decisions).

The referring physician will be contacted if additional information is required to support the request, or to explain why we are unable to provide an expedited appointment.
  • If your referral includes a request for expedited assessment, please include a clear statement of the reason and the requested timeline; our ability to follow-up will be delayed if we have to clarify those details
  • Relevant pathology reports, related operative reports and consult letters must be provided with a request for assessment unless those documents are already included in the patient’s BC Cancer chart
  • Carrier testing referrals: include a legible copy of any family member documents (genetic test report, family info letter, etc.) that your patient received
  • For someone who is not a current BC Cancer patient, the referral form must include current and complete contact information (mailing address and phone numbers)
  • If a family member needs to be the 1st contact, please provide that person’s name and phone number(s)
  • Please do not send a copy of the entire chart
HCP triage staff review each referral to confirm details such as:

  • Is expedited assessment requested to inform immediate decisions about cancer/other medical treatment?
  • Is a specific hereditary cancer gene mutation confirmed in a family member? 
  • Does the personal history of cancer/other features fit current criteria to offer an appointment?
  • Do we need to review additional medical records? 
  • Do we also need to review the family history of cancer?
Depending on the information above, the next steps may include: 

  • Requesting additional information from referring provider and/or patient
  • Booking a genetic counselling appointment
  • Sending the patient a family history form to complete
  • A letter to confirm the patient is on a waiting list to book a genetic counselling appointment
  • A letter to inform the referring provider and patient that no appointment will be booked
The referring provider will receive a written summary of the cancer risk assessment and risk management recommendations when HCP consultation is complete.
Genetic testing is offered when the patient’s personal and/or family history of cancer meets specific criteria. Genetic counselling is an important part of a decision to have genetic testing.

Genetic testing looks for an inherited change (mutation) in a gene that is known to increase the risk for specific types of cancer. It is usually done on a blood or saliva sample. Only about 5-10% of all cancers are linked to an inherited gene mutation.

The first (index) test in a family is usually most informative if offered to someone who has had cancer. Storage of a blood sample may be prudent for a person with uncertain health if s/he might be the best index for genetic testing in a family. For more information on the storage of blood samples, expand the "Urgent storage of a blood sample - when, why and how?" section above.

Most index genetic testing is currently done using a panel of hereditary cancer genes. The genetic counsellor will review which genes are being tested and the possible results.

If a hereditary cancer gene mutation is found, then a specific carrier test is available for family members. A carrier test looks only for the specific gene mutation that has been confirmed in a relative. 

Hereditary cancer genetic testing is usually offered to adults. It is available to children if the results will change their medical care (see specific syndromes). 
We provide expedited appointments if: 

  • A gene mutation has already been identified in the family
  • Genetic test results are needed to help with immediate clinical management decisions 
  • Requested for a patient who is eligible for consultation and is in poor health
For regular referrals, patients receive a letter to confirm they are on a waiting list and will be contacted by phone as soon as we are able to book a genetic counselling appointment.
Travel is NOT required. Our referral form includes a section to indicate the patient’s preferred appointment location. 

We offer in-person genetic counselling appointments at the Hereditary Cancer Program offices in Vancouver and Abbotsford, and at the BC Cancer Centres in Surrey and Victoria.

We also provide appointments by video-conference to most communities in BC/Yukon. The patient will receive specific instructions from our booking clerk about where to go and what to expect. Some appointments are done by telephone

Our booking clerk will contact the patient by phone and review the options when we are ready to book an appointment. 
Follow-up is available for a patient who had an HCP genetic counselling appointment, or was not offered an appointment when previously referred. 

Reasons to request HCP follow-up include: 

  • New cancer diagnosis in patient or family member
  • New genetic test results in a family member
  • Questions about new options for genetic testing or review of previous genetic test results
  • Questions about cancer screening and risk-reduction
  • Questions about available supports and resources
Complete a new HCP Referral form or contact HCP staff directly to request follow-up. Call 604-877-6000 local 672198 (Vancouver office), 604-851-4710 local 645236 (Abbotsford office), or send an email.

Self-referrals to HCP are accepted if a relative has shared details (e.g. letter, report, family reference number) about their hereditary cancer gene mutation.


Self-referral may also be an option for a patient who does not currently have a family doctor or nurse practitioner. 

Patients are welcome to contact HCP to discuss self-referral.


Call 604-877-6000 local 672198 (Vancouver office), 604-851-4710 local 645236 (Abbotsford office), or send an email.

The HCP team includes specialized physicians, genetic counsellors, nurses and support staff. Working together, we provide hereditary cancer risk assessment, genetic counselling and genetic testing. Our team also provides education (link to other section) about hereditary cancer topics. 

Physicians 

Vancouver:

  • Kasmintan (Intan) Schrader, Hereditary Cancer Program Co-Medical Director and Medical Geneticist
  • Sophie Sun, Hereditary Cancer Program Co-Medical Director and Medical Oncologist 
Vancouver/Victoria:

  • Gudrun Aubertin, Medical Geneticist (part-time with Hereditary Cancer Program)
Genetic Counsellors 

Vancouver:

  • Jennifer Nuk, Clinical Coordinator
  • Mary-Jill (MJ) Asrat
  • Carol Cremin (part-time) Familial Pancreatic Cancer Program 
  • Nili Heidary
  • Zoe Lohn
  • Tammy Petersen
  • Cheryl Portigal-Todd (part-time)
  • Jenna Scott (part-time)
  • Jennifer Thompson 
Abbotsford:

  • Angela Bedard (part-time)
  • Katie Compton
  • Allison Mindlin (part-time)
  • Ruth Thomas
Nurse Educator

Vancouver:

  • Mary McCullum
Support Staff 

Vancouver:

  • Mandy Jevon, Program Manager
  • Kim Barnaby, Clerk
  • Bianca Blake, Clerk
  • Hae Jung Min, Research Project Assistant
  • Pawan Tung, Clerk
Abbotsford:

  • Chalaine Lawrance, Clerk 
  • Chelsea Poole, Clerk
High-Risk Clinic 

Vancouver:

  • Rona Cheifetz, High-Risk Clinic Medical Leader (part-time with Hereditary Cancer Program)
  • Marco Gnoato, High-Risk Clinic Nurse Practitioner (part-time with Hereditary Cancer Program)
  • Mary McCullum, Nurse Educator and High-Risk Clinic Coordinator

Additional information


Syndromes
The identification of genes associated with hereditary cancer syndromes is an evolving field of research and clinical service. There are more than 100 hereditary cancer syndromes and some of these conditions are extremely rare. Therefore, the Hereditary Cancer Program does not develop referral criteria and risk management guidelines for each syndrome (gene). 

Hereditary Cancer Syndromes

The fact sheets below provide current information, referral criteria, cancer risks and cancer risk management guidelines for the following hereditary cancer syndromes:

Additional information

The following websites are excellent resources for those seeking more information about specific hereditary cancer syndromes:


Resources
HCP provides and recommends resources for those who seek additional information and support related to hereditary cancer. 

Patient/family education materials 

The following tools were developed for use by healthcare providers and are available at no charge from HCP:

To order these resources- call 604-877-6000 x 672198, send your order via fax to 604-707-5931, or send your order by email.

Additional resources

HCP content can also be found in these BC Cancer publications:

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