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High Risk Clinic

Part of the Hereditary Cancer Program, the clinic provides follow-up for eligible adults whose genetic test results or those of their family indicate a high risk of developing certain cancers.
Our Services

After receiving your or your family member's results from genetic testing you may be referred to the High Risk Clinic to: 

  • Develop a personalized care plan based on your risk
  • Manage preventative medical care and surgeries  
  • Ensure access to cancer screening and diagnostic tools, such as MRIs and mammograms 
Are you a health care provider with a patient in the High Risk Clinic? Learn about your role in their care

What to Expect

Once you are referred to the High Risk Clinic you will have your first consultation then on-going care. 

Your first consultation is with either a physician or nurse practitioner and can be in-person if you live within an hour of Vancouver or by phone if you live elsewhere in BC or the Yukon.


At the consultation, we review your personal health history and do a physical examination if in-person.


We review the cancer risks associated with your gene and discuss risk management options for each type of cancer.


If preventative surgery is an option and you are interested in this, we will refer you for a consultation with a surgeon in your own community.


If enhanced screening is recommended, these tests (such as mammograms or MRIs) will be ordered for you in your own community if they are available locally. If you need referrals to other specialists for screening (for example for intestinal cancers or skin cancers) we will arrange these if your primary care provider hasn't already done so.


We will discuss medication for cancer risk reduction if it is an option and prescribe these drugs if you wish to take them. 

‎In general, you will have a follow up visit every year unless you've had preventative mastectomies (breast removal) or develop a new cancer and are referred to an oncologist (cancer specialist). 


If you've had a recent cancer diagnosis and are not going to be followed any longer by your oncologist we will see you every 6 months until 5 years after you have finished your cancer treatment, then yearly. 


Follow-up visits are generally with the nurse practitioner. At each follow up your health is reviewed, a physical examination is done, and the results of any screening tests completed since your last visit are reviewed. Then arrangements are made for screening tests or referrals for the upcoming year. 

After all visits, whether in person or by phone, a summary letter is sent to your primary care provider. You should see your primary care provider (or attend a walk in clinic if you do not have a primary care provider) if you have a new problem in between visits (like a breast lump or pain or discharge).

Appointments

In-person visits occur at BC Cancer- Vancouver 600 West 10th Avenue, 2nd floor.

Need to change an appointment or update your contact information? Call 604 877 6000 x 673240 (or 1-800-663-3333 X 673240).

The physician or nurse practitioner can be reached for non-urgent questions about your health via email at HCPHRC@bccancer.bc.ca. It is important to include your full name and your PHN with your email. 

Tab Heading

Your questions

Hereditary cancer happens when a change in a gene that increases cancer risk is passed down from a parent to child. See Common Hereditary Cancer questions for more information on hereditary cancer, genetic testing and genetic counselling. 

 
You are eligible for the High Risk Clinic if you are: 

A person with breasts and a mutation in BRCA1, BRCA2, ATM, CHEK2, CDH1, PALB2, PTEN, STK11, TP53, or other gene associated with significantly increased lifetime risk of breast cancer.

A person with Li Fraumeni syndrome (TP53), a syndrome associated with an increased risk of many different cancers. 

A person with breasts between ages 30 to 50 with Neurofibromatosis 1 because of increased breast cancer risk. 

A person not currently under the care of an oncologist (cancer doctor) between ages 24 to 70 who the Hereditary Cancer Program's genetic counsellors determine is eligible because of your particular risk factors. 

If you are not eligible for the High Risk Clinic but have a risk of hereditary cancer, a care plan will be given to you and your care providers by the clinical team at the Hereditary Cancer Program.

Your primary health provider can contact the clinic at 604 877 6000 X 673240 and leave a message with the clerk asking to speak to the clinic physician or nurse practitioner who will give them a call back.

The High Risk Clinic will order mammograms, MRIs and other recommended screening as needed. 


If your primary care provider has already been ordering screening (such as annual mammograms following a breast cancer diagnosis), these can continue. The High Risk Clinic will order any additional screening (such as breast MRIs).
The High Risk Clinic will arrange referrals for specialist consultations for screening or surgery (gastroenterology, dermatology, etc).

Your primary care provider may make referrals before your first visit to us. This is particularly helpful if there will be a delay before you are seen or if you have previously been seen by a specialist in your own community (eg previous breast cancer surgery or previous gynecologic surgery). 
 

Find current information, referral criteria, cancer risks and cancer risk management guidelines for hereditary cancer syndromes.

If you have a mutation that increases your risk of breast cancer you can take oral contraceptives but there are risks and benefits to taking these. This will be discussed with you during your consultation.‎

 

If you have not had breast cancer, and are having your ovaries removed prior to your natural menopause then hormone replacement therapy is recommended.  

People who have had their breasts removed don't need a screening MRI. You also don’t need annual mammograms. You should have a physical examination every year with your primary care provider.

Surgery to remove ovaries and fallopian tubes can be done by a gynecologist in your community. They will follow a standard protocol for the procedure. 

You can find referrals and resources for health professionals to use when discussing hereditary cancer risk assessment and follow-up with your patients/families. 


Have a patient in the High Risk Clinic or wondering if they eligible? Learn about your role in their care

 

Our team

Dr. Rona Cheifetz, Medical Lead

Mr. Marco Gnoato, NP

Amandip Uppal, NP

Rebecca Morash, RN, Cancer Care Coordinator / Nurse Navigator

Clerk



Page last reviewed January 2023.

SOURCE: High Risk Clinic ( )
Page printed: . Unofficial document if printed. Please refer to SOURCE for latest information.

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