Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Facilitating family understanding, adjustment and communication when "it's in the genes" (#9)

Kim Hobbs 1
  1. Westmead Hospital, Westmead, NSW, Australia

Confirmation of inherited cancer risk in any individual has the potential to unleash a watershed of consequences for the many people directly impacted by that finding. Familial cancer health professionals can find themselves entangled in complex family dynamics and psychological distress, as those affected try to make sense of the implications of this random chance event.


Although inheritance of a mutation is well outside the control of individuals, most people upon hearing of their result, will be inundated by a range of emotions; including guilt, remorse, outrage, despair and a sense of injustice. Conversely, for some there may be relief that the ‘genetic lottery’ relieves them from the sense of self-blame that implicates them in the cause their cancer diagnosis. The ‘blind luck’ notion of inherited cancer risk may liberate some people from the burden of expectation that changes to diet, lifestyle and even personality traits may change their outcome.


Assisting understanding and interpretation of increased familial risk of cancer is complicated in itself. When the capacity for understanding is confounded by psychosocial risk factors, the juggling act becomes even more complicated. Issues include family estrangement, unresolved grief from previous losses of family members to cancer, premorbid mental health concerns and relationship dysfunction. People who have risk factors associated with low socio-demographic status may be particularly vulnerable. Those with poor health literacy, lower education, older age, cognitive impairment and from culturally and linguistically diverse backgrounds may be especially vulnerable and require more intensive intervention to both understand and adjust to their risk status.


This presentation will address some of the common issues encountered by individuals with inherited cancer syndromes, and provide guidance for the geneticists, counsellors and oncologists who care for them. Working collaboratively with the psycho-oncology members of the multidisciplinary team will benefit and support familial cancer specialists in their clinical practice.