Question

1. A 55-year-old patient has been diagnosed with cervical cancer. She reports that she has a strong family history of cancer; two sisters have breast cancer. Her mother died of cancer when the patient was a child, and she is not certain of the type of cancer. Because of her strong family history, she is concerned about the health status of her twin daughters who are in their early 30s. She has asked you to discuss the risks for cancer with them

• Identify the evidence base for the counseling and education and the strength of that evidence.
• How will you approach your counseling and education?

Answer 1

# Genetic testing :-

-This test can be usually recommended for when certain type of cancer run through a family and gene mutation is suspected .

-can perform this test in blood ,hair ,urine ,cheek cells etc

-this test identify specific changes in your gene ,chromosomes or protiens.these type of changes called genetic mutation.

-this help to identify some type of cancer such as :-

breast cancer,ovarian cancer,colon cacer ,prostate cancer and so on .

-help to identy your risk of devoloping a perticular cancer

-helps to find if you have gene that may increased chance of geting cancer to your children

-provide information to guide your health care

Risk factor for heriditory cancer :-

family history of cancer :- having 3 or more relatives on the same side of a family with the same or related form of cancer cells

-cacer of any age :- 2 or more relatives diagnosed with cancer at an early age .

multiple cancer :- one relative develop 2 or more type of cancer cells

rare cancer :-some type of cancer like ovarian ,sarcoma ,adrenocorticoid cancer are linked to genetic mutation .

# Here suggest the client to undergo a genitic test to confirm whether she has a genetic mutation or not .This help to do a genitic counselling and education based on evidence base .

-After confirm the test we can do genetic councelling as per the request of the client .

-we have to give a prescreening councelling to her daughter to identify the risk factor

-should provide a non directive and non judgmental approach

-should provide accurate and scientific information to family members that help them to take their own decision

-counselor should provide information according to their level of under standing :-

medical diagnosis ,prognosis and possible treatment .

mode of inheritence and risk of development .

choice available for dealing the risk .

-communication should be a 2 way process.they should provid information and should listen the fear worries of the family members

-provide information in clear sympathetic and appropriate manner

-use the term chance instead of risk while explaining disease .that make a positive way .

- maintain confidentiality

--ask them to follow up .that providing them a platform to solve their confused issues  

-make assessment of risk

-collecting genetic information and pedigree drawing

-making and validating the diagnosis

-estimating occurence and recurrence of risk

-communicating clinical information

-supporting the family

-help family to make decision and appropriate action

-serve as a patient advocate

genitic counsellors provide information and answer about genetic testing and management of genetic conditions and risk for diseases.