The Indiana Familial Cancer Clinic began in 1993 to provide care to families with a history of cancer. Clinical geneticists and cancer genetic counselors in the Department of Medical and Molecular Genetics provide genetics evaluation, genetic counseling, risk assessment, genetic testing and medical management services to individuals with a personal and or family history of cancer, polyps or pancreatitis. The clinic also provides services to children and adults with a gene mutation known to be causative for an increased cancer risk.
Make a Referral or Appointment
Physicians and health providers interested in making a referral to the Indiana Familial Cancer Clinic can call 317-944-3966 and/ or fax information to 317-968-1354 (attention: Cancer Genetics). Patients interested in making an appointment can call 317-944-3966.
The Indiana Familial Cancer Clinic provides individuals and families information on the following topics:
How predisposition to cancer can be inherited
How family history of cancer affects the risk for developing cancer
Whether or not the cancer in the family is likely to be inherited
Cancer risk estimates for family members who have not developed cancer
Cancer risk estimates associated with a specific gene for people with a mutation
Recommendations for medical screening
Appropriateness of genetic testing and informed consent for genetic testing
How gene mutations are inherited
Who should consider a cancer genetics consultation?
The majority of cancer occurrences do not occur as a result of a familial tendency or an inherited genetic change. Consequently, a genetics evaluation is not typically recommended for most individuals diagnosed with cancer. However, 5-10 percent of cancer diagnoses involve genetic or inherited factors. This estimate may be higher depending on the specific cancer type and family cancer history.
Individuals who are evaluated in this clinic may have a diagnosis of cancer and/or have a family history of cancer. Genetics consultation is also available for individuals who have tested positive for a gene mutation associated with increased cancer predisposition or people who have questions regarding the medical relevancy of genetic testing.
Individuals interested in a cancer genetics consultation may have one or more of the following:
Young age at diagnosis (e.g. colon cancer diagnosed at 32 years)
Multiple primary cancers in a single individual (e.g. sarcoma and breast cancer)
Bilaterality in paired organs or multifocal disease (e.g. cancer in both kidneys)
Rare tumor or cancer type (e.g. retinoblastoma, paraganglioma)
Multiple gastrointestinal (GI) polyps
Abnormal tumor studies designed to screen for specific cancer syndromes (e.g. abnormal MSI or IHC analysis concerning for Lynch syndrome)
Genetic analysis of a tumor which identifies a possible inherited gene change
Unusual tumor type (e.g. renal oncocytic hybrid tumor histology)
Unusual skin lesions or birth marks (e.g. fibrofolliculomas or hyperpigmentation of lips)
Multiple family members with cancer who are closely related to one another
Cancers occurring in multiple generations
Clusters of the same cancer type (e.g. brother, father, paternal uncle with prostate cancer)
Family members who have developed a rare or unusual cancer of combination of cancers (e.g. male breast cancer)
Family members with a combination of cancers suggestive of a known cancer syndrome (e.g. family members with breast, ovarian and prostate cancer)
Collecting family history information is an important part of a cancer genetics consultation. Patients can complete a family history questionnaire online with a username and password or with a paper form that can be mailed.
To improve accuracy on the evaluation, the cancer diagnoses of family members must be documented. Documentation includes pathology reports, autopsy reports, other medical records related to the cancer diagnosis, or death certificates. An information sheet explaining how to document a family history is available. Clinic staff can provide medical record release forms.
An individual’s health plan may require a referral from a primary care physician to cover the evaluation. In this case, the referral must be approved and completed prior to the appointment.
During the consultation, individuals meet with a genetic counselor and a medical geneticist. Consultations typically last 60 to 90 minutes.
The following information is reviewed during the appointment:
Personal medical history
Family history (of at least three generations) with emphasis on cancer diagnoses in biological family members
Risk assessment based on medical and family history information
Explanation of cancer genetics and how predisposition for cancer can be inherited
Medical screening recommendations
Assessment of the appropriateness of genetic testing
Discussion of the risks, benefits and limitations of genetic testing
Information regarding how gene mutations are inherited in a family and risk to other family members
Genetic testing is coordinated at the first appointment, if appropriate.