Abstract
Counseling for family members of cancer families is not common at hospitals, even in cancer centers, in Japan. At Shikoku Cancer Center, we have started a counseling service for family members of cancer families in 2000. Although we sometimes had counseling of patients with breast or colorectal cancer who requested to receive counseling, we hesitated to recommend all the patients who are possible members of families of familial cancer to receive a gene test and tell other family members that they may be very likely to have the same cancer in the near future because we may have had some troubles with them by doing so. However, we saw a very young female patient with locally advanced breast cancer recently, and she was an elder sister of the patient who died of breast cancer at 21 years at our hospital. When we saw the latter patient, we suspected that she was a member of cancer family but her family did not fulfill the criteria of breast cancer family. Therefore, we did not tell anything about the possibility of inheritance of the disease to the other family members. If we had told it to the elder sister, her cancer could have been found at an early stage. After we experienced this patient, we have decided to change our policy from a passive stance to an active one.
