About the Cancer Predisposition Program

The Cancer Predisposition team provides the coordination of care for children with a genetic predisposition to cancer by providing a multidisciplinary approach to comprehensive care and medical management. Care consists of physicians specialized in hereditary cancers to provide screening assessments and surveillance protocols for those children at risk for developing cancers. The program also has genetic counselors, psychologists and nursing staff. The program also works closely with other providers to coordinate care from a variety of pediatric specialists. Some include; Oncology, Medical Genetics, Thyroid Center, Gastroenterology, Bone Marrow Failure Program, Neurofibromatosis Program and Beckwith-Wiedemann Syndrome Clinic. Each member of our staff is dedicated to providing the most skilled and compassionate care available, in an environment that focuses on children and their families. 

Also key to the program are community physicians, who are often the most likely to spot signs of predisposition in families, particularly among siblings and other relatives. Some features of cancer predisposition include a family history of the same or related cancers; bilateral or multifocal tumors; more than one cancer under the age of 20; clinical features of a cancer predisposition syndrome; or a cancer occurring at a much younger age than usual.

Cancer predisposition services for families and physicians

  • Review information about the diagnosis, course and management of specific genetic conditions associated with increased cancer risk
  • Explain and coordinate molecular genetic testing to diagnose cancer-predisposition syndromes and to better determine cancer risk
  • Review and explain genetic test results
  • Assist in ordering appropriate cancer screening tests
  • Review family cancer histories to identify other family members who are potentially at risk
  • Offer genetic counseling about the risk of occurrence of a cancer-predisposition condition in future children
  • Create and distribute educational materials on genetic testing, cancer predisposition syndromes and support groups
  • Provide access to and enrollment in ongoing research in cancer genetics
  • Offer psychosocial support services

For referring physicians, we:

  • Provide comprehensive and detailed written reviews of our consultations
  • Collaborate in the medical management of patients, coordinate genetic testing, and recommend cancer surveillance testing for early detection of cancers, according to available guidelines
  • Explain and interpret genetic testing and cancer screening results
  • Recommend patient referrals to additional specialists, as needed
  • Distribute educational materials on genetic testing and cancer predisposition syndrome

Who can benefit

Referral to the Cancer Predisposition Program is recommended for children suspected of having a cancer predisposition syndrome. Reasons to refer include:

  • Tumor type with strong hereditary component (for example, retinoblastoma, pheochromocytoma/paraganglioma, rhabdoid tumor, adrenocortical carcinoma, pleuropulmonary blastoma, medullary thyroid cancer)
  • Multifocal/bilateral cancer, or multiple primary tumors
  • Early-onset tumor (adult-type cancer in a child; rhabdomyosarcoma in a child under 3 years old)
  • Same or related types of cancer in multiple close relatives
  • Patient with cancer and developmental delay/autism, birth defects or dysmorphic features (such as hemihypertrophy, macroglossia, macrocephaly or café-au-lait spots)
  • Patient incidentally found to carry a mutation, deletion or duplication involving a cancer predisposition gene (such as on whole exome sequencing or SNP array)
  • Patient with a known family history of a cancer predisposition syndrome
  • One or more family members with early onset of bone marrow failure (BMF) syndrome or myelodysplastic syndrome (MDS)