What We Offer You for Cancer Genetics
- Specialized expertise from one of the nation’s first programs for inherited cancer risk, focusing on all types of cancer, including breast, ovarian, colorectal, and gastric. Go to Conditions Treated
- Complete risk assessment, management, and treatment, including genetic testing, cancer prevention, and cancer screening recommendations as well as assistance with communicating genetic test results to family members. Go to Inherited Cancer Treatments
- Clinical trial opportunities, with the potential to customize treatment and improve care. Go to Clinical Trials
- Team approach, with experienced certified genetic counselors, renowned doctors, and dedicated advanced practice providers helping you make informed choices. Go to Your Care Team
- Full support, including social and emotional care, support groups, and guidance toward additional genetics services such as fertility, prenatal, neuro, and cardio, as needed. Go to Support Services
- Ease of access, with convenient appointments via telehealth, so that our multilingual genetic counselors can see you from anywhere in California. Go to Connecting to Care
Conditions Treated
We assess your hereditary and genetic risk to identify methods to prevent cancer, lead to earlier diagnosis, or guide cancer treatment for you and your family.
As a national referral center, we have experience with many types of inherited risk, including rare genetic findings in recently identified genes. Our team brings together experts in genetics, oncology, and other fields to interpret complex genetic information, so you receive deeper insight more quickly.
The Stanford Medicine Cancer Center is part of the Stanford Cancer Institute, an NCI-designated comprehensive cancer center.
Cancers With Genetic Risk
Cancer usually develops for reasons unrelated to your family. But inherited changes in DNA can play a role in some cases, through missing, duplicated, or miscoded genes. While these mutations do not always cause problems, they can increase the risk for certain cancerous and noncancerous tumors:
- Adrenal cancer
- Bladder cancer
- Bone and soft tissue cancer (sarcoma)
- Brain tumors
- Breast cancer
- Colorectal cancer
- Endocrine tumors
- Prostate cancer
- Skin cancer (melanoma)
- Small bowel/small intestine cancer
- Stomach cancer
- Thyroid cancer
- Uterine cancer
Cancer Syndromes
Sometimes an inherited mutation or a set of mutations can increase the risk of multiple cancer types in the same family, across generations. These syndromes, their known gene associations, and the conditions they may cause include:
A mutation in the BRCA1 or BRCA2 gene is the most common cause of hereditary risk for breast cancer. Mutations in TP53, PTEN, CDH1, ATM, CHEK2, PALB2, STK11, and other genes may also increase the risk of breast and other cancers.
Mutations in the APC gene can cause:
- Noncancerous and cancerous colorectal polyps
- Noncancerous and cancerous stomach (gastric) and small bowel polyps
- Noncancerous growths in tissue around the intestines (desmoid tumors)
- Thyroid cancer
Mutations in the FLCN gene can cause noncancerous skin lesions and may increase the risk of:
- Kidney cancer
- Kidney tumors
- Lung problems
Mutations in the DICER1 gene may increase the risk of a specific type of lung cancer called pleuropulmonary blastoma of childhood, kidney cancer, Sertoli-Leydig cell tumors of the ovary, and thyroid tumors.
Mutations in the PTCH1 gene increase the risk of:
- Basal cell carcinoma skin cancer
- Cancerous brain tumors
- Noncancerous jaw, heart, and ovarian tumors (fibromas)
Mutations in the CDH1 gene increase the risk of stomach (gastric) cancer. They may also increase the risk of:
- Breast cancer in your milk-producing glands (lobular breast cancer)
- Colorectal cancer
- Prostate cancer
Mutations in the FH gene can cause noncancerous tumors in your skin (cutaneous leiomyomas) and uterus (uterine leiomyomas, or fibroids) and may increase the risk of kidney cancer.
Mutations in the BRCA1, BRCA2, BRIP1, RAD51C, and RAD51D genes, the Lynch syndrome genes, and others increase the risk of ovarian cancer.
Mutations in the SDHA, SDHB, SDHC, SDHD, SDHAF2, and FH genes increase the risk of rare tumors (paraganglioma) in nerve cell bunches (ganglia). Paraganglioma may occur in your adrenal glands (pheochromocytoma) above your kidneys or in your head, neck, or trunk.
Mutations in the BMPR1A and SMAD4 genes can cause noncancerous gastrointestinal polyps (juvenile polyps) and gastrointestinal cancer.
Mutations in the TP53 gene significantly increase the risk of many different cancers. We can diagnose LFS in childhood. Although any tumor can occur in a person with LFS, the most common types are:
- Adrenal gland cancer (adrenocortical carcinoma)
- Bone cancer (osteosarcoma)
- Brain tumors
- Breast cancer
- Leukemia
- Soft tissue sarcoma
Mutations in the MLH1, MSH2, MSH6, PMS2, and EPCAM genes increase the risk of:
- Colorectal cancer (most common)
- Uterine (endometrial) cancer (common in LS)
- Ovarian cancer
- Pancreatic cancer
- Sebaceous adenoma (skin tumor)
- Small intestine cancer
- Stomach cancer
- Urinary tract cancer
- Brain cancer (less common)
A mutation in the menin gene may cause tumors in the:
- Parathyroid glands (most common)
- Pancreas (pancreatic neuroendocrine tumor)
- Pituitary gland
This mutation may also cause noncancerous tumors in your endocrine glands.
An inherited mutation in the RET gene causes:
- Medullary thyroid cancer
- Parathyroid, adrenal gland, and nerve tissue tumors
Mutations in both copies of the MUTYH gene cause many colorectal polyps and increase the risk for colorectal cancer.
Mutations in the NF2 gene can cause noncancerous nerve tumors, including on:
- The nerve from your ear to your brain (vestibular schwannomas)
- The membrane covering your brain and spinal cord (meningiomas)
- Other nerves or tissues in your brain or spinal cord
Mutations in the STK11 gene can cause specific polyps (Peutz-Jeghers polyps) to form in the small intestines. This sometimes occurs in childhood. PJS can also increase your risk of developing the following cancers:
- Breast cancer
- Cervical cancer
- Colorectal cancer
- Ovarian cancer
- Pancreatic cancer
Mutations in the PTEN gene may cause cancers in the breast, GI tract, thyroid, and uterus. They can also create noncancerous tumors in the brain, mouth, uterus, and skin.
Mutations in the SMARCB1 and LZTR1 genes can cause noncancerous nerve tumors (schwannomas) in adults. Children who have SMARCB1 gene mutations are at risk for certain malignant tumors of the brain. Learn more about schwannomatosis.
Mutations in the VHL gene cause risks for multiple tumor types, both cancerous and noncancerous. The most common cancer type is kidney cancer, and the most noncancerous tumor is a hemangioblastoma of the brain. VHL can also lead to tumors in the adrenal glands, pancreas, and elsewhere in the body, as well as multiple cysts in the kidneys and pancreas. Learn more about VHL syndrome.
Your Stanford Health Care team works with your oncologist and follows the most up-to-date evidence from the field of cancer genetics. Our doctors and certified genetic counselors write national guidelines on when to perform genetic testing and how to best manage future cancer risk for those with inherited cancer risk.
INNOVATION HIGHLIGHTS
- BRCA decision tool: Women worldwide use our free decision tool to learn more about their options for BRCA1 and BRCA2 gene mutations. These mutations can cause breast, ovarian, and other cancers.
- Care for transgender and gender-diverse (TGD) patients with Lynch syndrome (LS): We offer cancer surveillance, strategies to reduce cancer risk, and genetic counseling for TGD patients who have LS.
- Multiple-gene panel testing: We led the first clinical study on testing for mutations in many genes at the same time. This type of testing can result in earlier detection of mutations and increase access to care.
- Stomach cancer expertise: We offer leading expertise in the CDH1 gene mutation tied to stomach cancer. People from around the world seek our help when testing unexpectedly finds this rare inherited condition.
Comprehensive Risk Assessment
Our board-certified, cancer-focused genetic counselors guide you through each step of the process and help you reach highly personal decisions. You can also consult with top doctors whose published work continues to improve care. We offer the following genetic testing and risk assessment services:
Our consultations help people who have a family history of cancer, need treatment for cancer, or have previously had cancer. We evaluate personal and family medical histories, consult the latest research, and use the latest technology to help determine your risk. When appropriate, we discuss the benefits of genetic testing as well as its limits and possible impact.
Instead of testing one gene at a time, we now routinely use next-generation sequencing to analyze dozens of genes at once. We adopted this panel testing early on and proved its effectiveness at helping people with genetic risk. We continually discuss the benefits and limitations of combined DNA and RNA analysis. We lead the way in testing for lesser-known genes tied to cancer, especially breast cancer.
If you have children, we coordinate services with the genetic counselor at Stanford Medicine Children’s Health. If you are planning a pregnancy, we coordinate with both our prenatal genetic counseling colleagues and our Fertility Preservation Program to discuss options for prenatal testing, pre-conception testing, and fertility preservation.
Treatment Options and Managing Risk
We provide personalized options, helping you weigh both the benefits and drawbacks. Our recommendations depend on your risk level and the gene mutations identified, if any. We offer specialized expertise to devise a plan when the answer is not obvious or national guidelines do not yet exist. We also partner with other Stanford Health Care clinics to connect you with the best specialist for managing your specific cancer risk. Treatment and risk management options include:
If you face a higher risk for cancer, we can recommend tests and scans to detect disease at earlier stages, when it is more curable. We offer the latest techniques and continuously work to refine and improve them. Certain medications may also lower your chances of developing specific types of cancer.
While we recommend doing so only in certain cases, removing organs or tissue can protect your long-term health. Our surgeons’ expertise ensures safe and effective surgery as well as a fully supported recovery.
We provide recommendations for genetic testing of other family members. We can also help them find care in their state or area, if outside of California.
Identifying inherited mutations can guide cancer treatment, including disease that has spread (metastasized). Even if you have successfully completed treatment, knowing you have an inherited cancer risk can help target cancer screening and prevention options toward the specific areas in your body at risk for future cancer.
Innovation Through Clinical Research
Some of Silicon Valley’s brightest scientific minds are at the Stanford Cancer Institute and the Stanford Medicine Cancer Center. Medical discoveries and clinical advances happen here. Our physicians and scientists work every day to improve cancer prevention, detection, and care. We offer advanced diagnostics, the latest treatment technologies and techniques, and pioneering therapies in development through clinical trials. Let us put innovation to work for you.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest advanced clinical trials.
Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
We know cancer is more than a condition—it's one of life's greatest disruptors. We offer you and your caregivers the support you need at every step of the way, including a team that actively listens, develops a plan for your unique situation, and stays with you from diagnosis to treatment and beyond.
Your Stanford Health Care team partners with you to provide tailored risk assessments, recommendations, and support. Team members explain what the findings and choices mean for you and your family and answer your questions. They work alongside you to help decide which options best meet your needs.
Your Team
Certified Genetic Counselor
Our certified and licensed genetic counselors have special training in the science of cancer genetics and the best ways to work with you. They serve as your main point of contact during your initial consultation and follow-up visit. They assess family histories and test results and help you make decisions. Our counselors are certified by the American Board of Genetic Counseling and are licensed by the State of California.
View All {0} PodiatristsGenetic Counseling Assistant
Our genetic counseling assistants support our certified genetic counselors by helping to coordinate your care. They schedule appointments, collect information about your family history, and provide you with documentation after genetic counseling. They also act as a liaison with genetic testing laboratories.
View All {0} PodiatristsMedical Oncologist
Medical oncologists have specialized training in diagnosing and treating cancer using chemotherapy and biological, hormonal, and targeted therapies. Our team includes medical oncologists with expertise in cancer genetics. They order tests and help manage your care if you have a risky genetic change or a strong family history of cancer. They may also join your initial consultation.
View All {0} Medical OncologistsGastroenterologist
Gastroenterologists specialize in the care of digestive disorders. Our team includes a gastroenterologist trained in the genetics of cancers affecting the gastrointestinal tract, including the stomach and rectum.
View All {0} GastroenterologistsExtended Care Team
Nurses and Nurse Coordinators (RNs)
Nurses and nurse coordinators are registered nurses who coordinate your care with your cancer genetics team. They guide you from your first contact through follow-up care and help you find counseling, financial assistance, and other support services.
Care Coordinators
Care coordinators provide you with information and assistance before and during your appointment.
- Medical Assistants: Medical assistants work with our team to help provide care. They may prepare you for an examination, assist your doctor, or take your vital signs before your appointment.
- Patient Care Coordinators: Our patient care coordinators help you with scheduling appointments and accessing your lab results. They are your first line of contact before you see your provider and will guide you during your care.
- Patient Access Representatives: Patient access representatives can answer all your questions about health insurance coverage, help you apply for health insurance, and refer you to our financial counselors.
Research Coordinators
Doctors at Stanford Medicine Cancer Center participate in research efforts to advance the understanding of cancer genetics and treatments. Research coordinators help screen candidates for possible participation in clinical research trials.
Support Services
As part of your care, we design a personalized wellness plan to support you and your family. With just one call to Cancer Care Services, you can speak with staff who can help connect you to the services that are right for you. Contact Cancer Care Services for your personal support plan, which could include:
Support Group
We offer support groups for specific cancer diagnoses as well as through Bay Area Cancer Connections and Facing Our Risk of Cancer Empowered (FORCE) for people with inherited cancer risk.
We strive to make access to care as simple as possible. User-friendly virtual health tools and video appointments help you stay connected with your care team from home. We accept most insurance plans and offer discounted transportation, short-stay options, international travel, and translation services. We make it easy for you to get the care you deserve. Our team guides you through each step, so you can make decisions that are right for you.
Accessing care at Stanford Health Care is easy and convenient. We make every effort to coordinate your appointments so that you can see multiple providers, as needed, during a single visit. We guide you through the process, working with you to schedule treatments, arrange follow-up appointments, and resolve your concerns.
- Insurance and referrals: We make it easy to see our providers by accepting most insurance plans and self-referrals. If you come to us by referral, we coordinate with your referring doctor and share updates.
- MyHealth: Our MyHealth system allows you to access your records and view test results through a secure online portal and mobile app. You can also communicate with your care providers.
For Referring Physicians
PHYSICIAN HELPLINE
Fax: 650-320-9443
Monday–Friday, 8 a.m.–5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referral Information.
You may also submit a web referral or complete a referral form and fax it to 650-320-9443 or email the Referral Center at ReferralCenter@stanfordhealthcare.org.
- Send referrals online
- Place radiology and lab orders
- View referral status
- Access medical records
Get comprehensive care from anywhere in California through our virtual Hereditary Cancer Genetics Program. To make an appointment with a cancer genetics specialist, call 650-498-6000 or 833-444-SMCC.