Abstract
Identification of a cancer predisposing gene mutation raises difficult and complex issues for all involved. Those with a diagnosis of cancer may be coping with cancer treatment and facing their own mortality in addition to coming to terms with high risks of developing future disease, making decisions about how to manage the risks and informing relatives about the mutation. Those without cancer may be making a decision about whether or not to have genetic testing, and if they test positive whether or not to undergo regular screening or surgery to reduce the risk of a disease they may never develop. Providing effective genetic counselling and support for individuals and families with hereditary cancer requires in depth knowledge about cancer and genetics, excellent communication skills and in sound understanding of the issues involved.