Medical Oncologist
CION Cancer Clinics
What does a genetic counsellor actually do? | CION Cancer Clinics
A genetic counsellor works out whether a gene test makes sense for your family, and what the answer would mean. They draw your family tree, explain your choices before any sample is taken, and go through the result with you when it comes back. They do not push a test on anyone. This page explains what happens in the room, and what a counsellor leaves to your doctors. At CION Cancer Clinics in Hyderabad, our oncologists review your family history with you and guide you to the right genetic counselling and testing.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- What is a genetic counsellor there for?
- What does a counsellor actually do for your family?
- What happens across your visits with a counsellor?
- What the counsellor's terms mean in plain language
- What the counsellor does, and what others do
- What this page cannot tell you
- Four things families assume about counselling
- Common questions about genetic counsellors
The short answer
What is a genetic counsellor there for?
A genetic counsellor helps your family decide whether a gene test is worth doing, and then helps you understand and use the answer. They are trained in both genetics and in talking through difficult news. Their job is to make sure you choose with your eyes open, not to sell you a test.
Why a test needs a conversation first
A gene test is not like a blood count. The result can affect your brothers, sisters and children, not just you. It can raise questions about marriage, insurance and who in the family should be told. A counsellor walks through all of this before any sample is taken, so nothing on the report comes as a shock.
Why the answer needs a conversation after
Genetic reports are written in laboratory language. A single word such as pathogenic or uncertain changes what happens next. The counsellor translates the report into what it means for your screening, your treatment and your relatives. They also tell you plainly when a result changes nothing, which happens more often than families expect.
A counsellor is as willing to tell you that you do not need a test as to arrange one.Four parts of the job
What does a counsellor actually do for your family?
Most of the work happens before and after the test. The sample itself takes a few minutes.
Maps the family
They draw your family tree on paper, usually three generations deep on both sides. They ask who had cancer, what kind and at roughly what age. Relatives who were never ill matter just as much.
They will ask about
- Parents, siblings, children, aunts, uncles, cousins
- Whether parents are related by blood
- Any reports or death records you can find
Weighs whether to test
From the tree they judge whether an inherited fault is likely enough to be worth looking for. If it is, they suggest who should be tested first, usually the relative who already has cancer, and which test fits.
Explains the result
They go through the report line by line. They explain whether a fault was found, what it means for your own care, and what it does not mean. An uncertain result is explained just as carefully as a clear one.
Helps you tell relatives
If a fault is found, relatives can be tested for that exact fault. The counsellor helps you plan who to tell, in what order, and often writes a family letter you can hand over or forward.
Telling family is your choice. The counsellor supports you but does not contact relatives behind your back.Not sure whether this applies to you?
Ask an oncologistFrom first call to follow-up
What happens across your visits with a counsellor?
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A referral or a phone call
Your oncologist may refer you, or you may ask for an appointment yourself. You are usually asked to gather what you know about the family before you come, including any old reports.
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The first session: history and choices
The counsellor draws the family tree and explains what a test could and could not find. They cover cost, how long results take, and what happens to your sample. You can ask anything, in Telugu if you prefer.
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Deciding, with time to think
You do not have to decide on the day. Many people go home and talk it over with a spouse or parents first. If you agree, you sign a consent form and give a blood or saliva sample.
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The result session
The counsellor gives you the result, ideally in person or by video, and explains what it means. You leave with a written summary and, if needed, a letter for relatives.
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Follow-up as things change
Laboratories sometimes reclassify a result as evidence grows. A good counsellor tells you how you will be contacted if that happens, and when to come back.
Words you will hear
What the counsellor's terms mean in plain language
- Pedigree
- Your family tree drawn with standard symbols. Squares are men, circles are women, and shaded shapes mark who had cancer.
- Pre-test counselling
- The conversation before the sample is taken. It covers what the test looks for, what the results could be and how they might affect you.
- Post-test counselling
- The conversation when the result is ready. It explains the report and the next steps for you and your relatives.
- Informed consent
- Your agreement to be tested, given only after you understand what the test can and cannot tell you.
- Cascade testing
- Testing relatives one step at a time for a fault already found in the family. It is quicker and simpler than the first test.
- Variant of uncertain significance
- Often shortened to VUS. A spelling change in a gene that the laboratory cannot yet call harmful or harmless.
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Side by side
What the counsellor does, and what others do
The genetic counsellor
Your oncologist or another doctor
Draws the family tree and assesses the pattern
Treats the cancer that is already there
Explains the test and takes consent
Decides whether a result changes your treatment
Explains what the result means for the family
Arranges scans and surveillance you may need
Helps you tell relatives and plan their tests
Discusses risk-reducing options such as surgery
Being straight with you
What this page cannot tell you
It cannot tell you whether your own family needs a counsellor. That depends on who was diagnosed, with what and at what age, and only a proper look at your family tree answers it. It also cannot tell you what a report you are holding means. What your specific variant means is a question for the counsellor who ordered the test.
Who this does not apply to
Most people with one relative diagnosed at an older age do not need genetic counselling. If there is no pattern of young diagnoses, rare cancers or several relatives on one side, a referral is unlikely to change anything. Tumour testing, which looks at faults inside the cancer only, is a separate subject covered under targeted therapy.
When evidence is still thin
For some genes, the link to cancer is still being studied. A counsellor will say so plainly rather than give you a confident answer the science cannot yet support.
If you are unsure whether your family history counts, call the helpline and describe it. Someone will tell you honestly whether a referral is worth making.Commonly believed
Four things families assume about counselling
"Counselling means they think something is wrong with me."
It means someone wants to check whether your family pattern needs a closer look. Many families leave with the reassurance that no test is needed at all.
"Once I see a counsellor, I have to take the test."
You can stop at any point. Choosing not to test after a full conversation is a valid outcome, and nobody will pressure you. You can also come back later if circumstances change.
"The counsellor will tell my relatives without asking me."
Your result is confidential. The counsellor helps you decide how to share it, often with a letter, but the telling stays in your hands.
"I can read the report myself online, so I can skip the session."
The same gene name can carry very different meanings depending on the exact change and how it was classified. Searching the variant online often frightens people for no reason, or reassures them wrongly.
Questions we are asked
Common questions about genetic counsellors
Is a genetic counsellor a doctor?
Usually not. Most genetic counsellors have a master's degree in genetic counselling or a related science, with supervised clinical training. They work alongside oncologists and clinical geneticists, who are doctors. Where a medical decision is needed, the counsellor brings in the right doctor.
Do I need a referral to see one?
It depends on the clinic. Many accept a request directly from you, while others prefer a note from your oncologist. A referral helps because it brings your medical records with it. If you are unsure, call and ask how the clinic prefers to receive patients.
How long does a first session take?
Plan for a longer appointment than a routine clinic visit. Drawing the family tree and talking through the choices takes time, and rushing it defeats the purpose. Ask the clinic when you book so you can arrange travel from your district and time off work.
Can I bring family members with me?
Yes, and it often helps. A parent may remember relatives you never met, and a spouse or adult child may be the one helping you decide. Tell the clinic in advance if several people are coming so there is room.
Can the session be in Telugu?
Ask when you book. Being able to ask questions in your own language matters when the subject is this personal. If a counsellor who speaks Telugu is not available, a trained interpreter is better than a relative translating, because relatives often soften or skip difficult points.
Will the counsellor tell me whether to have surgery?
No. They will explain that risk-reducing surgery is one option among several, alongside closer screening and medicines. The decision itself is made with your surgeon and oncologist, over time, and is never rushed on the day of a result.
Does a counsellor deal with marriage and family questions?
Yes. Questions about whether to disclose a result before a marriage, or what it means when parents are related by blood, come up often in India. A counsellor can talk them through calmly and confidentially. The choice of what to share stays with you.
What if I just want to know whether I should worry?
That is a good reason to see a counsellor. Write down who in the family had cancer, what kind and at roughly what age. Call the CION helpline if you are not sure where to start, and someone will tell you whether a referral makes sense.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
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Sources
- MedlinePlus Genetics — What is genetic counseling?
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- NHS — Predictive genetic tests for cancer risk genes
- Cancer Research UK — Inherited cancer genes and increased cancer risk
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Genetic counsellor, clinical geneticist or oncologist: who does whatWhich professional handles which part of your carePre-test counselling: what is coveredThe conversation before any sample is takenWhat to bring to your first appointmentReports and family details that save a second visitPost-test counselling: the result sessionWhat happens when the result is ready
Talk to us
Wondering whether your family needs a counsellor?
Tell us who in your family was diagnosed and at roughly what age. We will tell you honestly whether a genetic counselling referral is worth making, and arrange it if it is. One helpline serves every CION centre.