Medical Oncologist
CION Cancer Clinics
Genetic counsellor, clinical geneticist or oncologist: who does what | CION Cancer Clinics
The genetic counsellor decides with you whether testing makes sense and explains the result. The clinical geneticist is a doctor for the rarer and more complicated families. The oncologist treats the cancer and decides whether a result changes that treatment. This page explains who does what, who to ask which question, and how the roles often overlap in Indian hospitals. 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
- Who does what when cancer might run in the family?
- What does each professional actually do?
- Who will you meet at each stage?
- What the job titles mean in plain language
- Which question should go to which person?
- What this page cannot tell you
- Four things families assume about who does what
- Common questions about genetics roles
The short answer
Who does what when cancer might run in the family?
The genetic counsellor works out whether testing makes sense and explains the result. The clinical geneticist is a doctor who handles the rarer and more complicated cases. The oncologist treats the cancer and decides whether a result changes that treatment. Most families meet two of the three, not all of them.
Why three roles and not one
Inherited cancer sits between two worlds. One is the family: who carries what, who should be tested and how to tell them. The other is the patient in front of the oncologist, who needs a treatment decision now. Each role covers a different part of that ground, and they work best when they talk to each other.
How it often works in India
Trained genetic counsellors are still few, and most work in larger cities. So your oncologist may do the first conversation and order the test, with a counsellor or geneticist joining for the result or for complex families. Video appointments help families in Telangana districts reach a counsellor without travelling.
Where your family doctor fits in
Your family doctor often notices the pattern first, because they know the whole family. They can refer you, keep a copy of your result in your records and remind relatives when their screening is due. They rarely order the gene test themselves, but they are an important link for relatives who live far from the hospital.
You do not have to work out who to see first. Start with whoever you already have, and they will bring in the others.Four people behind a result
What does each professional actually do?
Titles vary between hospitals. What matters is who is responsible for which decision.
Genetic counsellor
Usually trained to master's level in genetics and counselling, rather than as a doctor. Draws your family tree, explains choices, takes consent, gives results and helps you tell relatives.
Go to them for
- Whether testing is worth it
- What a result means for the family
- How to share news with relatives
Clinical geneticist
A doctor with specialist training in medical genetics. Sees complex families, children, and people whose features suggest a syndrome that affects more than cancer risk. May examine you as well as take a history.
Oncologist
Treats the cancer. Increasingly orders gene tests directly for people with certain cancers. Decides whether a result opens up a particular medicine, changes a surgical plan or needs extra scans.
Your oncologist remains in charge of your treatment whatever the gene result.Laboratory scientist
Runs the test and decides how to classify each gene change. You will rarely meet them, but their judgement sits behind every word on your report.
Their work decides
- Whether a change is called harmful, harmless or uncertain
- Whether a finding is confirmed by a second method
- When a result is reviewed and reissued
Not sure whether this applies to you?
Ask an oncologistStage by stage
Who will you meet at each stage?
-
The question is raised
Usually by your oncologist, your family doctor or a relative who has already been tested. Sometimes it is you, after noticing a pattern in the family.
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The family tree and the decision
A genetic counsellor, or your oncologist, maps the family and explains what a test could show. If the picture is complicated, a clinical geneticist is brought in.
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The test itself
A nurse or technician takes blood or saliva. The laboratory scientist reads the DNA and classifies anything found.
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The result and what it changes
The counsellor explains the result and what it means for relatives. The oncologist decides whether it changes your treatment. Often they plan this together at a team meeting.
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The years that follow
Depending on the result, screening may be run by a breast surgeon, a gynaecologist, a gastroenterologist or a radiologist. The counsellor stays the contact for family questions and any later reclassification.
Titles you will see
What the job titles mean in plain language
- Genetic counsellor
- A trained specialist who explains genetic testing and results, and supports families through decisions.
- Clinical geneticist
- A doctor who diagnoses and manages inherited conditions, including rare cancer syndromes.
- Medical oncologist
- A doctor who treats cancer with medicines, and often the first to raise the question of genetic testing.
- Mainstreaming
- When the cancer team orders the gene test directly, rather than sending you to a separate genetics clinic first.
- Tumour board
- A regular meeting where oncologists, surgeons and other specialists plan care together.
- Molecular pathologist
- A laboratory doctor who oversees DNA testing and signs off the report.
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Side by side
Which question should go to which person?
Your question
Best person to ask
Should anyone in my family be tested?
Genetic counsellor
Does this result change my treatment?
Oncologist
My child has other health problems too. Is it linked?
Clinical geneticist
How do I tell my brother and sister?
Genetic counsellor
Should I consider risk-reducing surgery?
Oncologist and surgeon, with the counsellor
Being straight with you
What this page cannot tell you
It cannot tell you which of these people your family needs. That depends on your history and on what is available near you. It cannot interpret a result either. What your specific variant means is a question for the counsellor who ordered the test.
Titles are not always used the same way
Some hospitals call a counsellor a genetics coordinator. Some oncologists have extra genetics training and do most of the counselling themselves. Ask what training the person has, and who takes over if your family turns out to be complicated.
Who this does not apply to
Most people with cancer do not need a genetics referral at all. One relative diagnosed at an older age is not usually a reason to see anyone beyond your oncologist. If your oncologist has ordered a test on the tumour only, that is a treatment question covered under targeted therapy, not a family one.
If nobody has mentioned genetics and you think your family pattern is unusual, it is fine to raise it yourself.Commonly believed
Four things families assume about who does what
"Only a doctor can explain a genetic result properly."
Genetic counsellors are specifically trained to explain results and their family impact. Where a medical decision is needed, they involve the right doctor.
"If my oncologist ordered the test, I do not need a counsellor."
For a simple result, your oncologist may cover everything. For a fault that affects relatives, or an uncertain result, a counsellor adds time and family planning the clinic visit cannot.
"A geneticist is only for children with rare diseases."
Children are part of the work, but clinical geneticists also see adults with rare cancer syndromes and families with complex or unusual patterns.
"Seeing several specialists means my case is serious."
It usually means the system is working as designed. Each person handles the part they know best, and they share one plan.
Questions we are asked
Common questions about genetics roles
Who should I see first?
Whoever you already have. If you are being treated for cancer, start with your oncologist. If you are well and worried about the family, ask your family doctor or contact a genetics clinic directly. Either route leads to the right person.
Can my oncologist order a genetic test without a counsellor?
Yes, and for some cancers this is now common practice. Your oncologist explains the test, takes consent and orders it. A counsellor is usually brought in if a fault is found or the result is uncertain.
How is a clinical geneticist different from a genetic counsellor?
A clinical geneticist is a doctor and can examine you, diagnose a syndrome and order wider investigations. A counsellor focuses on risk, testing decisions, results and family communication. In complex families they often work as a pair.
Are genetic counsellors certified in India?
Training programmes and a professional certification exist in India, but the field is still growing. It is reasonable to ask where your counsellor trained and whether they are certified. Our page on training and certification explains what to look for.
Who decides whether I need risk-reducing surgery?
You do, with your surgeon and oncologist. The counsellor helps you understand your risk and the choices, which include closer screening and medicines as well as surgery. Nobody should push you into surgery on the day of a result.
Who contacts me if my result is reclassified?
Usually the laboratory tells the clinician who ordered the test, who then contacts you. Ask at your result session who will do this, and keep your phone number up to date with them.
Can these appointments happen in Telugu?
Ask when you book. Some counsellors and doctors speak Telugu. Where they do not, a trained interpreter is better than a relative, because family members tend to soften or skip the hard parts.
What if I cannot tell who is responsible for my follow-up?
Ask for one named contact before you leave any appointment. If you are still unsure, call the CION helpline and someone will tell you who is holding your plan.
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
Medical Oncologist
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Sources
- National Cancer Institute — Cancer Genetics Risk Assessment and Counseling (PDQ)
- MedlinePlus Genetics — What is genetic counseling?
- MedlinePlus Genetics — How can I find a genetics professional in my area?
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
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
What a genetic counsellor doesA closer look at the counsellor's partGenetic counselling in India: training and certificationHow to check a counsellor's trainingHow to find a genetic counsellor in IndiaWhere to look when your hospital has noneDo you need a referral for genetic counselling?Whether you can book directly
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Not sure who your family should see?
Tell us about the diagnoses in your family and any care so far. We will point you to the right person and arrange the appointment if it helps. One helpline serves every CION centre.