Medical Oncologist
CION Cancer Clinics
The family letter after a genetic result: what to do next | CION Cancer Clinics
After a genetic test finds a fault, your counsellor writes a short letter meant to be shared with relatives, not filed away. It says what was found, who else might carry it, and what they should do next. This page explains what the letter contains, who should receive a copy, and what happens if someone in the family does not want to know. At CION Cancer Clinics in Hyderabad, our oncologists review your family history with you and guide you to the right genetic counselling and testing.
NG
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 family letter, and why did I get one?
- What the four sections of the letter actually say
- Who should actually receive a copy?
- Words the letter uses, in plain language
- WhatsApp, print or hand-deliver: does it matter?
- What if a relative does not want to know?
- Four things people assume about the family letter
- Common questions about the family letter
After the appointment
What is a family letter, and why did I get one?
A family letter is a short summary your genetic counsellor writes after your result, meant to be shown to your relatives rather than kept in a drawer. It explains what was found, which relatives it affects, and what they should do next. You did not get it by mistake. It is the standard last step of a counselling session.
Why it exists at all
Relatives cannot be tested for a fault they do not know exists. A counsellor cannot contact your family directly, so the letter is written for you to hand over or forward instead. It carries the counsellor's name and the clinic's details, so a relative who wants to ask a question has somewhere to send it.
What it is not
It is not a diagnosis for anyone but you, and it is not written in the dense language of the laboratory report. It is meant to be read on a phone, understood in one sitting, and passed to a brother or a cousin without needing you to translate it first.
Keep the original report yourself. The letter is what you share; the full report stays with your own file.Reading it
What the four sections of the letter actually say
Every family letter from CION follows roughly the same shape, so you know what to look for.
The finding, in plain words
Names the gene and states plainly that a fault was found, without the laboratory's technical shorthand.
Who is affected
Lists which relatives are at higher chance of carrying the same fault, based on how it is inherited in that particular gene.
What they should do
A single instruction: contact a genetic counsellor and mention the gene name and this letter, rather than book a general check-up.
How to reach us
The counsellor's name and the clinic contact, so a relative in another city or district is not left guessing where to start.
Not sure whether this applies to you?
Ask an oncologistPassing it on
Who should actually receive a copy?
Start with the closest blood relatives
Parents, brothers and sisters, and your own adult children first. They carry the highest chance of sharing the fault.
Then the side of the family it came from
If your counsellor traced the fault to one parent's side, that side's aunts, uncles and cousins matter more than the other side.
Do not leave out the men
A brother, a father or a son can carry the same fault and pass it on, even for genes people think of as affecting women.
Marriage does not change who needs it
A married-in relative does not carry your genes, but their children with your blood relative might. Share it with the couple, not just one side.
On the letter
Words the letter uses, in plain language
- At-risk relative
- Someone with a real chance of carrying the same fault because of how closely they are related to you.
- Cascade testing
- Testing that moves outward through a family, one relative at a time, once the first fault is confirmed.
- First-degree relative
- A parent, sibling or child. This group is usually named first because their chance of carrying the fault is highest.
- Predictive test
- The test a well relative has for the exact fault already found in the family, rather than a broad screening panel.
- Referral letter
- Another name some clinics use for the same document. It means the same thing as a family letter.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Choosing a method
WhatsApp, print or hand-deliver: does it matter?
Works well
Worth knowing
WhatsApp or email for relatives who are far away
Follow up with a call so it is not left unread
A printed copy for an older relative
Sit with them while they read it the first time
A family group message with the letter attached
Fine for awareness, but each relative still needs their own appointment
Asking one relative to pass it along the chain
Often stalls; a direct copy to each household works better
The part nobody prepares you for
What if a relative does not want to know?
Some relatives will read the letter straight away. Others will put it away and never mention it again, and that is their choice to make, not yours to enforce. You are not responsible for whether they act on it, only for making sure they had the chance to.
You cannot make the appointment for them
A counsellor needs the relative themselves on the phone or in the room, not a message relayed through you. If they change their mind later, the same letter and the same gene name still apply, so keep your own copy safe.
What this page cannot tell you
It cannot tell you exactly how your family will react, or settle a disagreement between relatives about whether to test. If sending the letter is causing real conflict at home, a counsellor can speak to the family together rather than leaving it to one person to manage.
If you have lost the letter or need another copy, call the helpline with your name and the date of your appointment.Commonly believed
Four things people assume about the family letter
"The clinic will contact my relatives directly."
It will not, for privacy reasons. The letter exists because the clinic cannot approach anyone who was not its own patient without your relative's consent.
"Only my children need to know, not my siblings."
Siblings share as much of your genetic material as your children do. Leaving them out is one of the most common reasons a fault stays hidden in a family for another generation.
"If I test negative later, the letter no longer applies."
Your own result does not change what was already found in a relative who tested positive. Each person's result stands on its own.
"A phone photo of the letter is enough."
It is a fine way to share it, but the relative still needs their own counselling appointment before any test. The letter opens the door; it does not replace what happens behind it.
Questions we are asked
Common questions about the family letter
Do I have to give the letter to every relative myself?
No. You can ask a parent or an older relative to pass it to their own side of the family if that feels more natural. What matters is that every at-risk relative eventually sees it, not who physically hands it over.
What if I do not want my family to know?
That is your decision, and the clinic will not contact anyone on your behalf. A counsellor can talk through what sharing would mean for your relatives' own health choices, but the letter is never sent without you.
Can a distant clinic use my family letter?
Yes. Any qualified genetic counsellor or clinical geneticist can act on it, wherever your relative lives. The letter names the exact gene and fault so another clinic can order the matching test without repeating your whole workup.
Does the letter say what my relative's result will be?
No. It only says they have a raised chance of carrying the same fault and should be tested. Their own result is theirs alone to receive and interpret with a counsellor.
How long is the letter valid for?
There is no expiry on the finding itself; a confirmed gene fault does not change over time. Testing guidance can be updated as evidence grows, so a relative testing several years later should still start with a counsellor rather than the old letter alone.
What if a relative has already died?
The letter still matters for their children and siblings, who remain at-risk relatives regardless. Mention the relationship when you contact a counsellor so they can work out the right testing order for the family that is left.
Can I send the letter before I have told anyone in person?
You can, though most families find it easier to say a few words first so the letter does not arrive as a shock out of nowhere. Either order is fine; there is no required sequence.
Who do I call if a relative has questions I cannot answer?
The counsellor named on the letter, or the CION helpline if they would rather speak to someone new. One helpline serves every centre, so it does not matter which city your relative is in.
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
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- Cancer Research UK — Telling your family about a cancer gene
- NHS — Predictive genetic tests for cancer risk genes
- MedlinePlus Genetics — How can I find a genetic counselor?
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 doesWho writes the letter and whyPost-test counselling: the result sessionWhat happens just before the letter is writtenHow to find a genetic counsellor in IndiaWhere a relative should start once they have the letterFollow-up after genetic counsellingWhat happens on your side after the letter is sent
Talk to us
Not sure who in your family should see the letter?
Tell us about your family tree and we will help you work out who is at-risk and how to reach them. One helpline serves every CION centre.