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Testing a relative who has died, through stored tissue | CION Cancer Clinics
If the relative who had cancer has died, a gene test may still be possible. Hospitals keep tissue from surgery and biopsies in small wax blocks, and a laboratory can sometimes find an inherited fault in them. This page explains when that is worth trying, how to trace the block, and why the result can be less certain than a fresh blood sample. At CION Cancer Clinics, our team helps carriers and their families plan checks, next steps and support after a genetic result.
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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
- Can a relative who has died still be tested for a gene fault?
- In which situations does testing a stored block help?
- How do you get a stored block tested?
- The words you will meet, in plain language
- How does a block compare with a fresh blood sample?
- Four things families assume about stored tissue
- What this page cannot tell you
- Common questions about testing stored tissue
The short answer
Can a relative who has died still be tested for a gene fault?
Often, yes. When a person has surgery or a biopsy, the hospital keeps the tissue in a small wax block, and that block can sometimes be used for an inherited gene test years later. It is not always possible, and the result is less certain than a fresh blood sample, but it can answer a question the family otherwise cannot.
Why the person who had cancer matters most
The cleanest way to test a family is to start with the relative who had the cancer. If a fault is found in them, well relatives can be tested for that one exact fault. If that relative has died, the family loses its starting point. Stored tissue is a way to get it back.
What the block actually contains
A tissue block holds a mix of tumour and normal cells, preserved in wax after a chemical fix. The inherited fault, if there is one, sits in the normal cells too. A laboratory can pull DNA out of the block, though the process breaks some of it into short pieces.
This page is about inherited testing. Tumour-only testing to guide treatment is covered under targeted therapy.When it is worth trying
In which situations does testing a stored block help?
A counsellor will usually suggest it only when it can change a decision for someone who is still alive.
The only affected relative has died
A mother or aunt had breast or ovarian cancer and nobody else in the family was diagnosed. Her block may be the only way to learn whether a fault was driving it.
A well relative tested negative
A negative result in someone who never had cancer is hard to read on its own. Knowing whether the affected relative carried a fault tells you whether that negative is reassuring.
Treatment choices for a living patient
Sometimes a living relative now has cancer and knowing the family fault would help plan their care. The block can speed that up.
When it usually does not help
- A living affected relative can simply give blood
- The cancer was common and diagnosed late in life
- No block can be traced
Not sure whether this applies to you?
Ask an oncologistStep by step
How do you get a stored block tested?
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Find out where the surgery or biopsy was done
Old discharge summaries and histopathology reports name the hospital and usually carry a block or accession number. That number is the key to everything that follows.
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Ask the pathology department whether it still exists
Hospitals keep blocks for different lengths of time. Some keep them for a long time, others discard them sooner. Ask early, because blocks are not kept indefinitely.
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Arrange permission to release it
The hospital will usually need a request from a doctor and consent from the next of kin. Your counsellor can write that request for you.
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The laboratory checks whether the DNA is usable
Old or poorly stored blocks can yield DNA too damaged to test. The lab tells you this before running the full test.
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The result comes back to the counsellor
They explain what was found, how confident the lab is, and which relatives should now be offered a test.
On the paperwork
The words you will meet, in plain language
- Tissue block
- A small cube of wax holding a preserved piece of tissue from surgery or a biopsy.
- Histopathology report
- The report describing what the pathologist saw under the microscope. It names the hospital and the block number.
- Germline
- Present in every cell from birth, and so inheritable. This is what a family test looks for.
- Somatic
- A fault found only in the tumour. It cannot be passed on, and a block test has to tell it apart from an inherited one.
- DNA quality
- How intact the extracted DNA is. Poor quality means gaps in what the lab can read.
- Proband
- The first person in a family to be tested. Here, that is the relative who has died.
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Side by side
How does a block compare with a fresh blood sample?
Fresh blood or saliva
Stored tissue block
DNA is intact and plentiful
DNA may be broken or scarce
Any inherited fault shows clearly
Tumour and inherited faults can be hard to separate
Almost always gives a readable result
Sometimes fails and gives no answer
Needs only the person's consent
Needs the hospital and the next of kin
Commonly believed
Four things families assume about stored tissue
"Once someone has died, there is nothing left to test."
If they had surgery or a biopsy, a block may still sit in a pathology store. Families are often surprised it exists at all.
"The hospital must have thrown it away by now."
Sometimes it has, but many hospitals keep blocks for a long time. The only way to know is to ask the pathology department directly.
"A normal result from the block means the family is safe."
A block test can miss faults that a blood test would catch, because damaged DNA leaves gaps. Your counsellor will say how much weight a normal result can carry.
"Tumour testing already done for treatment answers the family question."
Not always. A tumour test may hint at an inherited fault, but it is not designed to confirm one. A germline test, or a counsellor's review of the tumour report, is still needed.
Being straight with you
What this page cannot tell you
It cannot tell you whether your relative's block still exists, or whether its DNA is good enough to test. Only the hospital that holds it and the laboratory that receives it can answer that. Evidence on how reliable block testing is comes from studies that are still fairly small.
It cannot read a result for you
A block result can be harder to interpret than a blood result, because the laboratory has to decide whether a fault came from the tumour or from birth. What that specific result means is a question for the counsellor who ordered the test.
Who this does not apply to
Most families do not need this. If the relative who had cancer is alive, a blood sample is simpler and more reliable. If the family history is one late diagnosis of a common cancer, tracing an old block rarely changes anything. A counsellor will tell you honestly when it is not worth the effort.
Questions we are asked
Common questions about testing stored tissue
Who can give permission to release the block?
Usually the next of kin, such as a spouse or an adult child. The hospital will also want a written request from a doctor. Rules differ between hospitals, so ask the pathology department what they need before you travel.
Can we collect the block ourselves?
Some hospitals hand blocks to the family in a sealed pack, others send them directly to the laboratory. Direct transfer is safer. If you carry it, keep it cool and dry and do not open the packaging.
What if the surgery was done in another city?
The request can usually be made by phone and letter, and the block couriered. Many families from Telangana districts have blocks held in Hyderabad or in other states. Distance slows things down but rarely stops them.
Will the hospital lose the block if we send it?
Laboratories normally cut only a thin slice and return the rest. Ask for this in writing. Some hospitals prefer to send cut slides rather than the whole block, which also works for many tests.
What if the test fails?
The family is back to using the family history alone. Well relatives may still be offered testing on a wider panel of genes, or be watched more closely based on the pattern of cancer in the family.
Is a stored blood sample better than a block?
Usually, yes. Some laboratories keep leftover DNA or blood from earlier tests. If your relative ever had a blood test stored for research or genetics, ask about that first, because it gives cleaner DNA.
Does this cost more than an ordinary test?
Often it does, because extracting and checking old DNA is extra work, and courier and retrieval charges may apply. Ask the laboratory for a full quote, including what you pay if the DNA turns out to be unusable.
Where do I start?
Gather any old reports with the hospital name and block number. Take them to a genetic counsellor or your oncologist. Call the CION helpline if you are unsure who to approach, and someone will guide you to the right clinic.
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)
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Sources
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- NHS — Predictive genetic tests for cancer risk genes
- MedlinePlus Genetics — What is genetic testing?
- 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.
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Trying to trace a relative's old tissue block?
Tell us where the surgery or biopsy was done and we will help you work out whether a block test is worth requesting. One helpline serves every CION centre.