CION Ameerpet
Genetic counselling is not the same as genetic testing, and the difference matters. Counselling establishes whether testing is worth doing at all — and for a good many women, the outcome is well-founded reassurance rather than a blood test.
People often use the two words interchangeably, and arrive expecting a blood test. Genetic counselling is a conversation, and its first job is to establish whether a test is warranted at all. For a meaningful proportion of women, the honest answer is that it is not — their family history sits close to population risk, and knowing that with confidence is a genuinely good outcome.
Where testing is warranted, the counselling that precedes it is what makes the result usable. Ordering a genetic test is trivial; interpreting one is not. Before any sample is taken, you should understand what each possible result would mean for you, what it would mean for your children and siblings, and what you would actually do differently in each case. Working that out afterwards, holding a report you did not expect, is much harder.
There is also a practical reason the sequence matters. A test result cannot be un-known. Some women, having thought it through, decide they would rather not know — usually because they would not act differently, or because they are not ready to. That is a legitimate decision, and counselling is where it can be reached deliberately rather than by accident.
Its first job is deciding whether testing is warranted. For many women the answer is no, and that is a real result.
Understanding beforehand what each outcome would mean is what turns a laboratory report into a decision.
A result cannot be un-known. Choosing not to test, having thought it through, is a legitimate outcome.
A genetic test result is unusual in medicine because it is not only about you. A pathogenic variant found in you means each of your siblings and each of your children has a fifty per cent chance of carrying the same change — information they did not ask for and may not want. This is why counselling spends real time on family communication rather than only on biology, and why services provide written material you can simply pass on rather than having to explain it yourself. Many people find this, rather than the result itself, the hardest part of the whole process. Source: NCCN Genetic/Familial High-Risk Assessment guidelines.
Knowing the shape of it removes most of the apprehension. Nothing is decided that you have not agreed to.
A structured three-generation pedigree covering both sides of the family: who had which cancer, at what age, and how they are related to you. This includes bowel, endometrial, pancreatic, prostate and stomach cancer alongside breast and ovarian, and it includes male relatives. Gaps are expected; approximate ages are fine. This is where most of the assessment happens.
Your pedigree is weighed against recognised referral and testing criteria, which consider how closely related affected relatives are, their ages at diagnosis, how many are affected and whether they sit on the same side. The outcome is an estimate of how likely a hereditary cause is — and for many women, that estimate is low.
Three outcomes are possible and they are managed completely differently. A pathogenic variant is a definite finding with clear implications. No variant found is reassuring but does not eliminate risk if the family history is strong. A variant of uncertain significance is a change whose meaning is not yet known and is managed as though nothing had been found.
What a positive result would mean for siblings, children and cousins, and how cascade testing works. This is also where the practical difficulties are discussed — who to tell, when, and what to do about relatives who would rather not know. See cascade testing.
Whether to test, and which panel. You can decline, and you can defer — nothing needs deciding in the room. If you proceed, it is a blood or saliva sample, and results typically take a few weeks. Modern testing usually uses a multi-gene panel rather than BRCA1 and BRCA2 alone.
The result is explained in the context of your family history rather than handed over as a number. Where a variant is found, this is where surveillance, the timing of risk-reducing surgery, breast risk management and reproductive considerations are worked into a plan that fits your actual circumstances.
Preparation makes a substantial difference to how much the appointment achieves.
Your family history, gathered as fully as you can: for each affected blood relative, which cancer, their age at diagnosis, whether they are living, and how they are related — kept clearly separate by side of the family. Any genetic test report from a relative, the actual laboratory document rather than a summary, since it names the specific variant. Any pathology reports for your own cancers if you have had one. Details of any ancestry that might be relevant. Incomplete is fine.
Whether you actually want to know, and why. What you would do differently with a positive result — would you consider risk-reducing surgery, and at what point in your life? Whether you have relatives you would find it difficult to tell, and who might help. Whether you are planning a pregnancy, since that affects timing considerably. And whether now is the right moment — there is rarely urgency, and deferring is a valid choice.
Any one of these is a reasonable reason to ask for a genetics referral. You do not need several.
A mother, sister or daughter with ovarian cancer at any age is a recognised indication for counselling.
Testing is now offered to essentially all women with epithelial ovarian cancer, because the result guides your own treatment.
Especially in a close relative, in more than one relative, or where one person had cancer in both breasts.
Uncommon and strongly associated with BRCA2. A single case in the family warrants referral.
Points towards Lynch syndrome, which raises ovarian risk alongside much higher bowel and womb risk.
Testing you for that specific identified change is quick, inexpensive and definitive. Ask for their laboratory report.
You do not need a family history to be offered testing if you have been diagnosed with epithelial ovarian cancer. Testing is offered regardless, because the result guides your own treatment.
A genetic test is easy to order and hard to interpret. Counselling beforehand is what turns a laboratory result into a decision you can actually act on.
We're never more than 30 minutes away. Same panel of specialists at every centre. Same tumour board reviews. Same NCCN protocols. Pick the closest one and call directly — or let us pick for you.
CION Ameerpet
CION Kukatpally
CION L.B. Nagar
CION Tolichowki
CION Masab Tank
CION Banjara Hills
CION Kompally
CION Balanagar
CION Siddipet
CION Sangareddy
Not sure which centre fits best? Tell us where you are — we'll suggest the closest one with the right specialists.
Help me pick the right centreTravelling for treatment? We may have a centre right where you are.
Don't see your city? Call 18002028726 — we'll find your nearest CION partner centre.
Trained at AIIMS, Tata Memorial and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them - together.
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationShare your name and number — we'll call you back within 30 minutes to schedule your consultation.
No referral needed and no cost for the first consultation. Genetic counselling and BRCA and HRD testing are delivered in-house at CION.
Most descriptions of genetic counselling cover the biology and skip the rest. The rest is where the difficulty usually sits, and it is worth knowing about beforehand rather than discovering it afterwards.
Telling relatives is the part people find hardest. Some want to know at once; some are angry that you told them; some never respond. None of those reactions is your fault and you cannot make anyone test. What you can do is make the information available, and a counselling service will give you written material designed to be passed on without you having to explain it yourself.
The waiting is harder than expected. Results typically take a few weeks, and that period is uncomfortable in a way people rarely anticipate. And a positive result creates a strange in-between state — not ill, not entirely well, holding information about a future that may never arrive. The word previvor exists precisely because no existing category fitted. See living as a previvor.
Reactions vary enormously and none of them is your fault. You cannot make anyone test — only make the information available.
A few weeks, and harder than most people expect. Knowing that in advance helps a little.
Not ill, not entirely well. The word previvor exists because no existing category fitted.
Good counselling covers the conversations as well as the biology, including material you can pass on directly.
This is one of the areas where CION delivers the whole chain itself rather than coordinating it. Genetic counselling and BRCA and HRD testing are in-house, which means the pre-test conversation, the test, the interpretation and the management plan all happen with the same team — rather than across three referrals and several months, with the risk that the thread is lost between them.
Your first consultation is free and runs to about 45 minutes, which is long enough to take a three-generation family history from both sides properly. Bring what you have gathered, incomplete as it is, and any laboratory report from a tested relative. If you are undecided about testing, that is a perfectly good reason to come — the decision does not have to be made in the room, and for many women the outcome is that no test is needed.
Where a variant is confirmed, the plan that follows is set here too. Chemotherapy and maintenance therapy, including PARP-inhibitor-class treatment, are delivered in-house across 35+ centres in Telangana and Andhra Pradesh. Risk-reducing salpingo-oophorectomy and any gynaecologic-oncology surgery is coordinated with specialist partner centres and may be billed there — we state that upfront rather than leaving it to be discovered later.
Counselling, testing, interpretation and the plan afterwards, with one team rather than across several referrals.
Free and unhurried. Long enough to take a proper three-generation history from both sides.
For many women counselling ends in well-founded reassurance rather than a blood test, and that is a real result.
Risk-reducing salpingo-oophorectomy is performed at specialist partner centres and may be billed there.
Counselling is a conversation; testing is a laboratory analysis of a blood or saliva sample. Counselling comes first, and its initial job is to establish whether testing is warranted at all — for a meaningful proportion of women it is not, because their family history sits close to population risk, and establishing that with confidence is a genuinely useful outcome. Where testing is warranted, the counselling beforehand covers what each possible result would mean for you and your relatives, and what you would actually do differently. That is what turns a laboratory report into a decision you can act on.
The bulk of it is taking a structured three-generation family history covering both sides — who had which cancer, at what age, and how they are related to you, including bowel, endometrial, pancreatic, prostate and stomach cancer alongside breast and ovarian, and including male relatives. That pedigree is then weighed against established testing criteria. If testing looks warranted, the discussion turns to what each possible result would mean, the implications for your relatives, and how cascade testing works. The decision to test is yours, and nothing needs deciding in the room.
Your family history, gathered as fully as you can: for each affected blood relative, which cancer, their age at diagnosis, whether they are still living, and how they are related — kept clearly separate by side of the family. Approximate ages and gaps are entirely fine. If any relative has had genetic testing, bring their actual laboratory report rather than a summary letter, because it names the specific variant, which makes testing you quick and definitive. Bring pathology reports for any cancer you have had yourself, and mention any Ashkenazi Jewish or other founder ancestry.
No. Counselling and testing are separate steps, and declining or deferring the test is a legitimate outcome that counselling exists partly to make possible. Some people, having thought it through, decide they would rather not know — usually because they would not act differently, or because this is not the right moment in their life. A test result cannot be un-known, which is precisely why the decision deserves to be made deliberately rather than by default. You can also proceed later; there is rarely genuine urgency.
Three, and they are managed completely differently. A pathogenic variant is a definite finding with clear implications for your risk, your management and your relatives. No variant found is reassuring, but it does not eliminate risk where the family history is strong — it may mean the responsible gene was not on the panel or has not yet been identified, and management then continues based on the pedigree. A variant of uncertain significance is a change whose meaning is not yet known; it is managed as though nothing had been found, and most are eventually reclassified as benign.
You are not obliged to, and most people find this the hardest part of the whole process. What is worth weighing is that a pathogenic variant in you means each sibling and each child has a fifty per cent chance of carrying it, and that testing them for that specific known change is quick, inexpensive and gives a clear answer. Reactions vary enormously — some relatives want to know at once, some would rather not, and neither response is your fault. Counselling includes practical help with these conversations, including written material designed to be passed on directly.
Yes — genetic counselling and BRCA and HRD testing are delivered in-house at CION, so the pre-test conversation, the test, the interpretation and the management plan all happen with the same team rather than across several referrals. The first consultation is free and runs to about 45 minutes. Medical oncology, including chemotherapy and PARP-inhibitor-class maintenance therapy, is delivered in-house across more than 35 centres in Telangana and Andhra Pradesh. Risk-reducing and gynaecologic-oncology surgery is coordinated with specialist partner centres and may be billed there.