The patient is provided written material for review at home. The patient who decides to proceed with testing returns for a second visit. At this time informed consent is given and blood drawn. When test results are available, the patient returns for an explanation and a discussion of the implications for surveillance and for other family members. Individuals who have an inherited susceptibility often develop cancer at a younger age than others and therefore surveillance should start earlier than is customary.
Some patients choose prophylactic surgery.
Persons who have already had cancer may have an increased risk of a second cancer. Some persons are motivated to be tested in order to alert their family members, especially their children, to any increased risk, although children are not tested until they become adults. If a mutation has been documented in a relative who has had cancer, the absence of this mutation in a patient generally means that the patient's risk is not increased above the general public despite the positive family history. Persons found to have a mutation may be anxious or depressed or disappointed about the interventions available. Hence, pretest education is important so that a candidate for testing understands the implications of the possible test results before choosing testing.