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Collecting My Family History of Cancer

Cancer is usually caused by a combination of many factors such as the environment, lifestyle, and other changes that happen to our genes over time. Sometimes, certain cancers may run in families due to changes to our genes that can be passed down between generations. Knowing your family history of cancer can help your healthcare team understand if you might have a higher risk of developing certain cancers.

A printable form to collect your family history

Use this form to collect information about your family’s history of cancer and then share it with your healthcare provider. If you have more family members to include, you can simply print extra copies of the form! As you work on filling out your own form, take time to talk with your loved ones about family history and encourage them to complete their own.

Family History of Cancer Sheet

Download a printable copy

Comments

  • Alina Ahsan moderator
    5 days ago

    @gina I’m glad you’re feeling well, but I know the thought of an upcoming treatment can weigh on you. Have you had BCG treatments in the past? I hope it goes smoothly for you!
    I’m also sorry to hear about all of your husband’s health concerns. We actually have a sister community for people with COPD, too, if you wanted to share with him or check it out yourself: https://copd.net/ Let us know how the BCG goes!
    -Alina

  • Gina
    6 days ago

    I was diagnosed with bladder cancer 2 years ago. I asked my specialist what could have caused it as my family has no prior history of cancer of any kind. He said that smoking can cause it. I have never smoked a cigarette in my 70 years but my husband and former boss were heavy smokers. He told me that passive smoking at that level was probably the cause of my cancer.

  • Alina Ahsan moderator
    6 days ago

    @gina That completely makes sense that exposure to that much secondhand smoke increased your risk of bladder cancer. We actually have an article on that topic that I wanted to share with you: https://bladdercancer.net/clinical/secondhand-smoke/ How have you been doing since your diagnosis?
    -Alina, BladderCancer.net Team Member

  • Gina
    5 days ago

    Hi Alina, I am feeling fine at the moment, but not looking forward to the coming BCG sessions. Ah well, if it works, that is the most important thing and we have to put up with it.
    After 45 years of smoking, my husband doesn’t have bladder cancer, but he does have COPD, with severe emphysema and chronic heart failure, so the cigs. got him eventually..

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