Abstract

Genomic medicine is at the forefront of contemporary approaches to cancer research and care. This complex of stratified screening, clinical trials, research studies and targeted treatments is widely welcomed on the basis that it will transform professional practice and patients’ experiences, rendering cancer a treatable or preventable condition. There are, however, considerable challenges to the realisation of these benefits. In this paper we explore this from the perspective of health professionals and scientists involved in genomics, research and/or cancer care. Drawing on a series of qualitative interviews with professionals actively engaged in diagnosis, treatments, screening, trials and/or studies involving genomic medicine for cancer, we explore three main concerns that temper their enthusiasm for genomic medicine: (i) increasingly ‘difficult conversations’ with patients and families; (ii) the increased complexity of cancer biology, trials, and associated technologies of diagnosis and treatment; (iii) professional, organisational and funding challenges in cancer care. We argue that these concerns are part of practitioners’ efforts to provide good quality care to patients and suggest that there needs to be greater emphasis on supporting these efforts, alongside improvements in genomic education for professionals and patients more generally.