With the progress of the Human Genome Project, genetic testing has become widely available and useful in several kinds of familial cancer. As the results of the genetic testing may predict future onset of the disease and/or may influence other family members, clinical oncologists have to consider the psychological challenges and ethical complexities of communicating hereditary cancer risk information to families. A clinical genetics approach, including genetic counseling, is fundamental before and after the genetic testing. We introduce our activity at the Division of Clinical and Molecular Genetics, Shinshu University Hospital. Our system of a multidisciplinary approach to genetic counseling could be suitable for other hospitals in Japan.