Cancer genomics allows stratification of individuals into those at high and low risk of disease, and those who will and will not respond to specific treatments, allowing precision risk management and care. However, genomics will only realize its promise in an ethical and effective way if patients understand, cope with, and make informed decisions based on, somatic and germline results. Genome testing is producing an unprecedented volume of results. Somatic tumour test results can be clinically actionable, not clinically actionable (because there is no treatment available) or negative. Whole genome sequencing can identify clinically actionable variants which are: relevant to cancer or to other diseases not targeted, non-clinically actionable, or of unknown or uncertain significance. These results are often indeterminate, imprecise and complex, making them challenging for health professionals to communicate, and for patients to understand and use effectively in their decision-making. Potential negative consequences of such testing include high patient and family distress, misunderstanding, and consequent poor consent and decision-making. The small amount of research available suggests that patients do not feel adequately informed, have unrealistic expectations, and may feel burdened by additional complexity at a time of vulnerability. This presentation will discuss the psychosocial implications of genomic testing, and an update of the literature on this topic.