Hereditary cancer - how to know if you are at risk

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Hereditary cancer - how to know if you are at risk
Hereditary cancer - how to know if you are at risk
Anonim

Angelina Jolie's admission that she removed her mammary glands due to the high risk of developing breast cancer caused a real shock around the world. But her decision was fully justified - the terrible disease had already claimed the lives of many of her relatives

The topic of cancer prevention and diagnosis is relevant to all people in our time. But especially often it worries those whose loved ones have already faced this misfortune.

It's no secret that cancer can be hereditary. And often the life of many of the grown-up children turns into a panicked fear of waiting for the alarming symptoms like with "my father or my mother".

Expert Prof. Leonid Borisovich Ginzburg, a surgeon-oncologist of the highest category, explains to wday when there are serious reasons for concern and with the help of which tests it is possible to assess the risk of developing hereditary oncological diseases.

1. True hereditary cancer, or more correctly, genetically predisposed cancer, accounts for only 4-7% of all cancer cases. More than 90% of the remaining patients develop so-called sporadic cancer, which is not directly related to genetics, and the cause of tumor development are others, which can be divided into three large groups.

The first group is related to the way of life we lead, how we work, how much time we rest and sleep, when we become parents, when we marry or get married. As an old professor said: "The best way to prevent breast cancer is for a woman to get married early and have two children".

The second concerns the nature of the food. For example, in China, the incidence of colon cancer is 10 times lower than in Russia or other European countries, due to a diet rich in fiber (cereals, whole grain bread, seeds, vegetables, fruits) and relatively rare meat consumption.

The third group are carcinogenic factors (nicotine, tar, dust, exposure to the sun, chemical reagents, for example, detergents, asbestos dust).

These three groups mentioned above comprise approximately 30% of all cancer cases. So, most often, everything depends on us!

2. Hereditary cancer, which, I recall, accounts for only 4-7% of cancer cases, can be suspected, based on data that in the family, in close relatives, cancer appeared before the age of 45 or have had several different malignancies, for example colon, stomach, mammary or ovarian cancer. And also if the tumor affected two organs at once. I.e. the tumor at the same time or with a difference of several years developed in both parts of the lung or both kidneys.

Another minor aspect that can speak of a high risk is if there have been several cases of cancer in the same organ in the family in relatives on the same line - for example, a mother, grandmother and sister suffered from cancer on the breast.

Also, some forms of cancer indicate the likelihood of hereditary cancer in a given family. The identification of so-called "triple-negative breast cancer" even in one woman indicates the possibility of hereditary diseases.

3. In any case, it is worth talking to the doctor about whether there is a risk that this cancer is hereditary and whether it is okay to have genetic testing. In the presence of these factors, a screening genetic blood test for a particular mutation may be recommended.

But this research is not worth doing at all, as it is impractical due to the low probability of hereditary cancer and relatively high costs.

The detection of a mutation does not always indicate a 100 percent probability of developing a malignant neoplasm, but the risk of it increases a hundredfold - from 20 to 99% depending on the type of gene mutations found.

4. Particularly popular and common today is the definition of a mutation in the BRSA gene, or the so-called Jolie-gene, in suspected breast and ovarian cancer. In this case, women are recommended careful observation and even prophylactic subcutaneous mastectomy and oophorectomy (surgical removal of the mammary glands and ovaries).

The APS gene is determined in colon cancer and CDH1 in stomach cancer. The more frequent occurrence of cancer in a family can be explained not only by hereditary factors, but also by the characteristics of the lifestyle, nutrition or the action of carcinogenic factors in that family.

For example, if mom and dad smoke and develop lung cancer, the likelihood of developing malignant neoplasms in the lungs of their smoking children will be much higher. And this is due to the general carcinogenic effect of tobacco tar, not heredity.

In a family where three times a day consume fat, fried meat, smoked meat, fast food and eat few vegetables and fruits, the risk of developing colon cancer is several times higher than when the housewife prepares vegetable salads, fish dishes and put dairy products, vegetables and fruits on the table.

In a family where the mother's personal life is not happy, and the only daughter also did not marry and did not give birth, the risk of developing cancer of the reproductive system: cancer of the ovaries, breast, uterus is higher, than in the family where there is a happy sex life and two or three children.

This is also due to heredity, as well as the fact that hormones give birth and breastfeed women with a normal sexual life is much more balanced and reduces the risk of tumor mutations and the presence of chronic diseases of the female genital organs (for example, mastitis), which are one of the risk factors for developing breast cancer.

5. For early diagnosis of cancer, a banal professional examination is recommended first, which will help detect more than 80% of oncological diseases at an early stage. Annual fluorography, and better chest x-ray (more information with less radiation exposure), ultrasound of the abdomen, breast, pelvis, examinations by a surgeon, gynecologist, dentist, determination of tumor markers in people of age over 45, mammography, simple blood and urine tests, and if there are any complaints, the endoscopic examination of the colon and stomach. All this allows the detection of 80% of all oncological diseases at an early stage.

With a high risk of developing cancer, it is recommended that certain tests be performed more often. For example, if colon cancer runs in the family, and especially for hereditary colon cancer or polyposis, an annual fibrocolonoscopy is recommended. In certain types of gastritis in patients over 45 years of age - annual phigogastroscopy.

I want to remind again that doctors do not recommend the determination of gene mutations to all patients whose relatives had tumors of these organs, but only if there are signs of the hereditary cancer described above.

The rest of the patients are better off spending their money and time on regular and complete oncological examinations.

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