Do you have relatives with cancer around you? If so, it is recommended that you must read this article after reading ~
Infographic, Yang Zhengqiang/Photo
Recently, Lao Weifeng, deputy chief physician of the Department of Anorectal Surgery of Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine, shared a case on the hospital's WeChat public account "Run Shaw Hospital":
The 40-year-old Ms. Chen was diagnosed with cervical cancer and colon cancer in just 1 year, which made Ms. Chen's family extremely depressed and wondered why.
According to Ms. Chen' recollection, her grandmother died of digestive tract tumors in her early years, her mother was diagnosed with colon cancer 7 years ago, her two sisters also had a history of endometrial cancer and colon cancer, respectively, in addition, her grandmother's siblings had many people with malignant tumors.
After learning about Ms. Chen's condition and her family history, Dr. Lo believes that Ms. Chen's family is a suspected family of Lynch syndrome.
Eventually, through the detection of Ms. Chen's surgical specimens, it was found that her genotype was MSI-H and had an MLH1 germline mutation, which is a common related pathogenic gene in patients with Lynch syndrome. These genes are all blastline mutations inherited from the father or mother, so if the previous generation has Lynch syndrome, there is a 50% chance of being passed on to the next generation. ①
Cancer does really congregate!
Does cancer really congregate in families?
"The answer is yes!" Yi Lin, deputy director of the Oncology Laboratory of Chongqing Cancer Hospital, introduced in a health newspaper article that tumors are a polygenic genetic predisposing disease, and there is often a phenomenon of family aggregation. ②
In 2016, the Journal of the American Medical Association (JAMA), a top clinical medical journal, published a study by Harvard scientists in collaboration with Researchers from Denmark and Finland that illustrates the relationship between cancer and heredity. The study, which began in 1943 and ended in 2010, followed 203691 subjects for 32 years.
The results showed that about one-third of cancers are caused by genetic factors. Parents pass on the mutated oncogenes to their children, and this innately acquired variant gene is almost the same as the formation of acquired mutations, which means that cancer can indeed be inherited. ③
Infographic, Jin Peng/Photo
Therefore, if there are relatives and relatives suffering from cancer around you, you must pay attention, because cancer does have the phenomenon of family aggregation and the risk of inheritance from generation to generation. If someone in the family has these 7 types of cancer, others should be careful!
1. Breast cancer – daughters have a 2 to 3 times higher risk
Chen Xiuchun, chief physician of the Department of Breast Medicine of Henan Provincial Cancer Hospital, introduced in a health newspaper in 2020 that the study found that among breast cancer patients, 20% to 25% have familial aggregation, of which 55% to 60% belong to hereditary breast cancer, which accounts for 5% to 10% of the total breast cancer.
Breast cancer has a genetic predisposition, in general, the mother has breast cancer, the daughter has a 2 to 3 times higher chance of getting breast cancer than other women. Clinical recommendations are high-risk groups should be regular self-examination, every year to the hospital for physical examination, so as to achieve early detection, early diagnosis, early treatment. ④
2. Ovarian cancer – most caused by genetic mutations
Wu Xiaohua, chief physician of the Department of Gynecology of Cancer Oncology of Fudan University Affiliated Cancer Hospital, introduced in a health newspaper article in 2020 that the main feature of this type of ovarian cancer is familial aggregation, and the "real culprit" that leads to hereditary ovarian cancer syndrome is BRCA1/2 gene mutation.
BrCA1/2 are two genes that "inhibit" cell cancer, and once a mutation occurs, the valve that "inhibits" cancer is opened, resulting in a higher risk of cancer.
Studies have shown that more than 90% of hereditary ovarian cancers are caused by mutations in the BRCA1/2 gene. For women with a family history of ovarian cancer or breast cancer, genetic testing or effective genetic counseling is recommended that people with BRCA1/2 gene mutations be evaluated by a professional physician for prophylactic resection to avoid the risk of ovarian cancer or breast cancer. ④
3. Stomach cancer – there is a significant phenomenon of family aggregation
Chen Suqiong, chief physician of the Department of Oncology of the First People's Hospital of Yinchuan City, Ningxia, introduced in a health times article in 2020 that stomach cancer is not a genetic disease. However, if a person has a family history, the incidence is relatively higher than that of people without a family history.
Stomach cancer has obvious family aggregation phenomenon, there are two main reasons:
The first is genetic susceptibility, it is possible that there are indeed common living habits in the family, and there is a common genetic inheritance, so there may be susceptibility. Secondly, a large number of clinical data prove that the offspring of patients with stomach cancer in the family do not necessarily have stomach cancer. But dietary habits and the increase in everyone's exposure to certain carcinogens in the environment can indeed increase the body's susceptibility to cancer.
For familial stomach cancer, it is recommended to do regular screening and early prevention, if there is often epigastric pain, stomach swelling, unexplained weight loss and other symptoms, you should also go to the hospital for diagnosis as soon as possible. ④
4. Liver cancer – children are targeted for primary prevention
Wang Qian, deputy chief physician of the Department of Hepatobiliary and Pancreatic Surgery of Henan Provincial Cancer Hospital, introduced in an article in the Health Times in 2020 that if parents are diagnosed with liver cancer, their children are the first-level prevention object, because the vertical transmission of hepatitis B virus is easy to cause the family aggregation tendency of liver cancer. In particular, mothers who carry the hepatitis B virus have a higher chance of developing liver cancer in their offspring.
If there is a person with hepatitis in the family, it is necessary to vaccinate regularly, and it is recommended to use a meal sharing system to avoid cross-use of tableware at home and reduce the risk of hepatitis infection. There are liver cancer patients in the family, and their children must undergo comprehensive liver examinations regardless of their physical fitness, such as liver function, B ultrasound, etc. ④
5. Nasopharyngeal carcinoma – there is a clear family genetic predisposition
Deng Qinghua, chief physician of the Department of Radiation Therapy of Hangzhou Cancer Hospital in Zhejiang Province, introduced in a health newspaper article in 2020 that several people in the same family suffered from nasopharyngeal cancer at the same time, and the cause of analysis, heredity is the foundation, is a factor that cannot be ignored. Studies have found that people with a family history of nasopharyngeal cancer have a 20 to 40 times higher incidence than normal people.
There is a project in the routine physical examination that checks the nose, and many people think that it does not matter if you do not do it, in fact, this can screen for nasopharyngeal cancer. If the location of the nasopharyngeal tumor is not particularly hidden, an experienced otorhinolaryngologist can basically see the lesion when examining. At present, the clinical detection of EBV is also an important auxiliary diagnostic method for nasopharyngeal carcinoma. If someone in the family has ever had nasopharyngeal cancer, it is recommended that you go to the hospital for a nasal endoscopy and EBV testing. ④
6. Thyroid cancer – there is indeed a certain genetic predisposition
Xia Tingyi, the first famous doctor of the country, the former president of the Cancer Hospital of the Air Force General Hospital, and the director of the All-Army Tumor Radiotherapy Center, pointed out in the Health Times in 2011 that thyroid cancer has a certain genetic tendency, and if there are thyroid cancer patients in the immediate family, other members of the family should be listed as high-risk groups, go to the hospital for screening as early as possible, and if the condition requires it, they can also be subspsied and biopsyed under the guidance of B ultrasound. ⑤
7. Bowel cancer – 20% to 30% of patients with bowel cancer have a family history
Xie Fangwei, deputy chief physician of the Department of Oncology of the 900 Hospital of the People's Liberation Army Joint Logistics Support Force, said in an interview with the media in April 2015 that 20%-30% of colorectal cancer patients have a family history of various types of cancer. If an immediate family member suffers from familial intestinal polyposis, the family must go to the hospital for testing.
If the family prefers to eat foods such as meat and high protein, the risk of colorectal cancer in the family will also increase. The most important thing to effectively prevent colorectal cancer is to change the diet habits of high fat, high protein and low fiber, active exercise, and maintain sleep. After the age of 45, colonoscopy is performed on average every 5 to 10 years, or there is an option to have a fecal occult blood test every year or semi-annually. If there is a genetic predisposition, colonoscopy should be done every 1-3 years. If there is frequent blood in the stool, frequent stools, mucus stools and abdominal pain, the cause should be found out in time. ⑥
Finally, cancer is not only related to genetics, but also related to lifestyle, mood, stress and other factors. In addition to preventing cancer, in addition to a healthy lifestyle, people with a history of cancer at home must undergo regular cancer prevention examinations.
Edit: Lu Yang
Reviewer: Yang Xiaoming
This article is synthesized from:
(1) 2021-12-14 Run Shaw Hospital "Three generations of a family have cancer!" Is it the culprit? 》
(2) 2018-01-30Bearn Times": "Talk about those things about tumor inheritance"
③Familial Risk and Heritability of Cancer Among Twins in Nordic Countries.JAMA.2016;315(1):68-76. doi:10.1001/jama.2015.17703
(4) 2020-12-22Bearly Times "Those Familial Clusters of Cancers"
(5) 2011-04-07Beal Times "Thyroid Cancer May Be Inherited"
(6) 2015-04-16 People's Daily "5 types of cancer with high genetic predisposition"