The nightmare of Lao Zhang's family began five years ago: that year, he was diagnosed with bowel cancer, after that, the second son had a colonoscopy and found early cancer, and the third son was also diagnosed with bowel cancer because he went to the hospital for bleeding in the stool......
After research, the team of Cui Wei, director of the Department of Colorectal Surgery of Li Huili Hospital of Ningbo Medical Center, finally discovered the culprit - Lynch syndrome!
The father and son were diagnosed with bowel cancer one after another
Lao Zhang, 70 years old this year, was sent to the local health center by his family five years ago because of sudden weight loss and paleness.
But after a month or two, Lao Zhang's symptoms not only did not ease, but gradually worsened, and once he was dizzy and fell while going to the toilet, almost causing an accident. The CT results showed that Lao Zhang's colon had a lump, which was highly suspected to be a malignant tumor of the colon, and further colonoscopy confirmed that Lao Zhang had colon cancer.
After Lao Zhang heard the diagnosis of "cancer", it was like a bolt from the blue. When they heard that surgery was needed to remove a section of the intestine and that an enterostomy might be needed after the operation, the family panicked.
Just when the family was at a loss, Lao Zhang took the checklist and found Cui Wei, the director of the colorectal surgery department of Li Huili Hospital. Director Cui Wei has rich clinical experience in the diagnosis and treatment of intestinal tumor diseases. After initially reading Lao Zhang's checklist, he was relieved that the tumor could be removed from the operation and there was no need for a stoma. Hearing Director Cui Wei's words, Lao Zhang's heart hung up, and then he landed.
After careful preoperative planning, the operation was held as scheduled, and Lao Zhang recovered smoothly after the operation, his face began to be rosy, and his weight gradually increased. Before being discharged from the hospital, Cui Wei learned that Lao Zhang had four sons, none of whom had ever had a gastrointestinal endoscopy, and suggested that they should be examined as soon as possible.
Cui Wei, Director of Colorectal Surgery
The second son, who listened to the persuasion, made an appointment for a colonoscopy for himself shortly after his father was discharged from the hospital. Unexpectedly, he was found to have a huge polyp in his colon during the examination. Based on the microscopic appearance of the polyp, it is considered that the "polyp" has become cancerous.
Soon the second son was admitted to the hospital, and Dr. Yang Shaohui, deputy director of the first ward of colorectal surgery, performed polyp removal for him under colonoscopy, and the postoperative pathology further verified the previous judgment - the polyp has become cancerous, fortunately it is in a very early stage, and there is no need for further surgery or chemotherapy and radiotherapy, only regular reexamination.
It didn't take long for his third son, who was only in his early 30s, to have the same symptoms as his father, and he rushed to the hospital for treatment. Sure enough, he was also diagnosed with bowel cancer.
The average age of onset of this genetic disease is 44 years
The three members of the family were found by bowel cancer one after another, which hit Lao Zhang hard. He made a special trip to find Cui Wei and tried to unravel the mystery.
The symptoms of Lao Zhang's family made Cui Wei highly suspicious that it might be Lynch syndrome. At his suggestion, Lao Zhang and his two sons underwent genetic testing, and the results confirmed Cui Wei's guess.
Cui Wei explained that Lynch syndrome, also known as hereditary non-polyposis colorectal cancer, is an autosomal dominant genetic syndrome caused by a defect in mismatch repair genes that predisposes to colorectal cancer and other malignant tumors.
How heritable is the disease?" If one of the couples has a mutation, there is a 50% probability that each of the offspring members will carry the mutation. ”
According to Cui Wei, most patients with Lynch syndrome are inherited from their parents. Among them, it is most closely associated with colorectal cancer, with a lifetime risk of 82% and an average age of onset of 44 years old. In addition, it also leads to a lifetime risk of about 60% for women with an average age of onset of about 50 years and a 13% risk of stomach cancer with an average age of onset of 56 years.
These people are screened regularly
Cui Wei mentioned that Lynch syndrome can be prevented and treated, and early intervention can prevent the next generation from repeating the tragedy of the previous generation.
Cui Wei reminded that if Lynch syndrome has been diagnosed or there are colorectal cancer and reproductive system tumors in the immediate family, it is recommended that patients and their families undergo regular screening-
Colorectal cancer screening: Patients with Lynch syndrome with MLH1 or MSH2 gene mutations should start colonoscopy at the age of 20~25, and if the family member has a tumor before the age of 25, the initial age of screening should be 2~5 years in advance, and the examination should be carried out every 1-2 years.
Gastric cancer screening: It is recommended that patients undergo gastroscopy every 3~5 years from the age of 30~35.
Endometrial cancer screening: For those with gene mutations starting from 30-35 years old, it is recommended to have an endometrial biopsy every 1~2 years, and regularly perform transvaginal uterine bilateral adnexal ultrasound examination and serum CA125 detection, especially pay attention to abnormal uterine bleeding. Prophylactic hysterectomy and bilateral ovarian salpingectomy may be considered for women who have a genetic mutation and do not have the need to have children.
Top 10 high-incidence cancer screening strategies
Source | Yangcheng Evening News Comprehensive China News Network, The First Affiliated Hospital of Ningbo University, Li Huili Hospital of Ningbo Medical Center, CCTV News
Editor: Nie Yue
Source: Yangcheng Evening News WeChat public account