In my career as a doctor, I have encountered many patients and their families with helplessness and fear in the face of cancer. Cancer, the disease label of this era, has always felt ubiquitous, yet it seems out of reach. But what would you think if I told you that there are cancers that can't be avoided because they are hidden deep in our genes?
Once, I saw a middle-aged woman, whom we called Ms. Li. When Ms. Li came to see me, her face was full of worry. Her mother and sister both died early from breast cancer, which made her feel like she was racing against time every day. She came to me in the hope of finding a glimmer of life through genetic counseling and testing. We conducted a detailed family history and genetic testing and found that she carries a BRCA1 gene mutation, which increases her risk of breast cancer.
Ms. Lee's story is not unusual. In my practice, I have come across many similar cases whose stories reinforce the idea that cancer does have a hereditary aspect. But at the same time, Ms. Li's case also gives us hope. Through early diagnosis and intervention, we can develop more personalized prevention and treatment strategies, plan ahead of time, reduce the risk of disease or delay the progression of the disease.
Cancer and genes
Standing in the consultation room, looking at the patients and family members who come to consult, I am often asked the question, "Doctor, is cancer predestined?" and I always answer, "Not exactly, but genes do play a role that cannot be ignored." Here, let's talk about the relationship between cancer and genes, and unravel some mysteries that you may misunderstand.
How is cancer linked to genes?
First of all, know that everyone's body is made up of countless cells, and the core of each cell is its DNA – our genetic blueprint. Genes are a small piece of code on this blueprint that governs everything from the color of our eyes to how our bodies function.
From time to time, these codes will be bugged, aka mutated. Most mutations are harmless, but some can cause cells to grow uncontrollably and form tumors, which is where cancer originated. And when this mutation-prone gene can be passed from parents to children, cancer becomes a "genetic disease."
Genetic mutations: Typos in nature
Imagine you're typing and your finger accidentally slips and you make a mistake. Most of the time, it's not a big deal, it might just be a little joke. But if you're writing an important quote for a customer, a small mistake can make a big difference. Similarly, in our genes, these "typos" – genetic mutations, which may not have much impact most of the time, can lead to cancer if they occur in certain key genes.
Not all cancers are hereditary
It is important to note that not all cancers are genetic. In fact, hereditary cancers account for only a small percentage of all cancer cases. Most cancers are the result of a combination of our lifestyle, environmental factors, and random genetic mutations. That said, even if there is no history of cancer in the family, unhealthy lifestyle habits may increase the risk of cancer.
So what can genetic testing tell us?
In recent years, genetic testing has become more popular, and it can help us understand whether an individual carries certain genetic variants that increase the risk of cancer. For those who have a family history of cancer, this is a great way to find out if they are at high risk. But remember, just because you're high doesn't mean you're going to get it. Lifestyle changes and regular check-ups can greatly reduce the risk.
Introduction to highly hereditary cancer types
In the medical world, we often have questions like, "Doctor, if someone in my parents has cancer, will I get it too?" It's not a simple yes or no question, but there are some types of cancer that do have a higher genetic risk. Let's take a closer look at several highly hereditary cancers that may help you detect and take action sooner.
1. Breast cancer
Breast cancer is one of the most well-known hereditary cancers. In particular, when there are BRCA1 and BRCA2 gene mutations in the family, the risk of breast cancer increases substantially. If you have a family history of this, genetic testing can help assess the risk. Remember, early detection and early treatment are the keys to beating breast cancer.
2. Colorectal cancer
Another closely linked to familial genetics is colorectal cancer, specifically familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (Lynch syndrome). These two genetic disorders increase the risk of patients developing colorectal cancer. If someone in your family has one of these conditions, or has a case of colorectal cancer in an early life, it's important to have regular colorectoscopy.
3. Skin cancer
Melanoma is a serious form of skin cancer, and it is more common in some families. If someone in your family has melanoma, then your risk is also increased. Avoiding excessive sun exposure and regular skin exams are essential for prevention.
4. Prostate cancer
Although most prostate cancers are age-related, family history is also an important risk factor. If you have an immediate family member, such as a father or brother, who has prostate cancer, your risk increases. Knowing your family history and having a PSA blood test can help with early detection.
Diagnosis and prevention of hereditary cancers
In my career as a doctor, I have encountered many cases of familial cancer, which has made me deeply understand that when the shadow of cancer quietly extends to the family, genetic counseling and genetic testing become a ray of hope for them in the face of uncertainty. Therefore, for those who have a family history of cancer, it is especially important to know how to diagnose and prevent hereditary cancers.
The importance of genetic counseling
First and foremost, genetic counseling is the first step in preventing familial cancer. If someone in your family has cancer, especially if it's a parent, sibling, or child, it's important to seek genetic counseling. During the consultation, a genetic counselor will evaluate your family medical history to help you understand the genetic risk of cancer and decide whether to undergo genetic testing.
The role of genetic testing
Genetic testing can provide important information about an individual's risk of cancer. By detecting specific genetic variants, such as the BRCA1 and BRCA2 genes for breast cancer, we are able to identify high-risk groups. This information is important not only for individuals, but also for the health management of family members.
Introduction to preventive measures
Once you know your genetic risk, it's important to take proper precautions. This includes lifestyle modifications and regular check-ups.
Lifestyle modifications: Maintaining healthy lifestyle habits is key to cancer prevention. Eating a balanced diet, exercising regularly, quitting smoking, limiting alcohol, and controlling weight can all help reduce the risk of cancer.
Regular check-ups: Regular cancer screenings are more important than the general population for those who carry cancer-related gene mutations. This may include mammograms, coloroscopy, etc., depending on the individual's genetic risk and family medical history.