Wednesday, April 10

Can cancer be inherited?


Not only light eyes, full lips and the right size for fashion are inherited. Children also take from their parents the risk of suffering diseases, including – of course! – cancer, or rather the more than 200 different ailments that are known by that name. Science has classified some 200 genes that, if mutated, predispose to one or more cancers. Most, luckily, are rare, but it is advisable to keep an eye on them.

Most tumors, almost 80%, are the price of life, explains specialist Ana Beatriz Sánchez Heras, coordinator of the Familial and Hereditary Cancer Section of the Spanish Society of Medical Oncology (SEOM). It is what it means to live more years than those granted by human evolution, to have toxic habits, such as smoking and consuming alcoholic beverages, or being exposed to poisoned environments. Another 15% or 20% of cases respond to what specialists call family aggregation. It is not very well known why, in certain families some cancers proliferate. And then, beyond this curiosity, there are between 5% and 10% of the cases that come as standard. Not only is the risk of suffering them inherited, but they are tumors that frequently arrive in a row, appearing in the same person one after another.

With relatives, we not only share the same genetic code printed in our DNA, the same instruction manual of the cellular machinery. The members of a clan participate, according to Sánchez Heras, of the same customs, habits, type of diet and, by necessity, are exposed to the same types of carcinogens. Yesterday World Colon Cancer Day was celebrated and the SEOM specialist reviews for this newspaper the risk of inheriting the most lethal or common cancers.

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Lung

Very few cases of lung cancer are due to a genetic predisposition, barely 1% or 2%. Although there is, the most important risk factor and the main cause of this type of tumor is smoking. Including passive smokers.

colon and rectum

The hereditary factor is present in 5% of diagnoses. Obesity and smoking favor its appearance in Lynch syndrome. Participating in early detection programs is as good an idea to protect yourself as it is to lead a healthy life, with a healthy diet and regular physical activity.

Pancreas

10% is linked to genes. Increase the probability of developing it the consumption of alcohol, tobacco, obesity and chronic pancreatitis. The more relatives who have suffered from it, the greater the risk. Early diagnosis is very complicated in these tumors, although magnetic resonance imaging is increasingly used to identify them in time.

Mom

The possibility of inheriting the risk is between 5% and 10%. The removal of the breasts or ovaries in women with mutations in the BRCA1 and BCRA2 genes that predispose to these tumors can be a good preventive measure, which should be consulted.

Prostate

One of the tumors with the greatest genetic predisposition, between 7.5% and 19% of cases. It is the most frequent among the Spanish, not the deadliest. Early diagnosis is made by detecting an antigen called PSA in the blood and by digital rectal examination. From the age of 40 in the population at risk and recommended from the age of 50 in general.

Bladder

Very few cases are due to genetic predisposition, and those that do occur are related to Lynch syndrome. It is more linked to chemical factors, such as exposure to dyes and paints, and tobacco use.

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Leukemia

The genetic bases of leukemias are still poorly understood and rare. Most are related to exposure to chemicals, including tobacco, and viruses. Some syndromes, such as Li-Fraumeni or Fanconi Anemia, also favor them.

Stomach

5% of cases are related to genetic predisposition. Family aggregation occurs in one in ten. Helicobacter pylori infection and tobacco use are the main risk factors.

Kidney

Genetic predisposition is present in between 2% and 5% of patients. When this occurs, renal tumors manifest with cutaneous, ophthalmologic, or neurologic lesions, often in young people. In the general population, they are associated with smoking, arterial hypertension, obesity and advanced age.

Uterus and corpus uteri

5% of endometrial cancer diagnoses are directly related to the genetic load of the patient. Certain syndromes (Lynch, Cowden and Peutz-Jeghers) favor it. As primary prevention, a hysterectomy may be chosen. A gynecological examination with ultrasound and the taking of an endometrial aspirate sample can be used to make an early diagnosis.

How to avoid it

  • Primary prevention:
    Surgeries: removal of the breasts and ovaries in tumors associated with the BRCA1 and BRCA2 genes; of benign lesions (polyps) in the colon; total or partial removal of severely damaged colon and thyroid gland. The treatments are not without side effects. For the prevention of breast cancer, antiestrogens; anti-inflammatories against colon cancer; and aspirin against colon and Lynch syndrome.

  • Secondary prevention:
    The tests help in the early diagnosis of breast cancer (magnetic resonance imaging and regular mammograms), colon cancer (regular colonoscopies) and paragangliomas –rare tumors of the nerve pathways of the head and neck– (magnetic resonance imaging).

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