Angelina Jolie’s confession that she had her breasts removed because of the high risk of developing breast cancer caused a real shock throughout the world. But her decision was completely justified – terrible diseases claimed the lives of many of her close people.
The topic of prevention and diagnosis of oncological diseases is relevant for all people in our time. But especially often she worries those whose loved ones have already faced this misfortune.
It is no secret that oncological diseases can be hereditary. And often the life of many grown-up children turns into a panic fear of waiting for alarming symptoms like “a father’s or a mother’s.”
Our expert Leonid Borisovich Ginzburg, Candidate of Medical Sciences, an oncologist surgeon of the highest category, told when there are serious reasons for anxiety and with the help of which studies it is possible to assess the risk of developing hereditary oncological diseases.
– True hereditary cancer, or, more correctly, genetically predisposed cancer accounts for only 4-7 percent of all cases of cancer. More than 90% of the remaining patients develop so-called sporadic cancers that are not directly related to genetics and the cause of the development of the tumor is other causes, which can be divided into three large groups. The first group is related to the way of life that we lead, how we work, how much time we rest, sleep, when we have children, get married or get married. For example, as one wise old professor said, “The best way to prevent breast cancer is to get married and have two children on time.” The second relates to the nature of the diet. For example, in China, the incidence of colon cancer is 10 times less than in Russia, due to a diet rich in fiber (cereals, wholemeal bread, seeds, vegetables, fruits, berries), and the relatively rare consumption of meat. The third is carcinogenic factors (nicotine, tar, dust, excessive exposure to the sun, chemical reagents, for example, washing powder, asbestos dust). These three groups mentioned above account for about 30 percent of all cases of cancer. So more often it all depends on us!
– Hereditary cancer, which, recall, makes up only 3-7% of cases of oncological diseases, can be suspected on the basis of the fact that close relatives have cancer in the family before the age of 45 or there were several different malignant tumors, for example, cancer of the colon, stomach , breast and ovaries. And also if the tumor affected two paired organs at once. That is, a tumor has developed simultaneously or with a difference of several years in both lungs or kidneys. Another important aspect that may indicate a high risk – in the family, relatives on the same line had several cases of cancer of the same organ; for example, my mother, grandmother and sister had breast cancer. Certain forms of cancer also indicate the likelihood of hereditary cancer in a given family. The detection of the so-called “triple negative cancer” of the breast, even in one woman, indicates the possibility of hereditary diseases.
– In any case, it is worth talking to your doctor about whether there is a risk that this cancer is hereditary and whether it is worth conducting a genetic study. In the presence of these factors, a genetic screening blood test can be recommended to determine the mutation. However, this study is inappropriate for everyone in a row due to the low probability of developing hereditary cancer and the rather high cost. The detection of a mutation does not always indicate a 20% probability of developing a malignant neoplasm, but its risk increases hundreds of times and ranges from 99 to XNUMX percent, depending on the type of detected gene mutations.
– The definition of a mutation in the BRSA gene, or the so-called Jolie gene, is especially popular and widespread at the present time when breast and ovarian cancer is suspected. Women in this case are recommended careful observation and even prophylactic subcutaneous mastectomy and oophorectomy (surgical removal of the mammary glands and ovaries). Determine the APC gene in colon cancer, CDH1 in stomach cancer. The more frequent occurrence of cancer in one family can be explained not only by hereditary factors, but also by the peculiarities of lifestyle, nutrition, or the action of carcinogenic factors in this family. For example, if mom and dad smoke and have lung cancer, their smokers are much more likely to develop lung cancer. And this is due to the general carcinogenic effect of tobacco tar, and not in any way with heredity.
– In a family where three times a day they eat fatty, fried meat, smoked meats, fast food and eat little vegetables and fruits, the risk of getting colon cancer is several times higher than where the hostess prepares vegetable salads, fish dishes daily, buys dairy products , fruits and berries. In a family where the mother did not have a personal life 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 also higher than in a family where a happy sex life and there are two or three children. This is also not due to heredity, but to the fact that the hormonal background of a woman giving birth and breastfeeding with a normal sex life is much more balanced and reduces the risk of tumor mutations and the presence of chronic diseases of the female genital area (for example, mastopathy), which are one of the factors risk of developing breast cancer. For the early diagnosis of cancer, it is recommended, first of all, to undergo a banal professional examination, which will help to find more than 80% of oncological diseases at an early stage. Annual fluorography, or better radiography of the lungs (more informative with less radiation exposure), ultrasound of the abdominal cavity, mammary glands, small pelvis, examination of a surgeon, gynecologist, dentist, determination of tumor markers in people over 45 years old, mammography, simple blood and urine tests, and if there are any complaints, an endoscopic examination of the colon and stomach will reveal 80 percent of all cancers at an early stage. When the risk of developing cancer is high, it is recommended that certain tests be performed more often. For example, for colorectal cancer in the family, and especially for hereditary colon cancer or polyposis, annual fibrocolonoscopy is recommended. For certain types of gastritis in patients over 45 years of age – annual fibrogastroscopy.
Our expert – Leonid Ginzburg
Currently, in Moscow, St. Petersburg and large cities of Russia, the most common definition of the following gene mutations:
– BRCA1 BRCA2 ATM CHEK2 and others if there is a suspicion of a high risk of breast and ovarian cancer;
– MLH1 MSH2 EPCAM if hereditary colorectal cancer or familial polyposis is suspected;
– CDKN2A for suspected familial or hereditary pancreatic cancer or melanoma.
Search for mutations in hereditary cancer of the thyroid and parathyroid glands in the RET, NTRK1, PRKAR1A, PTEN, CDC73, MEN1 genes.
I want to remind you once again that doctors do not recommend determining gene mutations to all patients whose relatives had tumors of these organs, but only if there are signs of hereditary cancer described above.
For the rest of the patients, it is better to spend money and time on regular and complete oncological examination.