Two days ago, Xiao Ai received a message from a fan in the background: “My grandmother and mother have breast cancer, I know Angelina Jolie, her family is a breast cancer family, in order to prevent cancer, She had a bilateral mastectomy. Will I, like Julie, go for surgery early?”
In recent years, the trend of “familial cancer” has grown significantly. In many families, if one member of the family has cancer, the probability of other members of the family will also increase. In our lifetime, everyone has a certain probability of developing cancer, but some people have a relatively higher probability of being “born”, mainly because they “inherit” their parents’ cancer genes in the mother’s womb.
1. Some people are “born” more likely to get cancer
JAMA , published the world’s number one “Mayo Medical Center” paper, the team conducted genetic testing on 2,984 diagnosed cancer patients, and found that more than one-eighth of the patients had cancer-related gene mutations.
In 2006, some foreign media reported that in an American family, 11 people lost their lives due to the same cancer or suspected of the same cancer in 46 years. After genetic testing, it was found that 11 of the remaining family members also carried the mutated gene of this familial hereditary gastric cancer.
Luo Rongcheng, Director of Cancer Center of Southern Medical University also said that cancer is essentially a genetic disease. Cancer cells play an important physiological role in normal cells before “blackening”, but after exposure to certain conditions, such as viral infection, chemical carcinogenesis, radiation, etc., they are abnormally activated, which will induce cells to become cancerous.
Two and four types of cancer have genetic risks, high-risk groups should be vigilant
The etiology of many cancers is still unsolved, but it has been proven that There are more than 30 types of cancer with obvious genetic predisposition. Among them, the following 4 are more common:
1. Gastric cancer
Maybe many people think that gastric cancer is related to irregular diet and life. On the other hand, 5%-10% of gastric cancers belong to hereditary gastric cancers, among which diffuse gastric cancer accounts for the largest proportion. If one or two people in the family have the disease, and one of them is younger than 50 years old, they are all diffuse type and can be considered as hereditary gastric cancer.
2. Colorectal cancer
About 50% of patients gradually deteriorate into colorectal cancer due to the lack of timely intervention of intestinal polyps. Among them, 20%-30% of patients have a family history of various types of cancer, especially familial adenomatous polyposis. If not diagnosed early, it is likely to develop hundreds of polyps, and the mortality rate is relatively high. high.
3. Breast cancer, ovarian cancer
In hereditary breast and ovarian cancer, about 40%-50% are affected by BRCA1 /BRCA2 gene. It has been reported in the literature that people who carry BRCA1 gene mutations have a 50%-85% risk of breast cancer, and the risk of ovarian cancer is about 15%-45%; people who carry BRCA2 gene mutations have the same risk of breast cancer. 50% to 85%, and the risk of ovarian cancer is 10% to 20%.
3. How to reduce the risk of high-risk groups?
You are “inherently” at a higher risk of cancer than others, but it doesn’t mean that this group of people will get cancer. As long as it is properly controlled, the risk of cancer can be reduced, even lower than that of ordinary people. So what risk reduction measures should high-risk groups take?
1. Carry out cancer risk assessment
Families with a family history of cancer can go to the hospital for genetic counseling, combined with relevant genetic and molecular testing methods , such as genetic testing, can effectively identify whether there are potential risks, so as to formulate preventive plans.
Taking breast cancer as an example, risk assessment is recommended for four groups of people:
①Family members with known pathogenic mutations in BRCA1/2 gene;
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②At least 2 close relatives with breast cancer and/or ovarian epithelial cancer, fallopian tube cancer, primary peritoneal cancer at any age; the patient has a history of ovarian epithelial cancer/fallopian tube cancer/primary peritoneal cancer history.
③ Patients with early-onset breast cancer (age of onset ≤ 45 years old);
④ Patients with breast cancer, age of onset ≤ 50 years old, and any of the following conditions: the patient has at least two Primary breast cancer lesions; at least one close relative with breast cancer, age of onset ≤ 50 years old; at least one close relative with ovarian epithelial cancer/fallopian tube cancer/primary peritoneal cancer (any age).
If high risk is assessed, surgical prophylaxis may be considered. Professor Gong Chang, Department of Breast Surgery, Sun Yat-sen Hospital, Sun Yat-sen University reminded that surgical prevention should also be used as a reference. Preventive bilateral mastectomy can reduce the risk of breast cancer by about 90%; preventive removal of fallopian tubes and ovaries, It can also reduce the risk of ovarian cancer by 80%-90%.
2. Strengthening risk factor management
In addition to medically-guided intervention, lifestyle changes to avoid External environmental factors are also critical, such as high-fat diet, staying up late, smoking, drinking, etc., all of which are high risk of cancer and should be avoided as much as possible.
3. Regular screening
For high-risk groups of familial cancer, regular screening can detect physical abnormalities in time and avoid misdiagnosis and misdiagnosis. Missed the best time for treatment.
Gastric cancer: The screening of gastric cancer is mainly gastroscopy. If suspicious, biopsy can be taken for pathological examination.
Intestinal cancer: The most effective method is colonoscopy, and even during the examination, new polyps can be removed directly under the microscope.
Breast cancer: Compared with CT, it has the disadvantage of low sensitivity. Early screening of breast cancer is recommended to judge by mammography.
Ovarian Cancer: For ovarian screening, via ultrasound or serum tumor markers to judge.
Genes cannot be changed, this article is not for self-pity, but to remind people who are prone to disease, take precautions, eat properly, improve immunity, and Cancer is controlled before lesions. Doing this, cancer cells naturally dare not “make trouble”.
References:
[1] “Speak the truth! Some people are “born” more prone to cancer than others, and 1/8 of cancer is given by parents, especially these 8…”. Popular Science China. 2022-03-04
[2] “【Health 】Can cancer be inherited? To be honest with you: these 4 types need special attention! “. People’s Daily. 2019-03-09