Cancer is a multifaceted disease that plagues communities globally, and its hereditary aspects add an additional layer of complexity. When cancer runs in a family, it sheds light on the potential genetic predisposition for it, highlighting an inherited cancer risk distinctly higher than the general population1.
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The Intriguing Link between Cancer and Genetics
Within a family carrying such genetic risks, each member faces a 5 to 10 times higher chance of developing cancer compared to the average individual1. Dr. Pooja Babbar, Consultant – Medical Oncology, explains that many genetic or hereditary family syndromes increase an individual’s likelihood of developing cancer1.
Dr. Bhuvan Chugh, Senior Consultant – Medical Oncology, elucidates each gene in our body having two functional copies. For a cellular pathway to become defective, both these gene copies need to corrupt (known as Knudson’s two-hit hypothesis). Inheriting a defective gene copy necessitates only a single additional corrupted copy for the pathway to malfunction, contrary to two ‘hits’ required for a non-inherited case1.
In other words, individuals with a family history of cancer inherit this “first hit,” which makes them more prone to the “second hit” leading to cancer2.
Recognizing the Risk within First Relatives
In scenarios with familial cancer diversity, the risk is especially higher in first-degree relatives, such as parents, siblings, and children1. Such families should be more vigilant and consider undergoing genetic counselling. These professionals can conduct genotyping and gene analysis to identify potential inherited risks within the family1.
Pointers for Risk Assessment
When addressing familial cancer, consider three factors: the age of the diagnosed family member, the number of family members with cancer, and the type of cancer1. Earlier onset compared to the common age group, multiple cases within the family, or presence of certain cancer types (like breast, ovarian, or colorectal cancers) can all hint at a potential hereditary cancer syndrome3.
Genetic Testing: A Helpful Tool
Genetic testing plays a pivotal role in understanding an inherited risk, especially when introduced to a family with a history of cancer1. The best candidate for initial testing would be a family member already diagnosed with cancer, as they have the highest chance of carrying a gene mutation. If the test reveals positive results, then other family members should be tested for the same gene1.
Not All Cancers Are Inherited
While genetic predispositions increase the risk of certain cancers, not all mutations are hereditary1. Hereditary mutations related to malignancies such as breast, ovarian, pancreatic, and prostate cancers are common instances of inherited risk1. Genes like BRCA play a crucial role in DNA repair processes, and defects in these genes could lead to accumulated DNA errors, potentially triggering the onset of cancer1.
To conclude, coping with an inherited risk of cancer can be emotionally overwhelming and medically challenging. It is essential to identify and understand these risks, avail appropriate genetic counselling and testing, and pursue preventive and early detection measures accordingly.
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