Lynch syndrome could link family’s cancers

Ask Dr. Keith Roach M.D

DEAR DR. ROACH: On my mother’s side of the family, all four sisters out of seven children were diagnosed with cancer and have died from the disease. Their ages at the time they passed ranged between 60 and 70, and the type of cancer was different for each of them (lung, gallbladder, uterus and stomach). The men in the family do not seem to be affected even though all were raised in the same household with the same parents. Clearly the vulnerability lies with the women. Is there any genetic test or other proactive step that female (or male?) children can take to detect predisposition to cancer? My family doctor tells me that since the cancer was different for each, the best advice is to stay current with normal screenings, such as mammograms and Pap smears. Is there anything else you would recommend? Does this maternal family history typically reoccur with each new generation? — O.N. ANSWER: There are many cancers that run in families, but fewer syndromes that increase the risk for multiple cancers. One to be concerned with in your family’s situation is Lynch syndrome, also called hereditary nonpolyposis colorectal cancer. People with Lynch syndrome may get cancers of the stomach and gallbladder as your family members have, in addition to the colon cancer, which is common. Less common are cancer of the small intestine, urinary tract, brain and skin. Women are at risk for ovarian cancer as well as uterine cancer. Not everyone with Lynch syndrome will develop these types of cancer, nor necessarily cancer at all. It is often unrecognized. I am not at all sure your family is affected by this syndrome caused by specific genetic mutations; the lung cancer does not fit the pattern. However, given your family history, I would ask your doctor about referral to a licensed genetic counselor with experience in this condition. I’m not as sure as you are that the vulnerability lies only with the women. It’s possible it was just chance that the men were not affected. *** Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.