From peer pressure to peer support

Easing the burden of hereditary colorectal cancer

colorectal cancer

Members of the Myers family share a hereditary high risk for colorectal cancer.

Learning to fit in and conform with other children is a rite of passage for most of us, but when someone is living with a genetic disorder and the life-long threat of cancer, those formative years can be fairly tough. Just ask Kevin Myers. He has an inherited genetic disorder that results in a very high risk for colorectal cancer. It is called familial adenomatous polyposis, or FAP.

“I was seven or eight years old when I became aware that my dad’s mom and brother had died from this cancer, and my dad was frequently having pre-cancerous polyps scraped out of his Continue reading

Trained to screen patients for colon cancer, nurse finds a genetic link to this disease in her own family

Lynch syndrome

The Sylvest family tree includes Lynch syndrome, a genetic disorder that can cause cancer.

Lisa Sylvest is a cancer survivor who never met her father Karl’s parents. They lived in Denmark with their other son and daughter. Growing up, Lisa simply knew that her grandmother died at age 54 of a ‘female’ cancer. When Lisa was in high school, Karl’s brother died of brain cancer, also at age 54. Time passed, Lisa entered nursing school and her father’s sister developed endometrial cancer. Lisa traveled to Denmark to meet her relatives face-to-face for the first time.

When her father was diagnosed with advanced colon cancer at age 68, Lisa was a U-M Health System nurse working in gastroenterology, which deals with stomach and intestinal disorders. Her Continue reading

Are your genetics putting you at risk for colorectal cancer?

cancer geneticsColorectal cancer is the second leading cause of cancer-related deaths in the United States, trailing only lung cancer in the number of deaths each year. The American Cancer Society estimates 50,310 people will die from colorectal cancer in 2014 alone. Unlike lung cancer, however, there are ways to successfully screen for and prevent this common disease.

In conjunction with Colorectal Cancer Awareness Month, I have outlined some factors health care providers consider in assessing an individual’s risk for colorectal cancer and determining the best approaches for screening and prevention.

Screening = Prevention

Colon cancer screening has been very effective in reducing the number of colorectal cancer diagnoses and deaths in the United Continue reading

Cancer and Fertility

For young adults with cancer, facing decisions about treatments, including surgery, chemotherapy and radiation therapy can be overwhelming. Adding to that burden is the fact that the same treatments helping to extend survival may come with the trade-off of not being able to bear children in the future. This can occur for both men and women receiving cancer treatment.

For men, some treatments cause damage to the testes and/or interfere with sperm production. For women, some treatments can result in premature ovarian failure, early menopause, genetic damage to egg cells or difficulties maintaining a pregnancy. Not all cancer treatments will affect fertility and every person’s situation is different. Some of the factors include:

  • the type of cancer
  • which standard therapies are recommended
  • the location and stage of the cancer
  • the type and dose of chemotherapy
  • the dose and location of radiation therapy

Other factors depend on the person, such as fertility status before treatment, as well as age, since risk for infertility increases with age for both men and women.

Fertility issues can also arise for young patients who have not had a cancer diagnosis, but are at high risk based on a known hereditary cancer syndrome within the family, such as:

  • Hereditary Breast and Ovarian Cancer syndrome (related to BRCA1 and BRCA2 mutations)
  • Lynch syndrome (high risk for cancers of the reproductive organs)

Patients face options such as preventive removal of the ovaries and uterus before cancer develops.   Patients may also have the option of pre-implantation genetic diagnosis (PGD). PGD uses advanced reproductive technology and in-vitro fertilization to prevent passing a genetic risk factor on to future children.

For patients diagnosed with cancer, as well as patients considering preventive surgery, it is important to know there may be ways to preserve fertility. These options should be discussed with your doctors as early in your treatment planning as possible. The U-M Comprehensive Cancer Center Fertility Preservation Program is a resource for patients to learn more about these issues and options.

Continue learning about cancer and fertility preservation

Lynch Syndrome: The Genetic Side of Colorectal Cancer

Michigan Gov. Rick Snyder has designated March 22 Lynch Syndrome Awareness Day.

Her aunt died of colon cancer at age 72.  Her cousin died of colon cancer at age 49.  When her mother was diagnosed with colon cancer at age 70, three years after being treated for uterine cancer, Paula realized it was time to act.  She had her first colonoscopy at age 41.  While the colonoscopy was normal, her doctor recognized that the pattern of cancer in the family was concerning and suggested genetic counseling.  Genetic testing in Paula’s mother found a mutation in a gene called MSH6, confirming that their family has Lynch syndrome.

Lynch syndrome is an inherited condition caused by mutations in any one of 5 genes: MLH1, MSH2, MSH6, PMS2 and EPCAM/TACSTD1.  For people who have a mutation in one of these genes, the risk for certain cancers is increased.  Colorectal cancer is the main feature of Lynch syndrome. Other cancers that can be found in families with Lynch syndrome include:

  • uterine or endometrial
  • ovarian
  • stomach or small intestine
  • biliary tract
  • sebaceous skin tumors
  • urinary tract, such as kidney

Identifying families with Lynch syndrome allows us to intervene with screening and preventive options.  Colonoscopies every year beginning at age 20 can dramatically reduce the risk of colon cancer in people with Lynch syndrome. Continue reading