Adventist Health - Staying ahead of hereditary colorectal cancer

Around 10 percent of colon cancers are caused by an inherited genetic mutation, or harmful change. Lynch syndrome is one of the most common types of these mutations, and research shows that the syndrome can increase risk of colon cancer to 82 percent and the risk of uterine cancer up to 60 percent over an individual’s lifetime.

Candace Westgate, DO, answers questions about Lynch syndrome and how genetic screening can help empower your cancer prevention. Dr. Westgate has certification in women’s genomics counseling form the American College of Obstetrics and Gynecology and completed a medical genetics fellowship at the City of Hope Hospital. She is the medical director of the Adventist Health Early All-Around Detection (AHEAD) Program and works closely with her patients at Adventist Health St. Helena to manage cancer risk.

What is Lynch syndrome?

Lynch syndrome is a type of inherited cancer syndrome associated with a genetic predisposition to different cancer types. This means people with Lynch syndrome have a higher risk of certain types of cancer. Families with Lynch syndrome usually have several members who have developed cancer, sometimes occurring at unusually young ages (many times before the age of 50).

What cancers are associated with Lynch syndrome?

Lynch syndrome is the most common form of hereditary colorectal and uterine cancer and accounts for about 9-10 percent of cases of these cancers.Other cancers that can be seen in families with Lynch syndrome include: ovarian, urinary tract (bladder, kidney, ureter), stomach, small intestinal, pancreatic and biliary tract cancers.

“Muir-Torre” is another name for Lynch syndrome in which people develop uncommon skin lesions or tumors. Having Lynch syndrome does not guarantee that someone will get any of these cancers, but does increase one's risk of cancer significantly.

How does Lynch syndrome increase the risk of colon cancer?

Individuals with Lynch syndrome inherit an alteration in one of five genes. Most of these genes are involved in a process called mismatch repair—they act like spellcheckers to find and correct the "typos" made in the DNA replication process. Mutations in any one of these genes can lead to the accumulation of more and more of these mistakes and can thus predispose a person to cancer.

Does Lynch syndrome have any symptoms?

Lynch syndrome itself does not have any symptoms, but the cancers associated with it may produce symptoms. For example, symptoms of colorectal cancer may include a change in bowel habits, abdominal pain or rectal bleeding, whereas symptoms of uterine cancer may include abdominal pain and bloating, intermenstrual bleeding or post-menopausal bleeding.

Regular checkups with your physician will help you to stay up-do-date on recommended cancer screenings and will give you an opportunity to discuss any abnormal symptoms you may be experiencing.

When should you get tested for Lynch syndrome?

Family history is an important key to understanding your risk of colon and other cancers in the future. There are many societal guidelines that list criteria used to help doctors decide who should undergo genetic testing to better understand an individual’s risk of developing cancer. That’s why preventing cancer starts with knowing your family history and discussing it with a medical professional who is knowledgeable about hereditary cancer syndromes and cancer prevention. That’s what I do through the Adventist Health Early All-Around Detection (AHEAD) Program.

If you do meet the guidelines for hereditary cancer syndrome testing, which is as simple as a cheek swab or blood test, your results can be very powerful for you and your family. With this knowledge, physicians like me can offer revised management, increased screening and earlier screening, lifestyle modification recommendations and even risk-reducing surgeries, all with the goal of catching the cancer at a very early treatable stage or preventing it all together.