Whether cancer strikes young or old – genetic testing provides more treatment options
Welcome back for another myStrand issue on all things cancer and genetics from an Indian perspective. As some of the regular readers know, awareness of hereditary cancer risk is very close to our heart. Hence, this month we wanted to share another patient story with you that highlights just that point: A young woman aware that something is amiss, but oblivious to the benefits genetic testing could have had for her and her family had she followed her mother’s advice. And in our second article, we pay tribute to one of the finest actors of Bollywood, Vinod Khanna, who sadly lost his battle to a lesser known cancer, bladder cancer, last month. By sharing some important facts about this cancer, we hope we can spread a little more awareness about who is affected, what causes it, and how genetics has opened up treatment options over the years. And last but not least, we encourage you to take a look at the featured News articles. It was World Thalassemia Day on 8 May, and many a newspaper used the occasion to highlight the latest advancements in treating and preventing this rare disease, which, unfortunately, is very common in India.
Please write to us with any questions or suggestions for topics that you would like to see covered in myStrand. You can reach us at firstname.lastname@example.org or through any of the communication channels of our #StayAheadOfCancer campaign.
The myStrand team!
When cancer strikes early
Jaya (not her real name) was just 21 years old when her mother asked her to get tested for the BRCA1 and BRCA2 genes. “Why Maa? I’m only young, why should I worry about getting cancer at this age?” she thought, “I can always do it later.” Years went by and the thought of getting a genetic test for her inherited cancer risk done all but vanished from her mind. Her mother had successfully fought ovarian cancer at the age of 45; she was a survivor. Surely, hers wasn’t one of the 10% of breast and ovarian cancer cases that run in the family.
Why more and more young women get breast cancer
Her 30th birthday came and went, all was fine. However, that year, fate decided to raise its ugly head and Jaya was diagnosed with breast cancer. “Breast cancer, at the age of 30? Isn’t that too young!”, I hear you ask. Well, it used to be. Nowadays, doctors across the globe, but especially so in India (as we have seen to date in Strand’s diagnostics laboratory), have started seeing cases of breast and ovarian cancer in much younger patients. There are many factors contributing to the earlier appearance of cancer, like the age a girl has her first period and by what time she has given birth to her first child. Crucially, one warning sign that all women should heed is a genetic predisposition to cancer through an inherited gene mutation in one of the genes known to cause cancer, like the BRCA genes. These inherited gene mutations run in families and usually present themselves through a patchwork pattern of the same or even different types of cancer in different family members.
It is all in the family
Jaya was asked to meet Strand’s genetic counsellor to understand the history of major diseases in her family tree. As it turns out, it wasn’t just her mother that had suffered from cancer at a very young age: Jaya’s grandmother had suffered from breast cancer at the age of 35 years and was, unfortunately, lost to the disease. Jaya’s father’s sister had had colon cancer. Her mother’s sister had first been diagnosed with breast cancer at the age of 36 years and subsequently developed cancer in the other breast when she was 56 years. Her mother’s brother had been diagnosed with lung cancer at the age of 60 years. This extensive family history of predominantly breast and ovarian cancer (remember her mother was diagnosed with ovarian cancer at the age of 45) and other cancers prompted the genetic counsellor to recommend genetic testing for Jaya to ascertain if a hereditary gene mutation was to blame.
What genetic testing can do
Sure enough, genetic testing unearthed a mutation in her BRCA1 gene that was already known to the international medical community and had wreaked havoc on other families, too. This result has brought certainty to the whole family as to why it had been hit so hard by cancer. Going forward, this information will allow Jaya’s children to manage their health better once they are old enough to get tested for the same mutation. Another positive outcome from this test result is the fact, that Jaya’s cancer could be treated with a targeted medicine, approved for carriers of a BRCA mutation, which has spared her the undue suffering usually associated with chemotherapy and enabled her to lead a comparatively normal life while being treated for her cancer.
The ‘What if’ scenario
However, what if she had followed her mother’s advice and discovered that she was a BRCA1 mutation carrier when she was 21 years old? Would her life have taken a different course? Ever since the discovery of the fact that cancer risk can be inherited, the medical community has been looking for the best ways to prevent cancer or at least discover cancer early. Regular mammograms and MRI screening are a must for women known to have an increased hereditary risk. Knowing that the increased risk is real also gives women the opportunity to plan to have a family and then take the additional precautions, including risk-reducing surgery to remove breast tissue and ovaries. While many women fear such a drastic step, thanks to reconstructive surgery and hormone replacement therapy, it no longer has to have the emotional and aesthetic impact it would have had in previous decades.
And the moral of this story?
Being aware of your own health and that of your extended family members can alert you to your own risk of getting a certain disease like cancer. Today’s advances in medicine and genetic diagnostics can give you a head start in detecting cancer early or prevent it from developing in the first place. So don’t hesitate! If in doubt consult a doctor or speak to a genetic counsellor to learn more about your personal cancer risk – for your own peace of mind.
Disclaimer: The information provided in this article is in no way intended to replace expert medical advice. Always discuss the best possible course of action for your situation with your doctor.
What is inheritance (heredity) of genetic characteristics?
Every egg and sperm cell has one copy of a person’s genes – half of the total set other body cells have. When egg and sperm meet, the two copies combine together to produce a new set of genes in a new child. Therefore, the chance of a child inheriting a bad copy of a gene from one of his or her parents is 50%. However, nature doesn’t always make perfect copies and instead mixes and matches the sets of genes present in an egg or sperm cell. This is why siblings are similar but NOT identical. Siblings have a lot of genes in common with each other. Yet, some genes are different in each sibling, making each of them unique individuals.
8 Facts about Bladder Cancer
We have recently lost one of the finest actors from Hindi films, Mr. Vinod Khanna, to bladder cancer. The actor, who turned 70 last October, had been fighting advanced bladder cancer since Jan 2017. The word cancer evokes some well-known cancers like blood cancer (leukemia), brain tumor and gruesome pictures of oral and throat cancers that are published on cigarette packs. But bladder cancer? How many of us have heard about this type of cancer before? The question led to some research on our part and here we report a list of some facts about bladder cancer, we all should know:
- Bladder cancer is the fourth prominent cancer in men and eighth most common cancer amongst women, in the Western world. In India, bladder cancer has been noticed in patients ranging from 18-90 years, predominantly in men. In fact, the male-to-female ratio for bladder cancer in India is 8.6:1, especially in some regions of the country where a high incidence of this cancer has been noted (Yuvaraja et al. 2016).
- About 48% of bladder cancer cases are caused by cigarette smoking. Tobacco-related cancers are expected to account for 31% of all cancer deaths by 2021, as per some estimates based on the number of cases recorded in some cancer registries in India (Dsouza 2013).
- Records from the Delhi cancer registry show that in 2003, bladder cancer was the 6th most common cancer recorded.
- In Indian studies, the most common symptom of bladder cancer is blood being passed in the urine, passed out without any pain or discomfort. Passing blood in the urine can be a symptom of several other health issues as well. Therefore, a diagnosis of bladder cancer needs other medical investigations as well.
- Smoking cigarettes, beedis, hookahs and exposure to industrial chemicals from the paints, leather, and textiles industries are the most common causes of bladder cancer. Extracts from a herb called Aristolochia fangchi, used in Chinese medicine, may also cause bladder cancer.
- In patients diagnosed with bladder cancer, more than 70% will experience the recurrence of cancer.
- A total of 32 genes involved in the development of bladder cancer have been identified. Mutations in these genes have been shown to be associated with bladder cancer.
- The progression of bladder cancer can be tracked using liquid biopsy tests. In a nutshell, normal as well as cancer cells shed their DNA into body fluids like blood and urine. There are now techniques available to collect this DNA and identify genetic changes that are associated with cancer, from this DNA. This technique is known as Liquid Biopsy. At Strand, we have developed this technique to understand the status of patients suffering from several cancers, including bladder cancer.
Bladder cancer is treatable in its early stages. Lifestyle changes like quitting smoking can also reduce your risk of suffering from bladder cancer. For more information on cancers and their genetic causes, read our previous issues or head over to our blog. Or follow the StayAheadOfCancer campaign on Facebook.
For more information about Strand Life Sciences and our tests, call 1-800-1022-695 (toll-free in India) or write to us at email@example.com.
StayAheadofCancer – Inheritance
Do you look like your mother? Or do older relatives tell you that you dance just like your father? These are all things we inherit from our family. But unfortunately, there’s also a 50% chance that you inherit an increased risk of certain cancers, including breast cancer, if it runs in your family. A genetic counsellor can help you figure out whether you and other family members are at risk. Write to us at firstname.lastname@example.org or call us toll-free in India at 1-800-102-2695 for an appointment with one of our genetic counsellors. Watch now!