Description

Lynch syndrome is a condition that increases the risk of many types of cancer. This condition is passed down from parents to children.

Families that have Lynch syndrome have more cancer cases than expected. This could include colon cancer, endometrial cancer and other types of cancer. Lynch syndrome also causes cancer to occur at a younger age.

People with Lynch syndrome may need care tests to detect the cancer when it is small. The treatment is more likely to be successful when the cancer is detected early. Some people with Lynch syndrome could consider the possibility of treatments to prevent the cancer.

Lynch syndrome used to be called hereditary nonpolyposis colorectal cancer (HNPCC). HNPCC is a term used to describe families with a strong history of colon cancer. Lynch syndrome is the term that is used when the health professionals to find a gene that runs in the family and the cause of the cancer.

Symptoms

People with Lynch syndrome may experience:

  • The Colon cancer before 50 years of age
  • The cancer of the inner lining of the uterus (endometrial cancer) before age 50 years old
  • A personal history of more than one type of cancer
  • A family history of cancer before 50 years of age
  • A family history of other types of cancer caused by Lynch syndrome, including stomach cancer, ovarian cancer, pancreatic cancer, kidney cancer, bladder cancer, ureteral cancer, brain cancer, small bowel cancer, gallbladder cancer, bile duct cancer, and skin cancer

When to see a doctor

If a family member has Lynch syndrome, tell your health care professional. Ask your health professional for help to set up an appointment with a professional trained in genetics, such as a genetic counselor. This person can help you understand the Lynch syndrome, what is the cause and whether genetic testing is right for you.

Causes

Lynch syndrome is caused by genes that are passed from parents to children.

Genes are pieces of DNA. The DNA is like a set of instructions for every chemical process that occurs in the body.

As the cells grow and produce new cells as part of their life cycle, make copies of its DNA. Sometimes the copies of the errors. The body has a set of genes that keep the instructions to find the errors and correct them. Health professionals call these genes, mismatch repair genes.

People with Lynch syndrome have mismatch repair genes that do not function as expected. If an error occurs in the DNA, it is possible that is not arranged. This could cause the cells to grow out of control and become cancer cells.

Lynch syndrome runs in families in an autosomal dominant pattern of inheritance. This means that if one of the parents has the genes that cause Lynch syndrome, there is a 50% chance that each child will have the genes that cause Lynch syndrome. With which of the parents is a carrier of the gene does not affect the risk.

Risk factors

The risk of Lynch syndrome is greater in people who have a personal history or family history of cancers caused by this syndrome. Cancers are caused by Lynch syndrome include:

  • Biliary system types of cancer, including cancer of the gallbladder and bile duct cancer.
  • The brain cancer.
  • The digestive system of the types of cancer, including cancer of the stomach, small bowel cancer and colon cancer.
  • Female reproductive system cancers, including endometrial cancer and ovarian cancer.
  • Cancer of the pancreas.
  • The skin cancer.
  • Urinary system types of cancer, including kidney cancer, ureteral cancer, and bladder cancer.

Complications

Knowing that you have the Lynch syndrome can raise concerns about your health. You can also raise some concerns about other parts of your life. These may include:

  • Your privacy. You may have questions about what could happen if the others find out that you have Lynch syndrome. For example, you might be worried that your job or insurance companies can be found. A genetics professional can explain the laws that may protect you.
  • Their children. If you have Lynch syndrome, your children have a risk of inheriting it. A genetics professional can help you develop a plan to talk about this with their children. The plan could include how and when to tell them and when they should consider the evidence.
  • Their extended family. Have Lynch syndrome has implications for the whole family. Other blood relatives may have a chance of having Lynch syndrome. A genetics professional can help you come up with the best way to tell the members of the family.

Diagnosis

The diagnosis of Lynch syndrome could start with a review of the family history of cancer. Your healthcare provider will want to know if you or someone in your family has had colon cancer, endometrial cancer and other types of cancer. This can lead to other tests and procedures to diagnose Lynch syndrome.

The history of the family

Your healthcare provider may want you to consider the possibility of genetic testing for Lynch syndrome if the story of your family has one or more of the following:

  • Several family members with any Lynch-associated cancers, including cancer of the colon and cancer of the endometrium. Other types of cancer caused by Lynch syndrome are those that occur in the stomach, ovaries, pancreas, kidneys, bladder, ureters, brain, gallbladder, bile ducts, small intestine and skin.
  • One or more members of the family that had cancer before 50 years of age.
  • One or more members of the family who have had more than one type of cancer.
  • More than one generation of the family with the same type of cancer.

The evidence of the cancer cells

If you or someone in your family has had cancer, a sample of the cancer cells could be tested.

The tests in cancer cells include:

  • Immunohistochemistry (IHC) test. IHC testing uses special dyes to stain the tissue samples. The presence or absence of staining of the sample if the tissue has certain proteins. Lack of protein can help to determine if the genes associated with Lynch syndrome caused cancer.
  • Microsatellite instability (MSI) testing. Microsatellites are DNA fragments. In people with Lynch syndrome, there may be errors or instability in these parts.

Positive IHC or MSI results of the tests show that the cancer cells have genetic changes that are connected with the Lynch syndrome. But the results can not say with certainty if you have Lynch syndrome. Some people have these genetic changes only in their cancer cells. This means that the genetic changes were not hereditary.

People with Lynch syndrome have genes that cause Lynch syndrome in all the cells of their bodies. The genetic test is needed to see if all cells have these genes.

Genetic testing

Genetic testing looks for changes in the genes that cause Lynch syndrome. You can provide a sample of your blood for this test.

If a family member has Lynch syndrome, the test can't just look for the gene that runs in your family. If you are the first person in his family to be tested for Lynch syndrome, the test could examine many of the genes that can run in families. A genetics professional can help you decide which test is best for you.

Genetic testing may show:

  • A positive genetic test result.A positive result means that a genetic change that causes Lynch syndrome is found in our cells. This does not mean that you are going to have cancer. But this does not mean that the risk of certain types of cancer is higher than people who do not have Lynch syndrome. Your personal risk of cancer depends on the genes that run in your family. You can reduce your risk with tests to look for signs of cancer. Some treatments can help reduce the risk of certain types of cancer. A genetics professional can explain the individual risk to you based on your results.
  • A negative genetic test result. A negative result means that changes in the genes that cause Lynch syndrome is not found in the cells. This means that you probably do not have Lynch syndrome. But you could still have a greater risk of cancer. That's because people with a strong family history of cancer may have an increased risk of the disease.
  • A gene of the variation of unknown significance. Genetic testing does not always give you a yes or a no answer. Sometimes, the genetic testing is a gene that health professionals are not sure about. A genetics professional can tell you what this means to your health.

A positive genetic test result. A positive result means that a genetic change that causes Lynch syndrome is found in our cells. This does not mean that you are going to have cancer. But this does not mean that the risk of certain types of cancer is higher than people who do not have Lynch syndrome.

Your personal risk of cancer depends on the genes that run in your family. You can reduce your risk with tests to look for signs of cancer. Some treatments can help reduce the risk of certain types of cancer. A genetics professional can explain the individual risk to you based on your results.

Treatment

There is No cure for the Lynch syndrome. People with Lynch syndrome often have tests to look for early signs of cancer. If cancer is found when it is small, the treatment is more likely to be successful.

Sometimes the cancer can be prevented with the operations to remove some organs before they can develop cancer. Talk with your health care professional about your options.

Cancer screening for people with Lynch syndrome

Cancer screening tests are tests that look for signs of cancer in people who have no symptoms of cancer. That cancer screenings you need depends on your situation. Your health care professional believes that the Lynch syndrome genes they carry. Your healthcare provider will also consider what types of cancer in their family.

You may have tests to look for:

  • The Colon cancer. A colonoscopy is a procedure that uses a long, flexible tube to look inside your colon. This test can detect pre-cancerous growths, and areas of cancer. People with Lynch syndrome may begin colonoscopy screening every year or two to 20 or 30 years.
  • Cancer of the endometrium. Endometrial cancer is cancer that starts in the inner lining of the uterus. The lining is called the endometrium. To find this type of cancer, you could have the ultrasound images of the uterus. A sample of the endometrium may be removed. The sample is tested for signs of cancer. This procedure is called a biopsy of the endometrium.
  • The ovarian cancer. Your health care professional may suggest an ultrasound and blood tests to look for signs of cancer in the ovaries.
  • The stomach cancer and cancer of the small intestine. Your healthcare provider may suggest a procedure to look inside the esophagus, stomach and the small intestine. This procedure is called an endoscopy. It passes a long, thin tube with a camera on the end down her throat. You may also have a test to detect a bacterium that increases the risk of stomach cancer.
  • Urinary system cancer. Your health care professional may suggest testing a sample of urine for signs of cancers of the urinary system. This includes cancer of the kidneys, bladder, and ureters. The ureters are tubes that connect the kidneys to the bladder.
  • Cancer of the pancreas. Your health care professional may be able to suggest a diagnostic test to detect cancer of the pancreas. This is usually with a magnetic resonance imaging .
  • The brain cancer. Your health care professional may suggest a neurological exam. This examination includes tests of vision, hearing, balance, coordination, and reflexes. This test looks for signs of a brain cancer is pressing on the tissue of the brain or nerves.
  • The skin cancer. Your health care professional may be able to suggest an examination of the skin. This involves looking at your entire body for signs of skin cancer.

You may need other tests if your family has a history of other types of cancer. Ask your health care provider about which tests are best for you.

Aspirin for the prevention of cancer

Some research suggests that taking a daily aspirin can reduce the risk of cancer in people with Lynch syndrome. More research is needed to understand how much aspirin is necessary to get the most benefit. Discuss the potential benefits and risks of aspirin therapy with your health care professional. Together you can decide if this might be right for you.

Treatments to prevent cancers caused by Lynch syndrome

In certain situations, you might consider the possibility of surgery or treatments to prevent the cancer. Discuss the benefits and risks with your health care professional.

The treatments may be available for:

  • Endometrial cancer prevention. The surgery to remove the uterus is called hysterectomy. Prevents cancer of the endometrium. Another option may be a procedure for placing a contraceptive device in the womb. The device, called an intrauterine device (IUD), it emits a hormone that decreases the risk of endometrial cancer. It also prevents you from becoming pregnant.
  • Ovarian cancer prevention. The surgery to remove the ovaries is called an oophorectomy. Greatly reduces the risk of ovarian cancer. Another option may be oral contraceptive pills, also called birth control pills. Research suggests that taking oral contraceptive pills for at least five years reduces the risk of ovarian cancer.
  • Prevention of Colon cancer. The surgery to remove most or all of the colon is called a colectomy. Reduces the risk of colon cancer. This operation may be an option in certain situations. For example, it could be an option if you have had colon cancer. The removal of the colon that prevent you from getting colon cancer again.

Coping and support

Have Lynch syndrome can be stressful. Knowing that you have a higher risk of cancer may make you feel worried about your future. In time, you will find ways to cope with stress and worry. Until then, you might find it helpful to:

  • Find out everything you can about Lynch syndrome. Make a list of questions about the Lynch syndrome and to ask at your next appointment. Ask your health care team to other sources of information. Learn about the Lynch syndrome can help you to feel more confident when making decisions about your health.
  • Take care of yourself. Knowing that you have a higher risk of cancer may make you feel as if you can't control your health. Make healthy choices for the parts of your health that you can control. For example, choose a healthy diet. Exercise most days of the week. Maintain a healthy weight. Get enough sleep so that you wake up feeling rested. Go to all of your scheduled medical appointments, including cancer-screening tests.
  • Connect with others. Find friends and relatives with whom you can talk about your fears. Connect with other people with Lynch syndrome through advocacy groups. Examples include Lynch Syndrome International and Facing Our Risk of Cancer Empowered (FORCE). Find other people to your trust, you can talk with, such as the members of the clergy. Ask for a referral to a therapist who can help you understand your feelings.

Preparing for your appointment

If your healthcare provider thinks you might have Lynch syndrome, it may suggest that you meet with a genetics professional, such as a genetic counselor.

A genetics professional can help you decide if genetic testing could be useful to you. If you choose to have the test, they can help you understand your results.

What you can do

To prepare for his meeting with the genetics professional:

  • Gather your medical records. If you have had cancer, bring your medical records to your appointment.
  • Ask members of the family who have had cancer of the information. If the members of your family have had cancer, you ask for information about their diagnoses. Make a note of the types of cancer, types of treatments and age at diagnosis.
  • Consider the possibility of a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who comes with you may remember something that you missed or forgot.
  • Write questions to ask.

Questions to ask

Prepare a list of questions to ask. The questions may include:

  • What causes Lynch syndrome?
  • How is Lynch syndrome is passed down through families?
  • If I have a family with Lynch syndrome, what is the probability that I have it, too?
  • What types of tests are involved in the genetic testing?
  • What will be the results of genetic tests, tell me?
  • How long can I wait for my results?
  • If my genetic test result is positive, what is the probability that I have cancer?
  • What types of tests can detect Lynch-related cancer at an early stage?
  • If my genetic test result is negative, it means that I don't have cancer?
  • Are the results of the genetic test ever bad or not clear?
  • What will be my genetic test results mean for my family?
  • How much does genetic testing cost?
  • Does my insurance company to pay for genetic testing?
  • What laws protect me from discrimination, if my genetic test result is positive?
  • It is OK to decide against genetic testing?
  • If I choose not to have genetic testing, what does that mean for my health in the future?
  • Are there brochures or other printed material that I can take with me? What websites do you suggest?

In addition to the questions you have prepared, ask any other questions that you think of during your appointment.

What to expect

The genetics professional will likely ask questions about your health history and the health history of your family members. The questions may include:

  • Have you ever had cancer?
  • Have the members of your family had cancer?
  • How old was each member of the family with cancer diagnosed?
  • Have the members of the family never had genetic testing?
Symptoms and treatment of Lynch syndrome