Andrey Pavlenko is one of the best surgical oncologists in the country. Recently it became known that the doctor’s sick aggressive form of stomach cancer. The disease manifested itself only in the third stage. If faced with an aggressive form of cancer, the oncologist might even like patients to detect the disease at an early stage?
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Director of the Foundation for cancer prevention Ilya Fomintsev, a colleague of Andrei Pavlenko explained that Andrew is likely faced with one of the types of tumor syndromes: it is a disease in which a person inherits a specific mutation that significantly increases the risk of cancer at a young age. Will there screening? We made a cheat sheet for those who are afraid of cancer at a young age.
Usually everyone is afraid of cancer young. Nobody is surprised when the cancer occurs in humans in 90 years. Of course, the disease is a tragedy at any age, but young cancer is often aggressive, grows rapidly and this cancer is perceived in society as a tragedy. In such cases it often comes about tumor syndromes. The cause of these syndromes could significantly reduce the fear of cancer in society.
Screening breast ultrasound does not affect mortality from breast cancer. In addition, the ultrasound method is low sensitivity to this form of cancer and he shouldn’t be used for breast cancer screening.
However, ultrasound is quite useful during diagnosis of breast cancer, when there are suspicions or need differential diagnosis. In a situation when there are no complaints or symptoms or any suspicion for breast cancer – ultrasound inadequate method. In cases of genetic predisposition to breast cancer it is more efficient to do an MRI of the breast than a mammogram.
There is always the risk of becoming the first in the family who have a mutation in certain genes cause tumor syndrome. If you became one of such relatives as described above, it makes sense to consult with genetics and to advise their relatives to assess the risks to get sick. In addition, there are other cancer risk factors, what also should not be forgotten.
It makes no sense to conduct annual PAP test, do a full-body MRI, abdominal ultrasound and independently set their own tests and studies. Yes, there are aggressive forms of cancer that develop quickly. Often while we are talking about tumor syndromes, but, even in the high risk group, you should coordinate all diagnostic events with a well-educated doctor. The fact that the aggressive forms of cancer is much worse treatable and benefit from this screening will be a little. But to grasp the undesirable consequences of screening aimed at aggressive cancer, can all who it will be.
For example, cervical cancer for about 10 years and a PAP test makes sense to do not more often than once in three years. More frequent PAP test reduces mortality and morbidity from cervical cancer, but increases the risk of adverse effects of screening (false positive diagnoses, inappropriate intervention, etc.).
Lifestyle is only one of the factors that may reduce the risk of developing cancer. Do not underestimate the role of genetics and other factors, for example, a banal accident.
There are types of cancer that are very difficult or impossible to identify at an early stage – in fact you could say that some forms of cancer no early stages does not exist. On the contrary, some forms of cancer can never be the fourth stage.
In such cases, the screening, most likely, will not bring any benefit. The only proven way to protect yourself from the cancer syndrome is tested for genetic predisposition and preparation of mitigation plan based on its results.
Of course, the test need not all. It makes sense to do it only on indications which can determine the geneticist. For cases where the mutation has arisen spontaneously can be treated as a situation of sudden accidents, to predict such a scenario is almost impossible.
What is important to do not to miss cancer
1. Remember the family history of the disease. It was not cancer in the immediate family (mother/father, brother/sister, son/daughter, grandma/grandpa, aunt/uncle)?
2. If someone from the next of kin was suffering from cancer at a young age (before 50 years) and/or in the same family line, there were several cases of cancer, or one of my relatives had two or more different tumors, it is necessary to refer to oncogenetic and solve the question of the necessity of the genetic test that can identify a predisposition to a particular type of cancer.
3. Another sign that may indicate the presence of a tumor syndrome in a family can be so-called “cancer without risk factors”. For example, lung cancer in non-smokers relative or breast cancer in men.
4. In cases of predisposition to decide on tactics reduce the risk individually with your doctor. It should be noted that in Russia the preventive removal of organs is in fact illegal – it is not forbidden explicitly, but not described in the standards of assistance. And all implicit concepts in Russia is commonly interpreted as a prohibition. For example, when the identified mutations in the genes BRCA1 and BRCA2 in our country is not practiced preventive mastectomy, preventative removal of the stomach and say nothing – in our country it is almost impossible to do in legal limits.
What can be done to reduce the risk of cancer development
1. To assess their risk of a tumor syndrome and consult with oncogenetics, if necessary.
2. No Smoking.
3. Not to drink or to minimize the consumption of alcohol.
4. To be vaccinated against HPV before they become sexually active.
5. To maintain a healthy weight.
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