Sandhya Raghavan
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Written By: Sandhya Raghavan | Published : November 1, 2017 5:16 PM IST
In May 2013, when Angelina Jolie revealed to the world that she had a double mastectomy done, people were confused. Why would she do away with her breasts when she wasn't diagnosed with cancer in the first place? The actress had, in fact, taken much-needed preventive measure after a test revealed that she was carrying BRCA1 cancer gene that made her 87 percent more prone to cancer like her mother. By doing so, she inspired many women with the dreaded gene to take the difficult step in making themselves safe from the disease.
Our unique genetic makeup is what truly makes each of us one-of-a-kind. We inherit a great deal of qualities from our ancestors, like the unique colour of our eyes, our stature, behavioural traits and the texture of the hair. But unfortunately, this motley bag that contains great genetic gifts can also bear diseases and defects. Genetic diseases are caused due to a wrong instruction in the gene called a mutation. Some mutations may have no effect and some may be helpful. Sometimes, these mutations can cause deadly diseases and one of the deadliest ones is cancer. But can genes alone kill us? Dr Prasenjit Chatterjee, Consultant Clinical Oncologist, Apollo Gleneagles Hospital, Kolkata answers some of the most relevant questions about cancer and genes.
#1. If someone in my family has cancer, will I also get cancer?
An inherited mutation will increase the risk but genes alone will not cancer. The combination of a genetic risk, lifestyle and environment -- each of which adds to your risk-- will decide whether you will get cancer or not. "All cancers are genetic, but not all are inherited. Cancer is caused due to mutation in certain genes, but all mutations are not inherited," sums up Dr Chatterjee. The likelihood of you inheriting cancer only through the genes is 5 to 10 percent, though family cluster is 15 to 20 percent and through sporadic mutations are 7 to 8 percent. "And if you are a woman, you are more susceptible to inheriting cancer," adds Dr Chatterjee.
#2. How can I find out if I am genetically predisposed to cancer?
The first sign to watch out for is whether your blood relatives have had cancer. But people from an adopted backgrounds or those not in touch with their extended family may not be aware of their cancer risk. In such cases, it is best to go in for genetic counselling, says Dr Chatterjee. Genetic counsellors are professionals who can advise you and your family how to identify and manage your inherited risk of cancer. "The selection of appropriate candidates for genetic testing is based on their personal and familial characteristics that determine the individual's prior probability of being a mutation carrier. It also depends on the psychosocial readiness of the person to receive the genetic testing," says the doctor.
#3. What can I do if I have a running risk of cancer in the family?
As in any case of cancer, early detection is key says the doctor. If there is a risk of you inheriting the disease, go in for genetic counselling and screen yourself regularly for cancer. "A full body examination and investigational protocols should be followed," says Dr Chatterjee. After Angelina Jolie had her mastectomy, many women followed her example and got themselves tested for the risk. In what is dubbed as the 'Angelina Jolie Effect', there was a spike in genetic tests for breast cancer after the actress publically disclosed her mastectomy. Are Indian women open to mastectomy?
"Risk reduction surgery or prophylactic surgery is another option for those with a genetic risk," Dr Chatterjee points out. Women with a high family risk for breast or ovarian cancer can opt for both breasts to be removed totally. Sometimes, the nipples are left behind in case she wants to reconstruct her breasts. In some cases, ovaries and fallopian tube are also removed to reduce the risk. Did you know about these 6 myths of mastectomy?
Dr Chatterjee also recommends using chemopreventive measures for ovarian cancers where natural, synthetic or biological chemical agents can be used to reverse, suppress or prevent cancer progression. Drugs like Tamoxifen, raloxifen, aspirin and other NSAIDs are used for this purpose.
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