Author: Lynch Syndrome Ireland

Biology of Precancers and Opportunities for Cancer Interception: Lesson from Colorectal Cancer Susceptibility Syndromes

The two best defined syndromes are Lynch syndrome (LS) and familial adenomatous polyposis (FAP). Studying these groups on regular cancer surveillance provides insight into the tumor biology, potential avenues for prevention, and their effectiveness. In this article, we will review some of the lessons that can be learned from these conditions which may afford opportunities for cancer prevention.

Conclusions

Hereditary syndromes provide an opportunity to study early precancer evolution surveillance and interventions to prevent cancer. Understanding genotype and phenotype in colorectal cancer susceptibility syndromes allows for customized clinical trials in preventive medicine to be highly effective in their outcomes.

The increasing knowledge of precancer lesions and their biology may aid novel strategies for individualized prevention. It is essential to consider the adverse effects of such interventions when weighed against quality of life, particularly considering the age at which medication may begin.

Exciting advancements are being made in the field of cancer vaccination against LS colorectal cancer, however until trials show their validity the recommended surveillance protocols must be upheld. Extrapolating information from these hereditary colorectal cancer studies can also help pinpoint how certain sporadic cancers evolve and offer opportunities for cancer prevention.

https://aacrjournals.org/cancerpreventionresearch/article/16/8/421/728007/Biology-of-Precancers-and-Opportunities-for-Cancer?searchresult=1&sf180735319=1

Lynch Syndrome online training for primary care clinicians

The training involves watching a short video which covers:

  • A brief overview of Lynch syndrome
  • Their personalised cancer prevention programme
  • An introduction to the Lynch syndrome quick guide and how it can help you identify and manage your patient’s care
  • How to manage their first-degree family members’ care
Lynch Syndrome online training for primary care clinicians

The Upsides and Downsides of Cancer Genetic Testing

“Living with a hereditary cancer syndrome inevitably brings uncertainty. Despite taking preventative measures, the knowledge of increased risk frequently lingers in my mind.“

https://www.curetoday.com/view/the-upsides-and-downsides-of-cancer-genetic-testing

Resistant Starch

Taking a supplement of 30 grams of “resistant starch” a day – about the amount in two slightly unripe bananas – reduced the risk of multiple forms of cancer in people with a rare genetic condition.

Consuming resistant starch – a dietary fibre found in oatmeal, beans and bananas – reduces the risk of upper gastrointestinal cancers by nearly 50 per cent in people with Lynch syndrome. This is the first time a nutrient has been shown to prevent these cancers in people with the condition.

The nutrient supplement finding is significant because upper gastrointestinal cancers tend to be the deadliest for people with Lynch syndrome, says Matthew Yurgelun at the Dana-Farber Cancer Institute in Boston, Massachusetts, who wasn’t involved in the work.

https://www.newscientist.com/article/2330638-starch-supplement-reduces-the-risk-of-some-hereditary-cancers/?_ptid=%7Bkpdx%7DAAAAweYhyn3zhAoKcmJhNGYxWmNwZRIQbGt0Z2dpOHVzaTBmZzY2OBoMRVhMRlE5SEFCMVVTIiUxODIwMW9nMDgwLTAwMDAzMmRsYWJpZm1hbjJybHVxZGMzaDhzKhtzaG93VGVtcGxhdGVRSU9EQUhKOTFLS1oyMjcwAToMT1Q5RzRJMVpFNkRHQg1PVFZJRUVNM0I3N1pLUhJ2LYUA8Bh5ZHJkd3pqNTdaDTUxLjE3MS4yNDkuMjhiA2Rtc2ifxa2mBnAKeAQ

See: Cancer Prevention with Resistant Starch in Lynch Syndrome Patients in the CAPP2-Randomized Placebo Controlled Trial: Planned 10-Year Follow-up. https://www.capp3.org/media/26287/capr-22-0044_published_paper.pdf

What is the Lynch syndrome registry?

The Lynch syndrome registry pilot study led by The Cancer Screening and Prevention Research Group at Imperial College London, records information about the health status of individuals with Lynch syndrome. A select group of Lynch syndrome patients who have previously taken part in the Cancer Prevention Project 3 (CaPP3) trial will be invited to participate in the pilot study from across four hospitals in England.

The Lynch syndrome registry records and analyses important information about people with Lynch syndrome. This helps to understand how people with Lynch syndrome are looked after and cared for across England. All information is held on a secure and confidential computer database.

The registry will ultimately be an efficient system that with the help of the bowel cancer screening programme will allow nationally coordinated care for Lynch syndrome families. It will also become a valuable central research resource that could be used to support other studies.

https://www.lynchregistry.org.uk/index.html

Lights and shadows in the early-onset colorectal cancer management and research: An integrative perspective – Physician scientist with patient advocates

https://www.sciencedirect.com/science/article/pii/S1521691823000318

Practice points

  • -The global importance that Early-onset colorectal cancer (EOCRC) is acquiring, makes a joint and worldwide effort necessary to unravel the problem.
  • -Although most EOCRC cases seem to be sporadic, there is still an important proportion belonging to families with well-defined colorectal cancer predisposition syndromes.
  • –Excluding hereditary syndromes, general population screening strategies don’t cover most cases in the majority of countries, except in some defined ones with first-degree relatives with colorectal cancer.
  • -At present, the management of EOCRC should be considered a lifelong process: from the early care of symptoms to avoiding delays in diagnosis; through a multidisciplinary treatment in both the present and future; and with considerations for the possible consequences in the short and long term.
  • -The participation of patients in each step of the process, as well as in the awareness of the problem is especially critical in EOCRC.

Patient education – ICS

In our free Patient Education programmes, our cancer nurses provide information to guide you through and beyond your treatment including: what the treatment is, how it is given, managing side effects, and available supports.

We also have a programme for adult patients who have finished treatment or who are on maintenance therapy and living well with advanced cancer. Our Life and Cancer – Enhancing Survivorship (LACES) workshop can help you to adjust, live well, and feel your best, physically and emotionally.  

https://www.cancer.ie/cancer-information-and-support/patient-education

Hereditary and Familial Colorectal Cancer

While previous books on the topic have primarily focused on the genetic, molecular and pathological basis for these syndromes, there is a lack of information for busy physicians regarding the clinical management of hereditary cancer predisposition syndromes and colorectal cancer occurring in the familial setting.

The editors of this book have been fortunate to have received contributions from a multinational panel of expert clinicians who specialise in the clinical management of such individuals. They are extremely indebted to their generous contributions.

The Authors envisioned this book to be a leading manuscript and reference tool for those caring for patients and families of those with hereditary and familial colorectal cancer.

They hope to have achieved their aim to consolidate the current best practice and present it in a concise manner and see it as a crucial addition to current literature available.

While principally aimed at medical professionals, they trust that it will be of interest to genetic counsellor and nursing colleagues, as well as all those affected by the conditions described herein.

“How to set up an in-house nurse-led colorectal Lynch syndrome clinic”

In this paper, Filipe Carvalho goes through how he set- up his service, and outlines the essential steps to consider when setting up and managing an in-house nurse-led colorectal Lynch syndrome clinic.

The NHS long term plan sets a target that by 2028, 75% of cancers will be diagnosed at an early stage. One of the ways this ambition will be reached is through targeted screening and personalised surveillance of those most at risk of developing cancer, such as those with Lynch syndrome.

It highlights the educational requirements, patient criteria, the importance of thorough planning and the need to liaise-on with key stakeholders.

https://www.magonlinelibrary.com/doi/abs/10.12968/gasn.2023.21.6.22

Revealing the unique signatures of healthy guts as we age

The healthy elderly have a markedly different microbiome composition from those who were unwell…

Mechanistically, it’s not clear what is causing this divergence of increasingly unique microbiomes in healthy elderly people. Is this correlation or causation, in terms of healthy ageing? 

Sean Gibbons at the Institute for Systems Biology in Seattle, US, and co-workers will use their Global Grant for Gut Health to explore the unique gut microbial compositional signatures, gut microbial functional gene signatures, and associated blood metabolites in healthy elderly people.

https://www.nature.com/articles/d42473-023-00117-5?utm_source=twitter&utm_medium=social&utm_campaign=MEDR_BRCON_ENGM_GL_PCFU_CFULF_GGGH_c5SG&twclid=2125xkzxgn78gj9ni6iej35zfv