A panorama of the history of cancer and the progress of science in its treatment, with particular emphasis on unraveling its hereditary dimension, Professor Drakoulis Giannoukakos, Director of Research at the Laboratory of Molecular Diagnostics IPRETEA, at the National Research Centre for Natural Sciences "DEMOKRITOS", offered to the audience that attended the extremely interesting lecture entitled "Modern Clinical Applications of Human Genetics in the Diagnosis & Treatment of Hereditary Cancer".
The lecture, which took place in the framework of the 7th lecture series of the Institute of Public Health of the American College of Greece, is as follows:
From 1886, when the first reference to hereditary cancer was made by Pierre Paul Broca, until 1987, when the first evidence-based study of a case of hereditary retinoblastoma was presented, knowledge of the controversial issue of heredity has increased to an impressive degree, providing increasing possibilities for the prediction and treatment of the disease. Even until the 1980s, people attributed cancer to infectious factors.
Today, of course, we know that cancer is a genetic disease, involving changes or mutations in the genes of our cells. We have three types:
- Sporadic cancer - it affects 70% of cases and is caused by random factors - exogenous
- Familial - that is an accumulation of cancers in a family without an identified cause, possibly related to common environment or diet - covers 20% of cases and
- Hereditary - covers 10% of cases
These mutations are "recent" (1.000- 2,000 years old) and are not linked to ancient human genetic diversity. We all experience them in our lifetime, but most of them are repaired by our own organism. Unfortunately, as we get older, after a certain age, the ability to repair diminishes and sometimes leads to carcinogenesis. The incidence of cancers has not increased proportionately, despite what some claim to the contrary. What has increased is the population of the earth and life expectancy, and therefore, inevitably, the more people age and weaken their bodies, the more they become vulnerable to disease.
The organs with the highest rates of hereditary cancer are:
- the ovaries - 20% of ovarian cancer cases are hereditary;
- the breast; and
- the colon.
Lung cancer has the lowest heritability rates, since it has been shown to be due to environmental factors, with smoking predominating. It is worth noting that at ages over 60 years we do not consider heredity to be present - hereditary cancer occurs from 30 to 50 years (at 42 on average).
As for breast cancer, it is the one that occurs, compared to other forms, at younger ages (30-40 years) and affects the vast majority of women. Because it attracts greater interest from the public, researchers and, by extension, sponsorship and pharmaceutical funds, enormous progress has been made in its diagnosis and treatment. As a result, fewer and fewer women are dying from it. In Greece there are 6,000-8,000 cases of breast cancer every year.
It is important to inform the public in good time and, if possible, to draw up, in collaboration with our doctor, a family tree with the history of all our family members, so that we are aware of the risks we run. If there is a family history of cancer, we can, if we wish, undergo genetic testing, the results of which will help us to make crucial decisions about our health (the case of Angelina Jolie, who, after a similar test, underwent a bilateral preventive mastectomy, removal of fallopian tubes and ovaries). There are specific guidelines issued by reputable international oncological associations for cases where gene testing is recommended or required. The predominant method of gene testing today is by using new DNA reading technologies (next generation DNA sequencing) with the possibility of testing several genes simultaneously. Gene testing is not recommended before the age of 30.
Gene therapy does not yet exist, we can only intervene and "fix" a targeted area, e.g. the eye or a tissue, but we cannot intervene in the whole body.
Source: ygeiamou.gr
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