For many, a cancer diagnosis is attributed to lifestyle, environment, or plain misfortune. Rarely do people pause to consider that the root cause might be written in their family's genetic code. Contrary to popular belief, cancer itself is not passed from parent to child. However, specific genetic changes that significantly elevate cancer risk can be inherited through egg or sperm cells.
The Hidden 10%: Understanding Hereditary Cancer Risk
According to the US National Cancer Institute, up to 10% of all cancer cases may be driven by these inherited genetic changes. "Inheriting a cancer-related genetic change doesn’t mean you will definitely get cancer. It means that your risk of getting cancer is increased," the institute clarifies. Despite this substantial figure, awareness remains low due to difficult family health conversations, the misconception that a healthy lifestyle guarantees immunity, and limited understanding of genetic testing.
Dr. Vivek Sukumar, a GI and Hepatobiliary Pancreatic Surgeon at SSO Cancer Hospital, emphasises the need for clearer dialogue. He notes that while lifestyle and environment cause most cancers, 5 to 10 percent stem from inherited mutations. "Any patient who has a family history of cancer should undergo germline testing," he advises. Recognising this genetic risk allows for proactive measures long before cancer might develop.
Key Cancers with Hereditary Links and Early Action Plans
Dr. Sukumar identifies several cancers commonly associated with inherited mutations, which often appear earlier in life or affect multiple relatives.
Breast and Ovarian Cancer
Mutations in the BRCA1 and BRCA2 genes are famously linked to hereditary breast cancer. "Women with these mutations have a lifetime risk soaring to 60–80 percent, compared to about 12 percent in the general population," states Dr. Sukumar. For high-risk women, screening shouldn't wait until middle age. He recommends surveillance starting in the mid-20s, beginning with MRIs and adding mammograms later, alongside regular self-exams. Other genes like TP53, PTEN, and PALB2 also elevate risk.
For ovarian cancer, linked to BRCA mutations and Lynch syndrome, early detection is challenging. High-risk women may need monitoring from their late 20s or early 30s via pelvic exams, imaging, and blood tests. Oral contraceptives can lower risk, and preventive surgery is sometimes considered after childbearing.
Colorectal and Prostate Cancer
In colorectal cancer, Lynch syndrome and Familial Adenomatous Polyposis (FAP) are major hereditary culprits. These can trigger cancer in teens or early adulthood. High-risk individuals require earlier and more frequent colonoscopies to find and remove precancerous polyps. Diet and exercise remain crucial.
Inherited prostate cancer is under-discussed, yet certain gene mutations can double or triple a man's risk, especially with a family history of early diagnosis. Screening for high-risk men may start as early as age 40. Maintaining a healthy weight and a diet rich in fruits and vegetables is beneficial.
Melanoma (Skin Cancer)
Melanoma can also run in families, often involving mutations like CDKN2A. Dr. Sukumar stresses the importance of regular full-body skin checks, strict sun protection, and vigilance about changes in moles.
Knowledge is Power: Proactive Steps Forward
"Inherited cancer doesn’t mean cancer is inevitable. It means the body is sending a warning earlier than usual," concludes Dr. Sukumar. The key is to heed that warning. Understanding one's family history, considering genetic counselling and testing if indicated, and adhering to tailored, early surveillance plans can dramatically shift outcomes. This proactive approach empowers individuals to take control of their health, turning genetic risk into an opportunity for prevention and early intervention.
