Pico de Orizaba

Pico de Orizaba
Taken from Huatusco, Veracruz, the closest town to Margarita's family's ranch.

Wednesday, January 6, 2016

FAP and non-colorectal cancer risk

After having preventative surgery (colectomy) the FAP patient ceases being at risk of developing cancer of the colon (because they no longer have a colon).  When I had my colon removed, it was believed that the issue of FAP ceases until we have children and must worry about the future discovery of polyps in our childrens' colons when they enter puberty.  34 years later, we know that this was a very limited understanding of FAP and that maybe we should be much more concerned about the greatly increased possibilities along with what is yet to be understood.  Hence:

"The cumulative probability of developing any type of a noncolorectal cancer, mostly periampullary tumors, is 11% by age 50 years and 52% by age 75 years."

This is a quote from an article published by Medscape http://emedicine.medscape.com/article/175377-overview#a6

Putting this in perspective: on 0.3% of the U.S. population will develop cancer any given year (300 of every 100,000 people).  That said, you must understand that the rate increases dramatically after the age of 45.  For instance, in 2014 there were only 53,990 new cases for men/boys under the age of 45 and only 87,920 new cases for women/girls under the age of 45.  However, that rate increased more than 10 fold for men and women over the age of 45:  801,230 for men and 722,400 for women.

Not only this, the article mentions that some people express their APC mutation much later in life called AAPC instead of FAP, the onset of polyps appearing around the age of 36 and colon cancer appearing at the age of 54. Makes me think of the APC gene that my father inherited from his mother and the APC gene that my uncle inherited from that same mother; On my uncle's side, Turcot's Syndrome also appeared. But supposedly on my father's side, no... So, is it possible that those family members who were found without polyps at puberty and deemed free of the struggle, yet were not genetically tested, could find themselves in great risk as they approach their 50s? And what about their children who they believed were free from the colonoscopies at puberty? Could they be placing their children at the same risk of the deceased and unknown grandparents?

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