If I Have Lung Cancer, Is My Family Susceptible?

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Topics include: Understanding and Living Well

What causes lung cancer?  Can it be passed on genetically?  Dr. George Simon of MD Anderson Cancer Center and Dr. Rebecca Heist of Harvard Medical Center discuss various common causes of lung cancer, including chemicals, pesticides and radon exposure.  Dr. Simon concludes with screening options, including a new alternative to low-dose CAT scans.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

So we’ve talked about genes. But we were talking about I guess what you’d describe as oncogenes where there was some genetic change that then characterizes your cancer.                 

But those of us in the lay community think of genes like do you have blue eyes or black hair or no hair or whatever. And so we worry then about our families. So I’ll start with you, Dr. Heist. Somebody comes in that’s diagnosed with lung cancer and says, is my brother likely or my child—any connection there?

Dr. Heist:              

So most lung cancer is not inherited. There is probably a very, very small genetic susceptibility to it so a very slight genetic predisposition. But it is very, very slight. And one thing I do emphasize is we talk a lot about genes. But these genes that we’re talking about, and when we look at that pie chart, these are all genes that you didn’t get from your parents; you don’t pass on to your kids. These are just genes in the cancer. There’s always an exception to every rule.  So there are some that are very rarely familial.  But it is extraordinarily, extraordinarily rare.

So we think of lung cancer as being not a genetically driven disease in terms of inherited genetics.  But there is a very, very slight genetic predisposition.

Andrew Schorr:                  

Okay. And any other causes like if somebody worked in some industry and was exposed to chemicals, or there were pesticides or anything like that, asbestos? 

Dr. Heist:              

So asbestos is linked with mesothelioma. But it actually causes more lung cancers than mesothelioma, because lung cancer is just a more common disease. So environmental exposures like asbestos,  very, very high radon exposures, things like that are associated. And there are probably environmental factors that we don’t quite know. There’s about 10 to 15 percent of lung cancers that develop in people who have never smoked. And they’re probably being caused by some environmental factor.

And there’s probably some intersection between the environmental exposure and then somebody’s genetic susceptibility to how they process that carcinogen exposure that makes them develop the cancer. 

So that very tidy, inherited genetics part of lung cancer probably has something to do with that.

Andrew Schorr:                  

So Dr. Heist earlier mentioned early detection.  So is there anything that these folks who have already been affected by lung cancer can say to family members or friends? Is there some exam they should have or who should have it so that there could be earlier detection? 

Dr. Simon:

Recently, there was a large study called the National Lung Cancer Screening Trial that looked at finding out where they’re doing low-dose CAT scans in a particular group of individuals. That means they have to be about 50, to have a more than 20-pack history of smoking. Where doing scans on those would that lead to early detection of lung cancer, and would that save lives? And this large study, which has now been published, has demonstrated that it did save lives.  It did prolong survival.  There are some issues with this with doing CAT scans.  A lot of times, you find these nodules.  

It turns out that the vast majority of them are benign.  So it causes some anxiety to patients.  These patients with these benign nodules may undergo biopsies. 

And that’s inconvenient. It’s risky. It’s expensive. So there are some caveats to that. But I think NLST data suggests that low-dose screening CAT scans will improve survival.  There are also more exciting technologies that are on the horizon that may actually be better than NLST data. There are companies that are developing machines that measure VOCs.  VOC stands for. So patients with lung cancer sometimes exhale certain chemicals in their breath, which these machines, by using a technique called mass spectroscopy, can detect.

And it’s kind of like dogs smelling the urine of prostate cancer patients and identifying prostate cancer—so analogous to that. So there’s a company in the United States, and there’s a company in Israel that’s sort of developing these machines that can, by measuring the VOCs, potentially detect early lung cancer.

So as of now, low-dose CAT scans are being offered to patients in various centers to screen for lung cancers. But there may be better technologiesdown the road. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on October 4, 2016