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April Sorrell

Assistant Professor in the Department of Pediatric Hematopoietic Stem Cell transplant at the City of Hope

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Genetically Predisposed Hispanics Can Alter the Course of Cancer

02/21/2014 01:15PM | 19190 views

Advances in modern medicine have made it possible to identify children and young people who have an inherited risk of developing early onset cancers. This important development in healthcare has brought unprecedented opportunities to reduce onset of certain cancers, improve outcomes for kids and young adults who do develop cancer, and prevent reoccurrences from happening.

It’s an exciting time in the battle against cancer where we’re not just talking about different therapy approaches and treatment modifications after the fact, but intervening early enough to attempt prevention in high-risk individuals.

The earlier we can find the children that carry cancer-causing gene mutations, the better chance we have of altering the course of cancer in their lives. This is because the individual – along with their families – can take immediate advantage of this knowledge and make lifestyle changes that can strengthen their immune system and the body’s natural defenses to fight off cancer.

For example, if you know your child is a carrier of the gene mutation for leukemia, you may be able to slow down the development of cancer and decrease the odds that it will develop early in life by minimizing their exposure to major radiation, environmental toxins – anything known to speed up the development of cancer. Smoking, unhealthy for anyone, is particularly lethal for a child with an inherited risk of developing cancer; you certainly don’t want to be setting a bad example around them or exposing them to the dangers of secondhand smoke.

Most people don’t want to think that cancer is a real threat to them specifically, and I have found this to be particularly true of my patients from the Hispanic community. In fact, they may be resistant to making lifestyle changes if they see it as an acknowledgement of this threat. What has made the difference in overcoming this resistance is the availability of risk assessment and the subsequent understanding that they are at higher risk of developing cancer than the average person. I have seen many individuals and their families finally find the will to change their lifestyle after finding out they were carriers of a gene mutation. For them, it’s a way to start taking control of something that always seemed beyond their control.

One of the most dramatic examples of change I witnessed was a patient of mine who found out he had the gene mutation for hereditary leukemia. For generations, family members had been suffering and dying from the ravaging effects of the disease. It had become family folklore that if you started having bleeding and breathing problems, you were on death’s door.

Things changed once we were able to give them a definitive reason for the health problems running through their family. Where once they were sedentary and not concerned with environmental or other risk factors that might be impacting their health, they now started paying attention to their diet and exercising (the original patient diagnosed became a long-distance runner!) They started shopping at the local farmer’s market for fresh fruits and vegetables rich in antioxidants and they avoided foods that posed health risks, such as highly-processed foods and charcoal-burned meats.

Empowered with the knowledge that explained the cause of all their suffering, they took our recommendations for prevention seriously and did everything they could to minimize the risk of developing leukemia. They even lined up donors – siblings who didn’t carry the gene mutation – for possible bone marrow transplants in the event they showed signs of being pre-leukemic.

Each action they took gave them greater peace of mind and a sense that there was a real chance of beating the odds. This helped my patient deal with the fact that his three young children were all diagnosed as gene mutation carriers. Both parents worked busy jobs but were fortunate to be in a position where they could scale back their hours and spend more time with their kids to make positive lifestyle changes.

They did so at a crucial time, early enough to improve the quality of life for their family and more closely guide their kids toward healthier choices – before the children had the ability themselves to grasp the reasons or the consequences of not doing so.

Having to make lifestyle changes can sometimes seem overwhelming on top of the daily struggles that many patients already face. Those living paycheck to paycheck certainly don’t have the luxury of cutting back on hours. But even when stressed financially, I have seen many of my patients, especially from the Hispanic community, find ways to make positive changes happen. It might be something simple, like squeezing their own juice by hand, because they can’t afford a juicer. Some go so far as to start growing their own fruits and vegetables in backyard gardens when healthy foods seem out of reach (even getting up before dawn to work their gardens) – in terms of both cost and distance from their neighborhoods.

In essence, they will do everything within their means to help their families and give their children the best chance at living a healthier life – not unlike the resourcefulness and resilience that previous generations showed to give their children better lives in this country.

There is an opportunity here to have a big impact on the lives of our children and the battle against cancer. The patients who have changed their lives in order to ensure better lives for their children and their families are great examples of resiliency and resourcefulness. With this in mind, here are three questions to ask yourself:

What would you do if you found out you or your children were genetically predisposed to cancer? What lifestyle changes would you be able or willing to make? How would you not just survive such a diagnosis, but thrive in the face of it?

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