Genetic Cancer BasicsLinda Burhansstipanov, MSPH, DrPH

Native American Cancer Initiatives, Incorporated (NACI)

3022 South Nova Road Pine, CO 80470-7830

http://www.NatAmCancerInitiatives.org

Lynne Bemis, PhD, Head of Biomedical Sciences Department

University of Minnesota School of Medicine, Duluth Campus

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

2

Figure 1. Excerpt from GENA® objective 26

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

3

QUESTION: What does “Hereditary” Mean?

“Hereditary” means that the characteristic came from the sperm and egg (from you dad and mom) when you were conceived in the wombLess than 10% of all cancers are “hereditary”

BRCA1, BRCA2, HER2/neu

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

4

Example: Hereditary Breast Cancer Risk

Increases if you have a family member who has / had breast cancer:

“First degree relatives” means your parents, sibling or children Does not include “Indian adopted” parents, siblings or childrenIf a first degree relative is diagnosed with breast cancer you have more risk than if it is an auntie or a cousin

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

5

QUESTION: What does “1st degree relative” mean?

Parents (i.e., you came from their egg and sperm)Brother(s) or Sister(s) who came from the same womb as youChildren who came from your wombDoes not include family members we “adopt” in the Indian way

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

6

If a “first degree relative” is diagnosed with a type of cancer other than breast you may be at greater risk (hereditary form) if they have:

ColorectalOvarianProstate

Because these each may have the same hereditary damages in BRCA1 or BRCA2

Hereditary Breast Cancer Risk

thank you Laurie DeDecker for the use of the slide

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

7

If different types of cancer, such asIf one first degree relative has skin cancer and another has lymphoma, and another has kidney,

The genetic mutation is NOT likely to be related to BRCA1 or BRCA2

Hereditary Breast Cancer Risk

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

8

Sandy’s family cancer history

IntervieweeBreast - 36

Prostate – 50Died - 56

Males

Females

Cancer

Deceased

Died - 60Breast - 56

Died - 57

Died - 62Breast - 75

Died - 76

Ovarian - 40

Died - 42

No known Cancer in his family

No known Cancer in her family

Chippewa, FinnishChippewa

Possible BRCA Family History

thank you Laurie DeDecker for the use of the slide

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

9

Hereditary Breast Cancer: Triple Negative Breast Cancer

Breast tumor is negative for:Estrogen Progesterone HER2/neu genetic marker

1st noticed among African-American women diagnosed at young ageAggressive cancersNo information about how common this is among AIANs

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

10

So, if only up to 10% of all cancers are “hereditary”, then why do scientists say, “All cancer is genetic?”

Ahem …. It is okay if you want to guess at an answer!!Almost all of us are born with no cancer causing genes from mom (egg) and dad (sperm)But damage to body cells (“somatic”) during your life can start cancer to develop

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

11

“All cancer is genetic?”Some types of cancer begin when 2 types of damage happen to your body cells. Other types don’t begin to become cancer until 5 damages occur Damage may be from any of the “risk factors” summarized on the shield …

Like taking hormonal replacement therapy (that would be one type of damage)Then drinking a lot of alcohol when you were in your 20’s (that would be the second type of damage)

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

12

What does “Genetic” Mean?

Genes are the blueprint for our bodyGenes are contained in the 46 chromosomes (23 pairs, including the sex / germ cells) Our chromosomes are inherited from our parentsBut our bodies can be born with healthy genes that are damaged by our behaviors or sometimes by the environment

Cancer 100 “Overview of Cancer” (Burhansstipanov)Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]

13

Non-Hereditary Breast CancerCannot be passed directly from a parent to a child = they are not inherited from the sperm (father) or egg (mother)

Challenging to know what actually started the changes in body cells to have the genetic changesSome science sees certain types of tumors that help figure out what may have caused the cancer

More than 90% of all breast cancer!