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Dr. Andrew Rynne

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Is cancer of the stomach hereditary?

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Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

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Posted on Tue, 21 Mar 2017 in Digestion and Bowels
Question: My father died rather suddenly from stomach cancer at the age of 43. Because he died at a rather young age I was wondering if we should be concerned about a possible link with the HDGC gene, and whether we should get tested for this? Family cancer history on his side is as follows;

Dad's Mother had bladder cancer and had her bladder removed.
Dad's Dad died of lung cancer (believed to be from smoking) and secondary brain cancer
Dad's sister (only sibling) has had 2 melanomas removed.

I told this information to my doctor, who suggested that I get breath tested for the h.pylori bacteria in my stomach. I did this and the test showed up clear, but I want to understand what this means. Does this mean that I don't have a HDGC gene? Does it mean that I don't have stomach cancer? Should I continue to get these tests regularly? Should I tell all 3 of my brothers to get this test? Is there a test I can get specifically to check for HDGC, and should I get this test and tell my brothers to?
doctor
Answered by Dr. Tayyab Malik 9 hours later
Brief Answer:
HDGC at your age is extremely UNLIKELY. Genetic testing maybe considered

Detailed Answer:
Hi.
Thanks for posting your query at HCM.
I read your question thoroughly and understood your concern.

H Pylori infection is a risk factor for developing gastric cancer but its NOT certain that all individuals with this bacteria would eventually develop cancer. NOT all strains of H pylori are infectious and/or carcinogenic. Anyhow, since you tested negative for H pylori, so its all good.

HDGC is a cancer that results from mutation in CDH1 gene.
Genetic testing for CDH1 maybe considered. Criterion for genetic testing ( CDH1) is any "one" of following:

- Two gastric cancer cases in a family regardless of age, at least one confirmed diffuse gastric cancer
- Diffuse gastric cancer in an individual under the age of 40
- Personal or family history (first or second degree relative) of diffuse gastric cancer and lobular breast cancer, one diagnosed under the age of 50

Patients at risk for HDGC are also at risk for breast cancer.
Therefore, in addition, your also advised to:

-Clinical breast examinations performed by a doctor or nurse every 6 months
- Regular breast imaging with mammograms OR ultrasound

Wish you good and sound health.
Any further questions are welcomed.

Best regards
Dr Malik
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Tayyab Malik 16 hours later
Thank you for the information. However, I was hoping for more direct answers to my specific questions.

1) Given that I tested negative for h.pylori, does this mean that I don't have HDGC? How are the two related?

2) Is it still possible to have (or contract) stomach cancer when h.pylori is not present?

2) Given the family history information that I provided, would you personally recommend me and my brothers to undergo any specific testing for HDGC? Do you think we are at risk of HDGC?

Thank you.
doctor
Answered by Dr. Tayyab Malik 2 hours later
Brief Answer:
H pylori is NOT related to HDGC

Detailed Answer:
Hi.
Thanks for getting back to me.

Answers to your queries as follow:
1. Negative for H pylori does nor warranty that one would not develop HDGC.
H pylori infection is NOT linked to development of HDGC

2 Yes, one may contract a stomach cancer even in the absence of H Pylori

3 Its better for you and your brothers to have Genetic testing (CDH1) to rule out HDGC IF :
your father was diagnosed with HDGC in his 30s
OR
any other family member "alongwith your father" was diagnosed with gastric cancer,

Hope to answer your concerns.
Best regards

Dr Malik
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Tayyab Malik 39 minutes later
Thank you! That is very clear.

One more question - do you have any idea why, given the information that I provided, my doctor would have advised for me to undergo the h.pylori breath test?

Thanks again.
doctor
Answered by Dr. Tayyab Malik 2 hours later
Brief Answer:
Though NOT for HDGC, but H pylori is a risk for gastric cancer

Detailed Answer:
Hi.
Its pleasure to answer your concerns.

HDGC is one of the cancers that involves gastric cancer.

H.Pylori is designated as Class I carcinogen ( for gastric cancer but not HDGC) by the International Agency for Research on Cancer.

So, your treating Physician may have asked you to test for H pylori to rule out this risk factor. Though to rule out HDGC, one needs further testing as elaborated earlier.

Wish you good health

Feel free to clear any further doubts.
Direct question link
http://doctor.healthcaremagic.com/doctors/dr-tayyab-malik/71638

Best Regards
Dr Malik
Above answer was peer-reviewed by : Dr. Kampana
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