“If the parents have cancer, will the child have the same fate?” How much risk we send to children and what can we do

Many parents wonder if a family history of infarction, diabetes or cancer means an inevitable destiny for the child. Modern genetic medicine offers a more nuanced answer: the inheritance matters, but it is not a conviction. Not everything that is inherited is fulfilled: the genes can increase the risk of disease, but the way of life, nutrition and medical monitoring can change the end of the story. Dr. Anca Bârdan, genetic doctorexplains the signs that may indicate a significant genetic inheritance and when a specialized consultation becomes necessary.

What is inherited, in fact

“It is important to make a distinction between two situations: rare genetic diseases, caused by clear and well-defined mutations in a single gene, and frequent diseases, where we talk about predisposition,” explains Dr. Anca Bârdan, genetic doctor.

Monogenic diseases, such as cystic fibrosis, Duchenne muscle dystrophy or Huntington disease, are caused by pathogenic changes in a single gene and usually have a clear, recessive or dominant autosomal inheritance, with a high probability of manifestation when the version is present. In contrast, in the case of hereditary predisposition to cancer, mutations in genes such as BRCA1, BRCA2 or TP53 do not necessarily determine the disease, but significantly increase the risk of occurrence, sometimes up to 60-70%, compared to the general population.

For frequent diseases – diabetes, hypertension, cardiovascular disease or some common cancers – genetic inheritance means a “package of genes” that provide an increased risk, called polygenic risk. “You can do the disease even if you have no one in the family, if the environmental factors are unfavorable, or you can avoid it if you adapt your lifestyle and monitor properly,” says Dr. Bârdan. In other words, you can have a heart attack, diabetes or cancer in the family, but not a sentence: the genes only increase the probability, and the nutrition, the movement, the sleep and the time controls can tilt the balance in favor of your child.

When should we think of a genetic consultation

Certain signs in the family history can be considered “Red Flag”:

• Several relatives close to the same serious illness, especially at young ages, such as breast, ovarian or colon cancer before 40 years. “A first sign is the occurrence of the same family disease, for several generations, for example breast or ovarian cancer in the mother, daughter and grandmother, or the same form of epilepsy that appeared in several close relatives. Other times it is not the same disease, but there are related conditions, such as different types of cancers at young or more neurological.
• Another important signal is the age of onset -When a serious illness appears much earlier than we expected in the general population. “For example, colon cancer at 30 years or breast cancer at 25,” the doctor says.
• The atypical or aggressive evolution of a disease, As well as the unusual response to standard treatments may also indicate a genetic cause. In such cases, “it is very important for the family to reach a genetic doctor, to determine if a personalized monitoring and prevention plan is needed.”

What can the genetic tests of predisposition look like

Genetic predisposition tests are modern tools that can provide information on personal risk for frequent conditions, without making a diagnosis. “These tests can highlight sensitivities related to nutrition, metabolism, physical activity, sleep or stress and allow the adaptation of diet and lifestyle,” explains Dr. Bârdan.

Testing is made simple, blood or saliva, and the results are interpreted by the genetic doctor. In Romania, these tests are available in specialized clinics, but they are especially useful for adults motivated to change their health behaviors. “These tests do not diagnose, but provide useful information for prevention and building a personalized health plan,” adds the doctor.

What parents can do to break the chain

“We do not do genetic predisposition tests in children,” says Dr. Bârdan. In childhood, genetic testing is recommended only if there is the suspicion of a genetic disease that influences immediate health. In such cases, the result helps doctors to diagnose and customize treatment.

Otherwise, the key is the prevention: “When there is a family history for metabolic diseases, cardiovascular or other chronic conditions, prevention is done through a balanced lifestyle: rich food, vegetables, proteins and dairy, daily movement, sufficient sleep and regular medical controls. emphasizes the doctor.

Annual monitoring in the pediatrician, the usual analyzes and a balanced lifestyle can completely change the trajectory of genetic inheritance. The genes cannot be changed, but the environment in which we live, yes. And it can make the difference between risk and health.