Article and Video CATEGORIES

Cancer Journey

Search By

Dr. Jared Weiss is an Associate Professor of Clinical Research for Hematology/Oncology at the University of North Carolina School of Medicine in Chapel Hill, NC. He completed fellowship in Hematology and Oncology at the University of Pennsylvania and residency in Internal Medicine at Beth Israel Deaconess Medical Center in Boston, MA. He received his Doctor of Medicine at Yale University School of Medicine in New Haven, CT and his B.S. in neuroscience at Brown University, in Providence, RI.

Lung Cancer Video Library - Are There Significant Genetic Risks for Lung Cancer?
Tue, 03/08/2016 - 13:04
Lung Cancer Video Library
Author
Jared Weiss, MD, Associate Professor Clinical Research Hematology/Oncology
Image
Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the genetic risk (or lack thereof) for lung cancer.

Transcript

It is my privilege to speak to you today about genetics and lung cancer, a topic that I think gets some confusion at times that I’d like to clear up. As we develop targeted therapies for lung cancer, in addition to making extra work for our medical students to learn this, we get to a very complex view of genetics.

GCVL_LU-A04_Significant_Genetic_Lung_Cancer_Risks_01

These are the genetics that are in the cells in the lung; every cell in the body has, in its center, a nucleus, and that nucleus contains DNA. This DNA is the instructions to the cell for how to do all of the work that the cell does. You might imagine an analogy to a computer — imagine that all computers were sold with every software program you might ever use, and then just certain computers activated certain programs, so if you’re an analyst maybe Microsoft Excel is activated, if you’re an artist maybe Adobe Photoshop is activated — that’s kind of what the cells in our body do. They all have genetics, they all have DNA, but certain programs are activated.

The key distinction that I want to talk about is the difference between the DNA in the cells in the lung, and the DNA in your reproductive cells that you can hand on to your children. So when we talk about the genetics of targeted therapy, when we talk about EGFR, ALK, ROS1, all these wonderful genetic changes that are leading to more effective, less toxic targeted therapies for our patients, we’re talking about the genetics in the cell in the lung. We’re talking about the genetics that went bad to transform that once-healthy, useful lung cell, into a cell that instead does all the mischief that is lung cancer.

That’s one kind of genetics. Those kind of genetics you cannot pass on to your children — the cells in the lung, no matter how much they change, there is no risk to children.

In contrast, people worry about heritable genetics when we talk about cancer. These are the cells in your ovaries or in your testes if you’re male, and these are the genes, only these genes, that you receive from your parents and can pass on to your children.

GCVL_LU-A04_Significant_Genetic_Lung_Cancer_Risks_02

So these are my daughters: at left this is Betty, and I know she has a little more hair than her smiling sister Dina there, but I’ll tell you they are actually identical twins. They have the same DNA. When my wife and I made them, I donated a sperm, she donated an egg, those came together. We got those genes from our parents, we shared them to make these beautiful twins, but if later in life, before or after I have them, if I develop mutations in my lung, no matter where they come from — from bad luck, from smoking, from asbestos, from whatever they should come from, I cannot pass those on to my children. That is a different kind of genetics.

That’s probably the most important thing I have to share with you, but one of the most common questions I get in my clinic is, “well, are there any heritable factors to lung cancer?” That’s what we’ll spend the rest of our time talking about.

GCVL_LU-A04_Significant_Genetic_Lung_Cancer_Risks_03

This is in the realm of epidemiology or big studies of large numbers of people. I’m showing you here the relative risk of getting lung cancer if you have a family member with it. It’s roughly double, so there is some kind of family association here. You might say, “well, is this all smoking,” that you’re smoking, you’re around people who are smoking, and if you look at never-smokers, this effect basically still holds.

GCVL_LU-A04_Significant_Genetic_Lung_Cancer_Risks_04

There’s a greater risk in the family of developing lung cancer even if nobody smokes. So you might say, “okay, is there a heritable genetic factor to be talked about?”

GCVL_LU-A04_Significant_Genetic_Lung_Cancer_Risks_05

The problem is if you look at spouses, the same effect holds, and most of us aren’t too related to our spouses so it’s hard to argue that there’s genetics going on there. So it’s probably some of each.

In general, lung cancer is one of the cancers least associated with the kind of heritable genetics that can be received from your parents or passed to your children.

GCVL_LU-A04_Significant_Genetic_Lung_Cancer_Risks_06

There are a few specific syndromes that do have an association — TP53, xeroderma pigmentosum, retinoblastoma, Bloom’s syndrome, Werner’s syndrome, there’s some new data about a very rare but heritable T790m mutation, and there’s some cool data out there about genetic links to nicotine addiction — that there may be a heritable component to why some people taste that first cigarette and say, “this isn’t so good, not for me,” and other people start craving the next one.

So to summarize, the genetics you pass on to your children are not the same as the genetics we’re talking about when we talk about molecular mutations leading to targeted therapy, and the link with those heritable mutations is extremely, extremely weak in lung cancer. If you have lung cancer, it’s unlikely that your children have a greater risk. The only thing I really have to say about that is that if your children smoke, make them stop.

I thank you.

Video Language

Next Previous link

Previous PostNext Post

Related Content

Image
Spanish Targeted Therapy Lung Cancer Patient Forum 2023
Video
2023 Terapias Dirigidas en el Foro de Pacientes con Cáncer de Pulmón El vídeo completo sin editar está disponible On Demand   View HERE  
Image
Spanish TTF 2023
Article
Únete a nosotros, sábado 12 de agosto a las 9:00 a.m.  En este foro anual de pacientes en vivo, los principales oncólogos torácicos de todo el mundo discuten temas relevantes para los objetivos del cáncer de pulmón, así como mutaciones raras.  
Image
Targeted Therapies in Lung Cancer Patient Forum 2023
Article
Thank you for joining us on Saturday for the 2023 Targeted Therapies in Lung Cancer Patient Forum! The full unedited versions of the 2023 Targeted Therapies in Lung Cancer Patient Forum presentations from the Mainstage and Second Stage, are now available OnDemand. These topics will be edited and offered as shorter videos in the coming weeks.  

Forum Discussions

Hi, I'm sorry you're having these issues.  The type of shoulder pain that feels like nerve pain is most likely nerve pain.  The type of tumor that causes similar shoulder pain...

Thank you so much for the response! I have seen a lot of your post on here and it's really awesome of you to take the time to reply to all...

ONKTALK is tomorrow. 

I hope to see you there.

The forum is now available on demand here.  Don't hesitate to ask questions as they come up. 

Take care,

Janine

Hi happybluesun,  Welcome to Grace.   I'm sorry your mom is going through this. 

 

Driver mutations are mutations that drive (or cause) the cancer.  Having more than one driver mutation is...

Hi Janine, thank you very much for your reply. As of June 2023, my mom has been prescribed Almonertibi Mesilate Tablet, a targeted therapy medicine made by the Chinese company Haosen...

Recent Comments

JOIN THE CONVERSATION
Thank you so much for the…
By Worried472 on Tue, 09/26/2023 - 12:44
Hi, I'm sorry you're having…
By JanineT GRACE … on Tue, 09/26/2023 - 11:24
The forum is now available…
By JanineT GRACE … on Mon, 09/25/2023 - 14:10
Reminder
By JanineT GRACE … on Fri, 09/22/2023 - 15:50