Certain types of Cancer seem to run in some families owing to certain risk factors in common, such as smoking and obesity. But in some cases, an abnormal gene that is being passed along from generation to generation causes the Cancer. Although, this is often referred to as inherited Cancer, what is actually inherited is the abnormal gene that can lead to Cancer.

THE CASE

A 62-year-old gentleman without any co-morbidities was brought to the Surgical Oncology OPD with complaints of generalised weakness. He had come for regular follow-up and evaluation for anaemia (6 gms %). He was first diagnosed as a case of Adeno Carcinoma Rectum treated in April 2008 with Neo Adjuvant Chemotherapy, Radiotherapy and Low Anterior Resection. He was diagnosed with second malignancy – Adeno Carcinoma Transverse Colon in 2011 for which he underwent surgery, received Adjuvant Chemotherapy but didn't complete the course.

He had a very significant family history of malignancies with his elder brother having Carcinoma Oesophagus at the age of 65, and younger brother having Carcinoma Stomach at the age of 56.

Further evaluation with UGI Endoscopy & HPE revealed Adeno Carcinoma Stomach Cardia and PET revealed a localised disease.

THE PROCEDURE

He was optimised, 6 units of PRBSs was transfused and prepared for surgery. He underwent Radical Total Gastrectomy with Distal Pancreatectomy, Splenectomy, D2 Lymphadenectomy, Roux-En-Y Esophagojejunostomy and Feeding Jejunostomy under General Anaesthesia.

THE RESULT

Postoperative period was uneventful. The patient was advised further Chemotherapy. His family members have also been suggested for Genetic Counselling.