Hereditary Colorectal Cancer Multidisciplinary Program

Overview

At City of Hope, we have an expert multidisciplinary care team for individuals and their family members with Lynch syndrome, familial adenomatous polyposis, and other colon cancer-causing syndromes. In some families Lynch syndrome may develop into colorectal, ovarian, stomach, and other cancers. Familial adenomatous polyposis may lead to colorectal, thyroid, and brain tumors — among other cancers. Our team offers comprehensive hereditary syndrome care, including:

  • Genetic counseling
  • Precision cancer screening
  • Therapy

If you would like to be screened or want more information about the screening, please review our guidelines , visit our Cancer Screening and Prevention Program page or contact us at (626) 218-8662.

 

My job boils down to two things: Can we find the cause of the cancer predisposition and, if so, how can we keep an individual free from developing cancer once we’ve identified genes linked to it? If a genetic change is found early on, the potential exists to reverse destiny." Thomas Slavin, M.D., clinical geneticist

Genetic screening is one of the most advanced tools available to identify, and in some cases prevent, cancer. At City of Hope, our multidisciplinary team of genetics specialists understand the complex molecular mechanisms that drive different colorectal cancer types — and use next-generation sequencing technology to arrive at the most accurate diagnosis.
 
Our team spans several disciplines. For those who have a genetic predisposition for cancer, that means expanded access to leading-edge surgical methods, therapies, surveillance and clinical trials.

NEWS & BREAKTHROUGHS

Colon and rectal cancer occurs more commonly in some families, and we have identified genetic mutations that significantly increase the risk in other families." Steve Sentovich, M.D., colorectal surgeon

Most cancer develops sporadically — when a genetic problem occurs within a cell and causes it to start to grow and spread uncontrollably. For a smaller percentage of cancers, genetics is what drives the development and growth of cancer cells.

Genetic problems (mutations) passed down within certain families, that later develop into cancer, are called hereditary. Approximately 5-10% of colorectal cancers are strongly associated with hereditary risks, while another 20% or more are not as well-defined, but are likely inherited — or are a combination of genetics interacting with environmental factors like poor dietary habits.

Some factors suggesting a family may have a hereditary risk for cancer include:

  • Close family members (parents, siblings) diagnosed with the same cancer
  • Several family members and/or generations diagnosed with more than one cancer
  • Cancer that is diagnosed before age 50

Hereditary colorectal cancer types

There are two main types of hereditary colorectal cancer:

  • Lynch syndrome, also called hereditary nonpolyposis colorectal cancer, is usually found in families with multiple generations of people diagnosed with colon cancers at age 50 or younger. People found to have Lynch have a 50-80% lifetime risk of developing colorectal cancer; tend to develop it at younger ages; and females with the mutation have a 40-60% risk of developing endometrial cancer.
  • Familial adenomatous polyposis (FAP) causes hundreds, sometimes thousands, of polyps to develop in the colon and tends to develop in young people. If not caught early, the risk of colon cancer developing by age 40 is nearly 100%.

Most hereditary colorectal cancers are associated with Lynch syndrome; and Lynch syndrome can lead to other cancers, including stomach (gastric), endometrial (uterine), ovarian, small intestine, liver, gallbladder, bile duct, kidney, bladder, brain and skin.

 

Hereditary genetic testing vs. tumor testing

Hereditary genetic testing looks at mutations in all cells of the body — mutations that can be passed from generation to generation. Tumor testing looks for genetic anomalies that are newly acquired in the tumor, rather than inherited; new mutations that are causing cells to grow in an uncontrolled manner.

At City of Hope, we have the ability to test for changes in the tumor, as well as changes in an individual's genes that may be associated with a hereditary cancer syndrome.

 
City of Hope’s renowned physicians and researchers use the latest in technology and innovation to treat cancer — coupled with an enduring belief in providing compassionate care. Call 800-826-HOPE or go online to request an appointment.

Anatomic and Clinical Pathology

Michelle Afkhami, M.D.

Clinical Specialties

  • Anatomic and Clinical Pathology
  • Molecular Pathology
  • Hematopathology
Jerry G. Chu, M.D., Ph.D.

Clinical Specialties

  • Anatomic and Clinical Pathology
Sharon P. Wilczynski, M.D.

Clinical Specialties

  • Anatomic and Clinical Pathology

Clinical Genetics

Thomas P. Slavin, M.D.

Clinical Specialties

  • Clinical Genetics
  • Medical Genetics
  • Molecular Diagnostics
Jeffrey Weitzel, M.D.

Clinical Specialties

  • Clinical Genetics
  • Clinical Cancer Genetics

Colon and Rectal Surgery

Kurt A. Melstrom, M.D., F.A.C.S., F.A.S.C.R.S.

Clinical Specialties

  • Colon and Rectal Surgery
Stephen M. Sentovich, M.D., MBA

Clinical Specialties

  • Colon and Rectal Surgery

Gastroenterology

James L. Lin, M.D.

Clinical Specialties

  • Gastroenterology

Genetic Counseling

Bita Nehoray, M.S., L.C.G.C.

Clinical Specialties

  • Genetic Counseling
Ilana Solomon, Sc.M., M.A., L.C.G.C.

Clinical Specialties

  • Genetic Counseling

Gynecologic Oncology

Thanh H. Dellinger, M.D.

Clinical Specialties

  • Gynecologic Oncology
Ernest S. Han, M.D., Ph.D., F.A.C.O.G.

Clinical Specialties

  • Gynecologic Oncology
Stephen J. Lee, M.D.

Clinical Specialties

  • Gynecologic Oncology
Mark Wakabayashi, M.D., M.P.H.

Clinical Specialties

  • Gynecologic Oncology

Medical Oncology

Joseph Chao, M.D.

Clinical Specialties

  • Medical Oncology
Marwan G. Fakih, M.D.

Clinical Specialties

  • Medical Oncology

Surgical Oncology

Lily Lau Lai, M.D., F.A.C.S.

Clinical Specialties

  • Surgical Oncology
Yanghee Woo, M.D.

Clinical Specialties

  • Surgical Oncology
  • Robotic Surgery
  • Minimally Invasive Surgery