Treatments and drugs
Colon cancer associated with Lynch syndrome is treated similarly to other types of colon cancer. However, surgery for Lynch syndrome colon cancer is more likely to involve the removal of more of the colon, since people with Lynch syndrome have a high risk of developing additional colon cancer in the future.
Your treatment options will depend on the stage and location of your cancer, as well as your own health, age and personal preferences. Treatments for colon cancer may include surgery, chemotherapy and radiation therapy.
Cancer screening for people with Lynch syndrome
If you have Lynch syndrome, but haven't been diagnosed with an associated cancer — sometimes referred to as being a "previvor" — your doctor can develop a cancer-screening plan for you.
Stick to your doctor's recommended plan. Screening for cancer may help your doctor find tumors at their earliest stages — when they're more likely to be cured.
Research hasn't established which cancer screening tests are best for people with Lynch syndrome. As a result, medical groups vary on which tests they recommend. Which tests are best for you may depend on your family history and which gene is causing your Lynch syndrome.
As part of your cancer-screening plan, your doctor may recommend you have:
Colon cancer screening. A colonoscopy exam allows your doctor to see inside your entire colon and look for areas of abnormal growth that may indicate cancer. Colon cancer screening reduces the risk of dying of colon cancer by removing precancerous growths called polyps. People with Lynch syndrome typically begin colonoscopy screening every year or two starting in their 20s.
People with Lynch syndrome tend to develop colon polyps that are more difficult to detect. For this reason, newer colonoscopy techniques may be recommended. High-definition colonoscopy creates more-detailed images and narrow band colonoscopy uses special light to create clearer images of the colon. Chromoendoscopy uses dyes to color colon tissue, which may make it more likely that the flat polyps that tend to occur more often in people with Lynch syndrome are detected.
- Endometrial cancer screening. Women with Lynch syndrome may have an annual endometrial biopsy or ultrasound to screen for cancer beginning in their 30s.
- Ovarian cancer screening. An ultrasound can be used to assess your ovaries and this may be recommended beginning in your 30s. By comparing annual ultrasound images, your doctor may be able to see changes to your ovaries that may indicate cancer. Your doctor may also recommend annual blood tests.
- Urinary system cancer screening. Your doctor may recommend periodic screening for urinary tract cancers. Analysis of a urine sample may reveal blood or cancerous cells.
- Gastrointestinal cancer screening. Your doctor may recommend endoscopy screening for stomach cancer and small intestine cancer. An endoscopy procedure allows your doctor to see your stomach and other parts of your gastrointestinal system.
While research proves the effectiveness of colon cancer screening for reducing the risk of dying of the disease, similar research hasn't proved the effectiveness of screening for the other types of cancer. Still, experts recommend considering screening for these other types of cancer despite the lack of evidence.
Your doctor may recommend other cancer-screening tests if your family has a history of other cancers. Ask your doctor about what screening tests are best for you.
Aspirin for cancer prevention
Recent studies suggest taking a daily aspirin may reduce the risk of several cancers related to Lynch syndrome. More studies are needed to confirm this. Discuss the potential benefits and risks of aspirin therapy to determine whether this might be an option for you.
Surgery to prevent cancers caused by Lynch syndrome
In certain situations, people with Lynch syndrome may consider surgery to reduce their risk of cancer. Discuss the benefits and risks of preventive surgery with your doctor.
Surgical options for preventing cancer may include:
Surgery to remove your colon (colectomy). Surgery to remove most or all of your colon will reduce or eliminate the chance that you'll develop colon cancer. This procedure can be done in a way that allows you to expel waste normally without the need to wear a bag outside of your body to collect waste.
Little evidence exists to show that removing your colon has any advantage over frequent cancer screening, in terms of helping you live longer. Yet, some people prefer the peace of mind or may prefer avoiding frequent colonoscopy exams.
Surgery to remove your ovaries and uterus (oophorectomy and hysterectomy). Preventive surgery to remove your uterus eliminates the possibility that you'll develop endometrial cancer in the future. Removing your ovaries can reduce your risk of ovarian cancer.
Unlike with colon cancer, screening for ovarian cancer and endometrial cancer isn't proved to reduce the risk of dying of cancer. For this reason, doctors usually recommend preventive surgery for women who have completed childbearing.