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Treatments and drugs
By Mayo Clinic staffColon 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 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, your doctor will develop a cancer-screening plan for you. Stick to your doctor's recommended plan. Screening for cancer can help your doctor find tumors at their earliest stages — when they're more likely to be cured.
As part of your cancer-screening plan, your doctor may recommend you undergo:
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Colon cancer screening. A colonoscopy exam allows your doctor to see your entire colon and look for areas of abnormal growth that may indicate cancer. During a colonoscopy, you receive a sedative to help you relax. Your doctor inserts a long, flexible tube into your rectum. A camera on the end of the tube transmits images to a video screen that your doctor uses to see the inside of your colon.
People with Lynch syndrome typically begin colonoscopy screening every other year starting in their 20s. Your doctor may recommend you undergo colonoscopy every year when you reach your 30s.
- Endometrial cancer screening. Women with Lynch syndrome may undergo annual endometrial biopsy to screen for cancer beginning in their 30s. During an endometrial biopsy, your doctor removes a small piece of tissue from your uterus. The tissue is examined to look for changes in the cells that may indicate cancer.
- Ovarian cancer screening. Your doctor may recommend an annual ultrasound examination of your ovaries if you have Lynch syndrome. By comparing annual ultrasound images, your doctor may be able to see changes to your ovaries that may indicate cancer. Talk to your doctor about when to begin ovarian cancer screening.
- Urinary system cancer screening. If your family has a history of urinary system cancers related to Lynch syndrome, such as kidney cancer, your doctor may recommend annual screening for these cancers. Analysis of a urine sample may reveal cancerous cells.
- Gastrointestinal cancer screening. If your family has a history of gastrointestinal cancers associated with Lynch syndrome, such as stomach cancer and small intestine cancers, your doctor may recommend screening for these cancers beginning in your 30s. An endoscopy procedure allows your doctor to see your stomach and other parts of your gastrointestinal system. During an endoscopy procedure, your doctor looks for unusual areas that may indicate cancer.
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.
Surgery to prevent cancers caused by Lynch syndrome
In certain situations, you and your doctor may opt for surgery to prevent cancer in the future. If your increased risk of cancer makes you nervous or fearful for your health, surgery to remove your colon may put your mind at ease. Or if you're unable to comply with the need for frequent cancer screenings, you may opt to have your colon removed. But all operations carry risks. Discuss the benefits and risks of preventive surgery with your doctor.
Surgical options for preventing cancer may include:
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Surgery to remove your colon (colectomy). Surgery to remove your entire colon will eliminate the chance that you'll develop colon cancer. 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.
Talk to your surgeon about your surgical options. One option in this situation involves removing your entire colon and attaching your small intestine to your rectum (ileorectal anastomosis). This allows you to expel waste normally.
- 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. But these procedures also make it impossible to become pregnant. Women considering this surgery may wait until their 30s or until they're done having children.
