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A family history of colorectal cancer can increase the one's chances of having this illness. Research has found that gene mutations causing colorectal cancer can be passed on to the family members.
A gene is a block of the DNA. This holds the genetic code that is responsible for producing proteins that aid in the functioning of our body.
Nonpolyposis colorectal cancer and familial adenomatous polyposis (FAP) are two of the most common kinds of inherited colorectal cancers. Children of people who carry these genes have roughly 50 per cent chances of inheriting the gene causing this ailment. These two inherited forms of colorectal cancer can affect both men and women equally.
Read on to know in detail about the causes of FAP, its diagnosis and treatment.
What Causes FAP?
FAP is a rare condition. Its primary characteristic is the presence of benign polyps (growth in the large intestine and in the upper respiratory tract). Mostly, people develop polyps by about the age of 35. Sometimes, the detected patients are in their early teens. It is important to remove the polyps surgically or else they would take the shape of cancer.
FAP is caused due to a defect in the adenomatous polyposis coli gene. Mostly, this gene is inherited from the parent. Extra tissue is formed in the large intestine and rectum. At times, the presence of polyps is found in the upper gastrointestinal tract as well.
What Are The Symptoms Of FAP?
The major sign is the growth of several (about thousands) polyps in the rectum and colon. It usually begins as early as in one's teenage years. In most of the cases, especially if left untreated, these polyps would certainly develop into colon cancer or rectal cancer by the time one reaches 40 years.
Some of the symptoms that might indicate the presence of FAP.
- Pain in the abdomen
- Pain in the back passage
- Sudden weight loss without any specific reason
- Blood or mucus in the stool
- Bleeding from the back passage
- Constipation or diarrhoea
If one notices a change in the bowel habits that last longer than six weeks, then medical intervention becomes necessary to check for the occurrence of FAP.
Is FAP Rare?
FAP is quite uncommon. Studies have shown on an average that 1 in 22,000 could be a victim of this illness. On the other hand, colorectal cancer is understood to be sporadic. Research says that about less than 1 per cent of all colorectal cancer cases is assumed to be due to FAP.
How Is FAP Diagnosed?
If there is a family history of FAP, then it is essential to get yourself screened at frequent intervals. Screening is usually done annually and in the following ways:
• Colonoscopy: A tube is inserted through the rectum and the colon is examined.
• Sigmoidoscopy: A tube is inserted through the rectum. The purpose is to inspect the rectum and sigmoid.
• CT or MRI: Desmoid tumours can be identified through the imaging of the pelvis and abdomen.
• Esophagogastroduodenoscopy/side-viewing duodenoscopy: The inspection involves the stomach, oesophagus and the upper region of the small intestine. A biopsy might also be done.
Genetic testing is also important. A blood test is enough to check for the presence of the gene that causes FAP. Genetic testing might be required if:
You show some of the signs of FAP
Your family members have FAP
What Are The Treatment Options?
If small polyps are found during the examination through colonoscopy, then those would be removed. As you age, the polyps multiply and might become extremely difficult to remove them individually. In that case, you would need a surgery so that colon cancer does not occur.
If laparoscopy is the opted surgical procedure, then your hospital stay would not be long. Minimal invasive surgery just requires small incisions and maybe just a stitch or two.
- However, your condition would determine the kind of surgery that the doctor would advise you:
- Subtotal colectomy with ileorectal anastomosis - Rectum is left in place.
- Total proctocolectomy with a continent ileostomy - Colon and rectum are removed, an opening is created on the right side of the abdomen.
- Total proctocolectomy with ileoanal anastomosis - Colon and rectum are removed and a region of the small intestine is attached to the rectum.
Surgery is not the ultimate cure for FAP. Polyps might form again. If they are small, removing them endoscopically is advised. Regular screening with follow-up treatment is essential.