Does “cancer constitution” really exist?

Some time ago, a report about a 65-year-old woman named Wang from Hangzhou who suffered from three types of cancer within a year sparked heated discussions in society. Coincidentally, a few days ago, Ms. Zhang (pseudonym) from Jiangsu also encountered such a terrible thing. Since 2020, she has been diagnosed with colon cancer and thyroid cancer, and in 2024, she was diagnosed with breast cancer. Why did she suffer from multiple cancers? Is there really a "cancer constitution"? With these questions, the reporter interviewed Ms. Zhang's attending physician, Yuan Yuan, deputy director of the Department of Oncology at Jiangsu Cancer Hospital (Affiliated Cancer Hospital of Nanjing Medical University).

3 types of cancer diagnosed in 4 years

Ms. Zhang is in her 50s and her father has a history of malignant tumors. After 2020, she seemed to have entered a "cancer curse" and her life was repeatedly troubled by cancer. First, she was diagnosed with colon cancer, but fortunately it was in the early stage. After surgery, she gradually returned to normal life. In 2023, she was diagnosed with thyroid cancer during a physical examination. After surgery, she received endocrine therapy and her condition stabilized. During the follow-up this year, she was newly diagnosed with breast cancer and underwent surgery again and received adjuvant treatment.

Yuan Yuan introduced that the simultaneous discovery of two or more malignant tumors in the body is medically known as multicancer. The incidence rate is not high in China, accounting for approximately 0.35% to 2.4% of cancer patients. Generally, there are two primary cancers. Three primary cancers are relatively rare, and four or more are extremely rare.

The occurrence of malignant tumors is a complex process of accumulation of multiple factors and steps. The occurrence of multiple cancers is not caused by a single factor, but may be related to genetic factors, susceptibility factors, endocrine factors, lifestyle and environmental factors, as well as second tumors caused by treatment.

Is multi-cancer treatment ineffective?

Many people believe that it is bad luck to have more than two types of cancer, and the treatment effect will definitely not be as good as having only one type of cancer. Yuan Yuan said that this is a misunderstanding. "Clinically, the treatment process of multiple cancers is more complicated, but the effect may not be lower than that of patients with a single cancer of the same type. The patient's prognosis is related to the type and stage of the tumor. For example, even with surgical treatment of malignant tumors of the liver, gallbladder and pancreas, the 5-year survival rate is only maintained at around 20%. For cases like Ms. Zhang, the first two types of cancer are in the early stages and can basically be cured after surgery. The third type of cancer is also early breast cancer, and the 5-year survival rate is also above 90%. In addition, because cancer patients undergo regular checkups, the second and third cancers are often discovered early, giving them the opportunity for early diagnosis and treatment, and the possibility of cure."

Doctors will provide individualized treatment for multiple cancers according to each primary cancer. If there is no distant metastasis, comprehensive treatment with surgery as the main treatment is usually chosen. Therefore, compared with patients with only one tumor, the survival and prognosis of patients with multiple cancers will not be significantly different. The key lies in whether the intervention period of treatment is timely and whether the treatment measures are standardized.

Should I have my breasts removed?

Hollywood star Angelina Jolie has a family history of breast cancer. In early 2013, she learned that she was a carrier of the BRCA1 mutation gene, with an 80% and 50% chance of developing breast cancer and ovarian cancer, respectively. She chose to have bilateral mastectomy, ovaries, and fallopian tubes to reduce the risk of breast cancer and ovarian cancer.

Ms. Zhang herself has a "cancer constitution". If she has a daughter who is a carrier of the BRCA mutation gene, should she have her breast removed just in case? Yuan Yuan said that Ms. Zhang's daughter is at high risk of breast cancer and ovarian cancer. At present, there is controversy over whether it is necessary to prevent double mastectomy for people with BRCA gene mutations. You need to consult a specialist in detail. Don't panic too much. Just do the following three things: First, go to the hospital to consult a specialist, conduct corresponding cancer screening regularly, and detect potential risks early; second, pay attention to improving your lifestyle, avoid exposure to carcinogens or the environment, and reduce the risk of cancer; third, maintain a good mentality and an optimistic attitude towards life.

Correspondent/Xu Linhua; Reporter/Tao Tao