Lynch Syndrome

Treatment

If you've been diagnosed with Lynch syndrome or are at risk of the disorder, Mayo Clinic physicians will develop a screening program to help reduce your risk as much as possible. Many cancer-prevention strategies exist, and your doctors will design an individualized program that provides you with the best possible care while attempting to limit the number of procedures you undergo.

Colonoscopy

The treatment of choice for colon cancer screening, colonoscopy is a visual examination of your colon and rectum using a colonoscope, a thin, flexible tube with a camera on its tip. The camera sends magnified images of your colon to a television screen. If your doctor discovers precancerous polyps during the exam, they're often removed immediately using instruments inserted through the colonoscope. Removing polyps — small clumps of cells that can eventually become malignant — is the best way to prevent colorectal cancer. People diagnosed with Lynch syndrome usually undergo colonoscopy screening every other year starting in their 20s. After age 40, your doctor is likely to recommend annual testing.

Pelvic ultrasound

Beginning in their mid-30s, women with Lynch syndrome usually start undergoing annual gynecological exams and pelvic ultrasounds — a safe, noninvasive procedure that uses high-energy sound waves to produce images of internal organs. Women in their mid-to-late 40s whose families are complete may consider undergoing surgery to remove the uterus, ovaries and fallopian tubes to decrease the risk of endometrial and ovarian cancer. This approach hasn't been proven to save lives and shouldn't be undertaken without careful consideration and consultations with your treatment team.

Other tests

Depending on your family and personal history, Mayo Clinic physicians may recommend additional tests, including chest X-rays, mammograms, urine cytology — a simple test to help detect cancer of the urinary system — PSA tests, abdominal imaging, dermatological exams and upper endoscopy, a test used to detect cancer in your upper intestinal tract, including your stomach and small intestine.

Lifestyle counseling

In addition to lifelong screening, Mayo Clinic physicians advise patients about simple lifestyle changes that may help prevent colon polyps such as:

• Limiting or eliminating red meat
• Quitting smoking
• Getting regular exercise
• Drinking alcohol in moderation, if at all
• Supplementing your diet with calcium and vitamin D

Surgical treatment

For Lynch syndrome patients who have developed colon cancer, Mayo Clinic colorectal specialists usually recommend subtotal colectomy, which removes the entire colon but retains the rectum. The end of your small intestine is then attached to the rectum, allowing you to have normal bowel movements.

Mayo Clinic surgeons perform the majority of colorectal surgeries using minimally invasive (laparoscopic) techniques. Mayo has been a leader in developing and using laparoscopic surgery for nearly two decades and is internationally recognized as one of the world's foremost centers for this procedure.

Unlike traditional open surgery, which uses a long abdominal incision, laparoscopic surgery is performed through several small incisions that require just a stitch or two to close. The long-term outcomes for laparoscopic and open surgery are similar, but laparoscopic surgery offers important benefits to patients, including less post-operative pain, a shorter hospital stay and a faster overall recovery. Mayo Clinic surgeons also use nerve-sparing techniques to help preserve urinary and sexual function in patients undergoing colon surgery.

Colectomy doesn't prevent cancer from developing in the rectum. You have about a 12 percent chance of developing rectal cancer within 10 years of colon surgery, so you will still need careful screening for rectal polyps.