Camille Grammer in Remission from Endometrial Cancer

"Real Housewives" cast member developed the cancer after a diagnosis with the hereditary disease Lynch syndrome

As a former cast member of "The Real Housewives of Beverly Hills," Camille Grammer knows plenty about dealing with drama. But she was unprepared for the drama that entered her own life in 2013.

Camille knew that cancer ran in her family. Her grandmother had endometrial cancer, and her mother was diagnosed with stage III ovarian cancer at age 47. When Camille was 35, she decided to have herself tested for genetic markers and found out that she had Lynch syndrome. Her doctors strongly encouraged her to undergo a hysterectomy, but Camille was not yet ready to undergo menopause and opted instead for close observation. Twice a year, she underwent an endometrial biopsy, and in 2013, she received the unfortunate, but not unexpected, news that she had developed stage III endometrial cancer.

Camille underwent a radical hysterectomy at MD Anderson Cancer Center in Houston which was followed by several rounds of chemotherapy and radiation therapy.

With her cancer now in remission, Camille is raising awareness about specific  cancers of the female reproductive organs. Camille points out that these cancers can be silent killers because of the lack of knowledge about the symptoms, and the tendency for women to feel embarrassed to talk about these types of diseases. These factors increase the risk that the cancers will go undiagnosed until they have progressed to later––and much more dangerous––stages.

"I'm a survivor," Camille says, "and we’re going to raise awareness to help other women in our position to survive and beat this."

What is Lynch Syndrome?

Lynch syndrome, previously called hereditary nonpolyposis colorectal cancer (HNPCC), is an inherited disorder that increases the risk of many types of cancer, particularly colorectal cancer. People with Lynch syndrome also have an increased risk of cancers of the stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain, and skin. Additionally, women with this disorder have a high risk of cancer of the ovaries and lining of the uterus (the endometrium).

In the United States,  approximately 134,000 new cases of colorectal cancer are diagnosed each year, according to the National Institutes of Health. Approximately 3 to 5 percent of these cancers are caused by Lynch syndrome.

People with Lynch syndrome may occasionally have noncancerous (benign) growths (polyps) in the colon, called colon polyps. In individuals with this disorder, colon polyps occur earlier but not in greater numbers than they do in the general population.

What are the Genetics of Lynch Syndrome?

Variations in the MLH1, MSH2, MSH6, PMS2, or EPCAM gene increase the risk of developing Lynch syndrome.

The MLH1, MSH2, MSH6, and PMS2 genes are involved in the repair of mistakes that occur when DNA is copied in preparation for cell division (a process called DNA replication). Mutations in any of these genes prevent the proper repair of DNA replication mistakes. As the abnormal cells continue to divide, the accumulated mistakes can lead to uncontrolled cell growth and possibly cancer.

Mutations in the EPCAM gene also lead to impaired DNA repair, although the gene is not itself involved in this process. The EPCAM gene lies next to the MSH2 gene on chromosome 2; certain EPCAM gene mutations cause the MSH2 gene to be turned off (inactivated), interrupting DNA repair and leading to accumulated DNA mistakes.

Although mutations in these genes predispose individuals to cancer, not all people who carry these mutations develop cancerous tumors.

Lynch syndrome cancer risk is inherited in an autosomal dominant pattern, which means one inherited copy of the altered gene in each cell is sufficient to increase cancer risk. It is important to note that people inherit an increased risk of cancer, not the disease itself. Not all people who inherit mutations in these genes will develop cancer.

What are the Risks for Individuals with Lynch Syndrome?

Individuals with Lynch syndrome have a 25 percent chance of developing colon cancer by age 50. That risk increases with age. By age 70, there is an 82 percent risk of colorectal cancer.

Lynch syndrome increases the risk of:

  • Endometrial cancer by up to 71 percent;   
  • Gastric cancer by up to 13 percent;
  • Ovarian cancer by up to 12 percent;  and
  • Lifetime risk of developing some type of cancer by up to 90 percent

Lynch syndrome can also lead to multiple cancer diagnoses. People with Lynch syndrome have a significantly increased risk of developing a second cancer within 15 years of their first cancer diagnosis.

How Do I Know if I Have Lynch Syndrome?

A personal medical history is very important in diagnosing individuals with Lynch syndrome. These red flags can identify a person who may benefit from genetic testing:

  • Having colorectal or endometrial cancer before the age of 50;
  • Having two or more Lynch syndrome associated cancers at any age; or
  • Having a known Lynch syndrome mutation in the family
  • Genetic testing can be used to assess the risk.  It can be done either by a saliva sample or by drawing blood.

What Can Be Done to Help Individuals with Lynch Syndrome?

For those diagnosed with Lynch syndrome, preventive measures may significantly reduce the risk of cancer, delay the onset of cancer, or detect cancer at an earlier, more treatable stage. Organizations such as the National Comprehensive Cancer Network recommend starting screening at a younger age (as young as age 25) and completing screenings more often than typically recommended (every one to two years).

Colonoscopy can reduce the risk of colorectal cancer in individuals with Lynch syndrome by more than 56 percent. Surgically removing the uterus and ovaries can reduce endometrial and ovarian cancer by up to 100 percent for at-risk women.

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Celebrity Diagnosis: Teachable Moments in Cancer is produced by Celebrity Diagnosis LLC to raise awareness and knowledge of health and medical issues. The information on the subjects of these articles is derived from public news sources. Celebrity Diagnosis LLC and its employees are not involved in the care of any of the subjects nor do they have access to, or knowledge of, the subjects' medical records or personal health information. Celebrity Diagnosis LLC is solely responsible for the contents of these articles.

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