Sunday, 7 August 2011

Brochure for patients and carers

The bulk of this post is the text of a brochure prepared by staff of the Familial Cancer Centre at Peter MacCallum Cancer Centre. Many copies of this brochure, printed on glossy paper, should be available from the Familial Cancer Centre for doctors to distribute to GS patients and carers. I assisted with editing the text, which was a compromise between “keep it simple” and “make it accurate”. Note that some cases of Gorlin Syndrome are not due to mutations in the PTCH1 gene; this is the mutation for which a test has become available, and which is usually the culprit … but not always. Tests for the other mutations may be developed, later.



GORLIN SYNDROME

Also known as

Nevoid Basal Cell Carcinoma Syndrome

Basal Cell Nevus Syndrome

Multiple Basal Cell Carcinoma


WHAT IS GORLIN SYNDROME?

Gorlin syndrome is an inherited autosomal dominant trait, meaning that there is a 50% chance that children will inherit it from their parents, however some cases occur as the result of a new mutation instead of an inherited one. Typically, the syndrome is expressed in young adulthood but on occasion children as young as 2 years of age manifest disease expression.


APPEARANCE

Palmar/Plantar Pits: Small pits or depressions on the palms of the hands and soles of the feet

Facial Differences: Larger head than usual, prominent forehead or jaw line, wide-set eyes, broad nasal bridge and eye problems

Skeletal Troubles: Including improper curve of the spine, a sunken or protruding chest, hand deformity, misaligned shoulder blades, fused or splayed ribs, intracranial calcification. Some children are born with a cleft lip or palate.


WHAT ARE THE TREATMENT OPTIONS?

Electrodessication and curettage

Laser Vaporisation

Micrographic (Moh’s) Surgery

Oral Retinoids

Cryosurgery

Surgical Excision

Topical creams

Photodynamic Therapy


Radiation therapy is not suitable for people with Gorlin Syndrome as it will generally causes masses of BCCs to form



WHAT SURVEILLANCE DO I NEED?

During Pregnancy: An ultrasound during pregnancy can help predict if a baby has a large head, so a delivery with forceps or by Caesarean section can be planned if required

Newborn: If a baby is born with a large head, X-rays can confirm the inheritance of Gorlin syndrome by detecting bone abnormalities
Childhood: Annual dental screening should commence from about 8 years of age for the detection and early treatment of jaw cysts. There is also a need for at least annual surveillance of the skin by a Dermatologist.

Adulthood: Adults should inspect their skin regularly. Annual surveillance of the skin by a Dermatologist is recommended and dental screening should continue into adult life, its frequency depending on the findings of each X-ray.

New jaw cysts often slow from the mid-thirties.


GENETIC TESTING AND COUNSELLING

Gorlin Syndrome results from an alteration of the PTCH-1 (Patched) tumour suppressor gene which effects the Hedgehog signaling pathway in the body’s cells.


Familial Cancer Centres offer genetic testing to confirm an alteration as well as provide counseling for families and manage their screening. Contact details of Familial Cancer Centres within Australia are listed over the page.


SYMPTOMS

Basal Cell Carcinoma (BCC): Multiple skin BCCs

Jaw Cysts: Multiple odontogenic keratocysts developing during teenage and young adult years


Brain Tumours: known as Medulloblastoma that develop in childhood

Fibromas: of the heart or in a woman’s ovaries.

Tumours can also develop in the brain, intestines, muscles and bone.

_______________________________________


CONTACTS AND SUPPORT

Information is available from:

BCCNS Life Support Network
 www.bccns.org (US Group)

Gorlin Syndrome Group
www.gorlingroup.org
info@gorlingroup.org (UK Group)

Patient Fellowship is available from the Google Group:

Australian Gorlin Syndrome Mutual Support Group

Gorlin Syndrome In And Beyond Australia” on Facebook


FAMILY CANCER CLINICS


Victoria

Monash Medical Centre

246 Clayton Road

CLAYTON VIC 3168

Phone: (03) 9594 2026

Peter MacCallum Cancer Centre

St Andrew's Place

EAST MELBOURNE VIC 3002

Phone: (03) 9656 1199

Royal Melbourne Hospital

Grattan St

PARKVILLE VIC 3050

Phone: (03) 9342 7151

Austin Repatriation Hospital

Banksia Street

WEST HEIDELBERG VIC 3081

Phone: (03) 9496 5000


Australian Capital Territory

The Canberra Hospital

GARREN ACT 2606

Phone: (02) 6244 4042


Northern Territory

Women's and Children's Hospital

NORTH ADELAIDE SA 5006

Phone: (08) 8204 7375


Queensland

Herston Hospital Complex

HERSTON QLD 4029

Phone: (07) 3636 1686

Brisbane North Breast Cancer Family Clinic

534 Hamilton Road

CHERMSIDE QLD 4032

Phone: (07) 3350 7411



Western Australia

Genetic Services of Western Australia

374 Bagot Road

SUBIACO WA 6006

Phone: (08) 9340 1603

Telephone: (08) 9483 2824

Perth Mount Hospital

140 Mounts Bay Road

PERTH WA 6000


NSW

Royal Prince Alfred Hospital

CAMPERDOWN NSW 2050

Phone: (02) 9515 5080

St George Hospital

Gray St

KOGARAH NSW

Phone: (02) 9350 3815

Nepean Hospital

PO Box 63

PENRITH NSW 2750

Phone: (02) 4734 3362

Hunter Genetics

PO Box 84

WARATAH NSW 2298

Phone: (02) 4985 3132

Prince of Wales Hospital

High Street

RANDWICK NSW 2031

Phone: (02) 9382 2551

St Vincents Hospital

Victoria Rd

DARLINGHURST NSW 2011

Phone: (02) 8382 3395

Westmead Hospital

WESTMEAD NSW 2145

Phone: (02) 9845 6947

Royal North Shore Hospital

Level 2 Vindin House

ST LEONARDS NSW 2065

Phone: (02) 9926 5665

Wollongong Hospital

Phone: (02) 4222 5576


South Australia

Women's and Children's Hospital

NORTH ADELAIDE SA 5006

Phone: (08) 8161 6995


Tasmania

Royal Hobart Hospital

PO Box 1061L

HOBART TAS 7000

Phone: (03) 6222 8296


Due to the rarity of Gorlins Syndrome, clinical trials are not currently available in Australia. Part of the problem is that researchers cannot find enough cases to study to make the progress needed to find better treatments and provide more information about your disease. You can be involved by registering your information with the Centre for Analysis of Rare Tumours (CART-WHEEL) as well as be contacted for participation in a relevant trial.

www.cart-wheel.org

1 comment:

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    ReplyDelete

The software informed me that I will receive an email alerting me when comments are posted. I intend to reply, if email addresses are supplied. See the second post of August 2011 ("Raising Awareness among Dermatologists") for other ways to contact the Australian Mutual Support Group.