02.10.2015

New england journal of medicine urinary tract infection

Professor of Cancer Medicine and Oncology, Consultant Oncologist, Imperial College and Imperial College Healthcare NHS Trust. Professor Justin Stebbing trained in medicine at Trinity College Oxford, where he gained a first class degree.
Professor Stebbing has published over 500 peer-reviewed papers in journals such as the Lancet, New England Journal, Blood, the Journal of Clinical Oncology, Annals of Internal Medicine, as well as writing regularly for national newspapers and presenting new data on optimal cancer therapies at the major international conferences. He is a Fellow of the Royal College of Physicians, the American Board of Internal Medicine and the Royal College of Pathologists, and sits on the advisory Boards of a number of international cancer committees.
He has an extensive clinical practice and links this to a wide number of translational research studies. IMPORTANT NOTE: You have Javascript disabled in your browser, which will affect your experience on this site. There are four major genes involved in the development of Lynch syndrome: MLH1, MSH2, MSH6, and PMS2. An inherited mutation in one of these genes means that the body is not able to properly repair DNA.
There is a 50 percent chance that a person with Lynch syndrome will pass the mutation on to their children.
Here’s how it works: Every person has two copies of each of the four Lynch syndrome genes—one copy inherited from the mother and one copy inherited from the father. Colorectal Cancer: Individuals with Lynch syndrome have a higher-than-average risk of developing colorectal cancer and they tend to develop it at a younger age.
Other cancers: Some other cancers associated with Lynch syndrome are cancers of the ovary, small intestine, urinary tract, hepatobiliary tract, skin, and brain.
If you have questions and would like to speak to a genetic counselor about Lynch syndrome please either contact the Kintalk UCSF genetic counselors or you can find a cancer genetic counselor near you on the National Society of Genetic Counselors or the NCI Cancer Genetics Services Directory.


After completion of junior doctor posts in Oxford, he undertook junior doctor training and a residency at The Johns Hopkins Hospital in the US, returning to London to continue his career in oncology at The Royal Marsden and then St Bartholomew’s Hospitals.
His focus at Imperial is on new therapies in cancer, and the systemic management of patients with solid malignancies including a number of new biomarker-based approaches, with an emphasis on circulating tumour cells. He chairs the World Vaccine Congress and the Irish Cancer Society oversight committee and is on the editorial board of a number of world leading general medical and cancer journals such as the Journal of Clinical Oncology and the Lancet Oncology; he was awarded the Silvia Lawler prize in 2015. In 2016 Justin was internationally recognised with his appointment as co-Editor-in-Chief of Oncogene (Nature Publishing Group’s cancer journal) and election to the American Society for Clinical Investigation.
Lynch syndrome is sometimes referred to as hereditary nonpolyposis colorectal cancer syndrome (HNPCC).
Genes carry directions to cells and tell them to make specific proteins that perform and regulate all body functions.
The majority of cases of Lynch syndrome are the result of mutations in either the MLH1 or MSH2 genes; however, mutations in the MSH6, PMS2, or other genes can also cause Lynch syndrome. Put simply, there is a mistake in a gene that normally helps prevent cancer—which is why Lynch syndrome is associated with a higher risk of some cancers. Although it is not one of the mismatch repair genes (MLH1, MSH2, MSH6 or PMS2), it does cause the MSH2 gene to not be expressed. The average lifetime risk for developing colorectal cancer is approximately 6 percent; however, individuals with Lynch syndrome have a lifetime risk of 60-80 percent and their average age at diagnosis is about 45 years. Individuals who have sebaceous gland skin tumors (sebaceous adenomas, sebaceous carcinomas, epitheliomas, keratoacanthomas) are often referred to as having the Muir-Torre variant of Lynch syndrome.
Professor Stebbing’s original PhD research investigated the interplay between the immune system and cancer; he was appointed a senior lecturer in 2007, and a Professor in 2009. Recently, Justin’s team published in Nature Medicine the discovery of a new cancer-causing gene which we have now implicated in breast, gastro-intestinal, lung and other solid tumours.


Individuals with EPCAM mutations often have colon or endometrial tumors that show a loss of the MSH2 and MSH6 proteins.
In other words, someone who has one normal Lynch syndrome gene and one mutated Lynch syndrome gene will have Lynch syndrome. Some data indicates that the cumulative colorectal cancer incidence for those with Lynch syndrome is 82 percent. The charity Action Against Cancer  has been set up to support Justin’s work which concentrates on drug development and has the ambitious goal of developing cures. The National Institute for Health Research (NIHR) awarded Justin Stebbing its first translational research professorship in oncology, aiming to bridge the gap between the laboratory and the patient to ensure therapy is personalised.
Although Lynch syndrome is primarily associated with colorectal and uterine cancers, it has also been associated with an increased risk of ovarian cancer and cancers of the small intestine, urinary tract, hepatobiliary tract, skin, and brain.
Additionally, genetic testing for the MSH2 and MSH6 gene will be negative, meaning no mutation found. Individuals with Lynch syndrome also have an increased risk of developing a second primary colorectal cancer.
The focus of this is understanding why some patients with cancer relapse, and developing a program to reverse this and prevent it.
With the excellent research record we have at Imperial College London and the clinical expertise from Imperial College Healthcare NHS Trust, we believe we are ideally placed to achieve this. Genetic mutations can be inherited from a parent or can be random mutations that occur as a result of a mistake during cell division or in response to environmental factors.



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