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ARE PARKINSON DISEASE PATIENTS PROTECTED FROM SOME BUT NOT ALL CANCERS?

ARE PARKINSON DISEASE PATIENTS PROTECTED FROM SOME BUT NOT ALL CANCERS? To the Editor: We read the article by Inzelberg et al. with interest. We have followed a large family from Western Nebraska (Family D) with autosomal dominant Parkinson disease (PD) since 1992. The pedigree contains 190 individuals with 23 affected members spanning six generations. The linkage studies demonstrated the presence of PARK8 parkinsonism (LRRK2, R1441C) in affected and in some asymptomatic family members. There were eight diagnoses of cancer (pancreas, gall bladder, lung, testicular, and colon) in this family according to direct report and review of medical records. Of the 18 known mutation carriers in this family, four have been diagnosed with colon cancer, and three of these developed in the ascending colon, specifically the ileocecal valve area. Only one of these mutation-positive patients has been diagnosed with PD; the other two remain asymptomatic mutation carriers. All three patients with colon cancer had colon resections without need for chemotherapy or radiation. All have had at least two follow-up colonoscopies with no cancer recurrence. There is little known about association of cancer with genetic forms of parkinsonism particularly with PARK8 parkinsonism. Therefore, these data may serve as a substrate for further investigations in this area. Perhaps LRRK2 gene expression is wider then initially anticipated. It is unclear whether more colon cancer or other types of cancer are present in this family. We will continue our research on this and other PARK8 families. It may also be worthwhile to explore the presence of colon cancer in LRRK2 mice model.