Cancer strikes whole families like the Nolans due to tragic twist, experts say
The Nolan sisters have suffered a string of tragedies over the years, all as a direct result of cancer.
The disease first struck their father, Tommy Nolan Sr. who died of liver cancer in 1998. And since then, Bernie, Anne and Linda Nolan have all suffered from the deadly disease, with Bernie sadly passing away in 2013.
Just this week, Loose Women's Coleen bravely opened up about her own cancer diagnosis after coming across unusual patches of skin on her shoulder and face - which turned out to be melanoma.
"My first instinct, typical me, was to laugh hysterically because I just thought that's the most ridiculous thing I've ever heard anybody say," she told the ITV show. "I'm sick of cancer and I also my first instinct was, I'm not telling anybody in my family because this, that I've got at the moment, seems nothing compared to what my sisters have been through."
It came just days after the Mirror spoke with her sister, Linda, 64, who revealed she has lost her hair for the fourth time after her incurable cancer spread to her brain.
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Coleen revealed she had been diagnosed with basal cell carcinoma on her shoulder and melanoma on her face (Ken McKay/ITV/REX/Shutterstock)
Linda Nolan has opened up about her devastating journey with cancer and chemo (Andy Stenning/Daily Mirror)These days, much is known about the factors that can increase an individual's risk, but why is it that the killer condition all too often targets entire families?
Here, we take a look at the family's history with cancer as an expert geneticist explains why some families might see similar cases of cancer among members, even if they test negative for well-known genetic defaults such as the BRCA1 and BRCA2 faulty genes, known as the 'Jolie Gene.'
According to Cancer Research UK, most families will have at least one person who has or has had cancer. But having a couple of relatives diagnosed with cancer doesn't mean there is a cancer gene fault running in the family.
In families with an inherited faulty gene, there is usually a pattern of specific types of cancer. The strength of your family history depends on: who in your family has had cancer; the types of cancer they have had; how old they were at diagnosis; how closely related the relatives with cancer are to each other.
The more relatives who have had the same or related types of cancer, and the younger they were at diagnosis, the stronger someone's family history is, with it being more likely that the cancers are being caused by an inherited faulty gene.
In the case of the Nolan family, who rose to fame after forming the girl group The Nolans in 1974, they have experienced similar cancers. Anne was the first sister to be diagnosed with breast cancer in 2000.
The star, 72, was then diagnosed with stage three breast cancer 20 years later in April 2020 and is now in remission after receiving the all-clear. Just days after her second diagnosis, her younger sister Linda found out about her liver cancer - a cancer that their father died from.
Nolan sisters Coleen, Maureen, Bernie and Linda performing in 1981 (Andre Csillag/REX/Shutterstock)This came after Linda was first diagnosed with breast cancer in 2005, which returned as incurable secondary breast cancer in her hip in 2017. In 2020 she was also found to be suffering from liver cancer. Doctors then found two sizable tumours surrounded by smaller ones in her brain earlier this year.
Meanwhile, their late sister Bernie announced she had been diagnosed with breast cancer in April 2010. In October of the same year, Bernie was declared cancer-free following a mastectomy, chemotherapy and treatment with Herceptin. She announced in February 2012 that she was no longer taking cancer treatment drugs.
However, by the end of October 2012, Bernie's cancer had returned. Doctors told the singer that the disease returned to her left breast, brain, lungs, liver and bones. The star passed at her home in Surrey in July 2013 aged just 52.
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And this week it was revealed that Loose Women presenter Coleen, 58, had been diagnosed with basal cell carcinoma on her shoulder and melanoma on her face. Speaking with the Mirror in 2020, Linda confirmed that she, Anne, and Bernie tested negative for the BRCA gene mutation.
"Anne had breast cancer first in 2000, then me in 2006, then Bernie in 2010. Then we tested for the BRCA gene mutation and we don't have it, but they did say we'll have a rogue gene somewhere – it's just one they haven't found out about yet. They took our blood so they could use it for testing.
"It's weird because the doctor said it's not just bad luck that three sisters have got breast cancer. There's something not right there, so for the other girls it's very scary. They're doubly aware of checking themselves because they could have this gene that we don't know about."
Speaking to The Mirror, consultant clinical geneticist at The Royal Marsden NHS Foundation Trust, Dr Terri McVeigh, explained how families can inherit an alteration in genes that increases their risk of cancer, although some faults are too tricky to test with the current technology.
Bernie Nolan died from breast cancer in 2013 (Getty Images Europe)
Anne Nolan and her sister Linda walking in support of Bernie (Sunday Mirror)"Genes are tiny chunks of the DNA genetic code that we inherit from each of our parents. They are tiny structures inside our cells, that carry instructions to make proteins that carry out different jobs in the body," Dr McVeigh explains.
"We normally have two copies of most genes, one of which we inherit from our mother and the other which we inherit from our father. We have about 20,000 different genes. Some of these genes work to protect against the development of cancer - called tumour suppressors
"Certain individuals are born with an inherited risk of cancer, because of an inherited alteration (also known as a variant or mutation) in one of these genes. In people where one copy of the gene is already broken, a cell only has to lose the one remaining copy for cells to start growing unrestrained and for cancer to develop.
"People from certain ethnic backgrounds may also be at higher cancer risk because some groups have had more genetic changes concentrated in their population over the generations.
"Genetic testing is useful in such families as it can help us identify those relatives at higher risk of developing cancer, and, importantly, allow us to take actions to try to facilitate early detection, or prevention where possible. Very often, even if we suspect a hereditary cause of cancer, genetic testing doesn't identify a genetic alteration.
"A result like this cannot fully exclude the possibility that there may still be inherited risk factors in a family – there may be alterations in genes we don't routinely test yet, or there may be tricky parts of the gene that cannot be easily tested by current technology."
Dr McVeigh also highlights how non-genetic risk factors can come into play, such as shared environmental exposures. In cases where a genetic alteration isn't identified, doctors may recommend extra screening depending on the family history.
Linda, pictured with Coleen, Bernie and Maureen in 2012, says 'it's not just bad luck' that three sisters have had breast cancer (FilmMagic)At the Royal Marsden, a screening programme has begun to detect so-called germline cancer predisposition genes in high-risk populations before a cancer develops, so that patients with a mutated gene can be followed to make sure a tumour is detected early.
The NHS England Genomic Medicine service also offers genetic testing of patients who have already developed cancer. The expert adds: "Cancer genetics is a really rapidly moving area of medicine, and there may be an opportunity for additional genetic testing in the future as our knowledge grows."
Cancer Research UK warns that you may have a strong family history if some of the following situations apply to you: cancers developed when the family members were young, multiple close relatives on the same side of your family have had cancer, the relatives have had the same type of cancer, or different cancers that can be caused by the same gene fault, one of your relatives has had a gene fault found by genetic tests.
Nicola Smith, senior health information manager at Cancer Research UK, said: “Only roughly 5-10 per cent of cancer diagnoses are linked to an inherited faulty gene from a parent.
"Faulty genes aren’t always passed on to children, but even when they are it doesn’t mean that a person will definitely get cancer - they just have a higher risk of developing particular types of cancer than other people. It's a much less common cause of cancer than ageing or other factors, such as smoking.
"However, if people are concerned that they have a strong family history of cancer - for example, if multiple relatives have had the same type of cancer at a young age - then they can talk to their GP. If the doctor thinks that someone might be at increased risk, they can refer them to a genetics clinic."
Whatever people living with cancer need to ask about cancer, work, money or life. The big things and the small stuff. Macmillan is at the end of the phone and online to provide support. Call the Macmillan Support Line on 0808 808 00 00 or visit macmillan.org.uk and ask anything.
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