Justin Hardy’s Inspiring Story and Hereditary Diffuse Gastric Cancer Awareness

by Stacy Partin, ThinkGenetic Intern

Editor’s note: Since the time of this publication Justin Hardy has unfortunately passed away due to complications from his gastric cancer. He died peacefully in his home on May 29, 2022. Those wishing to donate in Justin’s memory have been asked to contribute to the HardyStrong Scholarship Fund for future student athletes at https://www.gofundme.com/f/khhx2-hardystrong. 

Justin Hardy, Washington University basketball star, recently received his own segment on ESPN’s “Sports Center: Featured” highlighting his dedication to playing basketball throughout the course of his treatment of stage four stomach cancer.

Justin Hardy’s Inspiring Story

Hardy was not only leading an impressive athletic career as the second-highest scorer on Wash-U’s team, but he was also an ambitious student. He was busy working on his double major in accounting and finance at WASH-U when he received news of his diagnosis in April 2021.

Hardy told KSDK-TV:  “The sadness was really tough at first just because I felt my life was kind of closing in on me. And there wasn’t going to be all the things that I loved in my life. I felt like most things were gone and I was finished playing basketball.”

Hardy decided to continue living life to the fullest by continuing to play basketball despite his rigorous cancer treatments, and also graduated a semester early with two degrees.

While many have heard his inspiring story, not as many have heard of his genetic condition that made it more likely for him to get cancer.

How does Justin Hardy have stomach cancer at such a young age?

While anyone can be diagnosed with cancer at any age, there are certain genetic conditions that make it more likely to develop cancer. Sometimes people find out about their genetic condition after they already have a diagnosis of cancer.

In Justin Hardy’s case, he was found to have a condition called  Hereditary Diffuse Gastric Cancer (HDGC). This condition is caused by a harmful genetic change in a gene called CDH1.

What do changes in the CDH1 gene do?

Our body has many genes that are designed to protect us from cancer. When the genes aren’t working well, it makes it more likely that someone will develop certain types of cancer. A person with a harmful change in the CDH1 gene has a much higher chance of developing certain types of breast and stomach cancer

If someone has a CDH1 gene change, are their family members at increased risk for cancer too?

If a person has a CDH1 gene change, there is a 50% chance that each of their children may also have the gene change. There is also a 50% chance that their parents have the gene change, and a 50% that each of their siblings may also have it.

Family members who have a harmful change in the gene CDH1 are also at an increased risk to develop certain stomach and breast cancers. However, there are steps people can take to reduce their risks! People with harmful changes in CDH1 are encouraged to talk to their doctors about certain medicines, screenings, and surgeries they should consider to reduce their risk.

What do doctors recommend to prevent stomach cancer in patients with\ have harmful changes in CDH1?

There are different types of stomach cancer. The specific type of stomach cancer that people with CDH1 changes are at higher risk for is called “diffuse gastric cancer.” This type of cancer is very hard to catch at early stages. Usually, by the time the cancer has been found, it is hard to control and may have spread to other parts of someone’s body. Because of this, it is suggested that these individuals have their stomach removed to prevent cancer from forming. However, each person has a choice about whether or not they have their stomach removed. People can live without a stomach and still enjoy meals and a good quality of life.

There is research currently going on to try to develop better ways to detect this type of stomach  cancer earlier so that people might not have to have their stomachs removed. The National Institutes of Health (NIH) also has an interesting article about ways their researchers are trying to develop drugs to prevent cancers from forming in the first place.

It is also currently recommended that people with breasts have increased screenings with MRIs and mammograms. It is important to understand that these are the current guidelines. These guidelines may change over time and it is important for folks to follow up with their doctors to ensure they are receiving up-to-date recommendations.

Should I get genetic testing for HDGC?

Based on current guidelines, if you have been diagnosed with diffuse gastric cancer under the age of 50, have a family history of diffuse gastric cancer, or have had a family history of a certain type of breast cancer called lobular breast cancer, it would be a good idea to consider seeing a genetic counselor to discuss whether genetic testing is right for you.

Additionally, it is currently recommended that individuals of Māori ancestry receive genetic testing, as they frequently have harmful changes in CDH1. Māori ancestry includes indigenous polynesian individuals from New Zealand. Click here to find a genetic counselor near you.

What support exists for people with HDGC?

“No Stomach For Cancer” is a non-profit patient advocacy organization that advances awareness and education about stomach cancer. They have great information on their site about preparing for stomach removal. They also have a section of their site dedicated to sharing the stories of other individuals who have had their stomach removed.

Are there other genetic conditions that can cause an increased risk for cancer?

CDH1 isn’t the only genetic condition that can make someone more likely to develop cancer. It can be helpful to learn more about your family health history and talk to your doctor to see if genetic testing is right for you. Even when genetic testing isn’t a good fit, your doctor may have different recommendations based upon your family history, such as increased screenings for different types of cancer.

The information presented in this blog post should not be taken as medical advice. Talk to your doctor if you have any questions or concerns.

Sources:

• Muir J, Aronson M, Esplen MJ, Pollett A, Swallow CJ. Prophylactic Total Gastrectomy: a Prospective Cohort Study of Long-Term Impact on Quality of Life. J Gastrointest Surg. 2016 Dec;20(12):1950-1958. doi: 10.1007/s11605-016-3287-8. Epub 2016 Oct 17. PMID: 27752808.
• Corso, G., 2022. Pleiotropic cancer manifestations of germline CDH1 mutations: Risks and management. Journal of Surgical Oncology.. doi:10.1002/jso.26847
• Gamble LA, Heller T, Davis JL. Hereditary Diffuse Gastric Cancer Syndrome and the Role of CDH1: A Review. JAMA Surg. 2021 Apr 1;156(4):387-392. doi: 10.1001/jamasurg.2020.6155. PMID: 33404644.
• Kaurah P, Huntsman DG. Hereditary Diffuse Gastric Cancer. 2002 Nov 4 [Updated 2018 Mar 22]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1139