Emerging Adults Carrying a CDH1 Pathogenic or Likely Pathogenic Variant Face Diet and Lifestyle Challenges after Total Gastrectomy

Abstract

Emerging adults with a CDH1 pathogenetic or likely pathogenetic variant face a life-altering decision whether to undergo prophylactic total gastrectomy or to have frequent endoscopies for gastric cancer risk management. They are in a unique life stage with distinct characteristics, such as identity finding, career seeking, relationship exploring, establishing financial independence, and planning for or pursuing pregnancy. Research has shown that these emerging adults heavily weighed dietary and nutrition concerns after prophylactic total gastrectomy in their decision making for both timing of surgery and whether they should or should not undergo the surgery. These concerns are valid because of the significant dietary and lifestyle modifications that emerging adults need to commit to in order to prevent common sequelae after prophylactic total gastrectomy, which include early satiety, nausea, dumping syndrome, bile reflux, excessive weight loss, micronutrient deficiencies, and metabolic bone disorders. Therefore, working with a multidisciplinary team with expertise in CDH1 and hereditary diffusegastric cancer, including a registered dietitian nutritionist, is essential for this population.