The importance of family history

Most of us know that we can thank our parents' genes for much of what we are. DNA—the road map of human life—determines how tall we grow, the color of our hair (not to mention whether it will fall out) and even how long we're likely to live.

But inheritance isn't so much a dead-end street as it is a road with many forks. We don't have to accept our fate blindly. In fact, if we read our genealogy carefully—learning about our genetic weaknesses—we can see trouble coming and choose a route that heads it off at the pass.

A prime example in my practice is prostate cancer. In the last year, studies at Johns Hopkins University have shown that a man whose father has had prostate cancer is at 2-1/2 times the risk for developing the disease himself. And if both his father and his grandfather had it, the risk jumps to 9 times. Put another way, if your father or grandfather had prostate cancer before age 55, your risk of getting it is 50 percent.

What's good about knowing you're likely to get prostate cancer? Simple. It's far better than not knowing you do have it.

Prostate cancer, like most malignancies, grows fairly slowly, and it can be cured entirely if detected early. With an annual digital rectal exam after 40 and regular blood tests after 50, most prostate cancers can be detected before it's too late.

Likewise, though many forms of diabetes run in families, a diabetic dad is no death sentence. Recent research has shown that lifestyle changes such as a low-fat diet and regular exercise can help both head off diabetes and also control it without insulin.

Of the other diseases with known or suspected familial links, most of them are either preventable, curable (with early detection) or both. It pays to know your genetic road map and take a few simple steps to avoid road hazards.

Susceptibility to most colo-rectal cancers, for example, is thought to be passed on genetically, but a healthful lifestyle and early detection can help disarm this killer. A low-fat, high-fiber diet has been shown in numerous studies to reduce the risk, and regular colonoscopy (visual examination of the colon with a flexible instrument) can catch polyps (precancerous growths) before they become cancers.

The importance of diet and exercise in protecting you from inheritable circulatory disorders such as heart disease, high blood pressure, high cholesterol and stroke should be no secret. And I shouldn't even have to mention smoking.

But you may not have known that vulnerability to some forms of skin cancer can be passed from generation to generation. If you have a parent or grandparent who's had skin cancer, be extra diligent with your sunscreen and exam your skin once a month for discoloration, roughness or persistent sores.

I applaud the enthusiasm for genealogy that we've seen over the last decade or two. But we need to know more about our roots than just birthdays, migrations and notable achievements.

Talk to your parents, grandparents and other relatives about what ailed your ancestors. Press them to be specific. (Prostate problems, for example, are different from prostate cancer.) And check death certificates for causes. Over the years, medicine has become much more precise and terminology has changed, but your doctor can help you sort out what's important.

Keep a record of what you discover about your predecessor's health, so that medical history becomes a part of your family tree. Genetic heritage is a vital part of the legacy your forebears left you. Be sure you make the most of it.

In health.


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