Discussing health issues is usually a topic delicately danced around when, in reality, it's better to dive right in and be nosy, says Dr. Alfred George Jr., a geneticist and director of the Vanderbilt Institute for Integrative Genomics. The more details - who, what, when - that you know about your family's medical history, the better off your future generations will be.
Discussing health issues is usually a topic delicately danced around when, in reality, it's better to dive right in and be nosy, says Dr. Alfred George Jr., a geneticist and director of the Vanderbilt Institute for Integrative Genomics.
The more details - who, what, when - that you know about your family's medical history, the better off your future generations will be.
"I've noticed over the last few years, there's been a slow deterioration in the amount of time that physicians have to devote (to patient medical histories)," said George, who was in Peoria, Ill., recently as part of the University of Illinois College of Medicine at Peoria's "Living Healthy" series. "It's information that physicians need to know to make informed decisions and that you should know as well.
"I've made the provocative statement at my institution that I don't think physicians should be entrusted with doing family medical histories. It should be off their table, or at least they shouldn't be the primary collectors of this information. You should."
Why is it so important to know if grandma had colon cancer or cystic fibrosis? Because some diseases can be passed on from generation to generation with one damaged gene. Cystic fibrosis is a prime example.
Other diseases, such as cancer and even high blood pressure, have a genetic component but are also greatly influenced by lifestyle.
George is promoting the U.S. Surgeon General's Web site - www.hhs.gov/familyhistory - because it offers an easy, interactive tool for creating a family medical history, also known as a pedigree.
Though the field of genetics dawned nearly 150 years ago with Gregory Mendel's discovery that certain pea plants passed on specific traits, technology has been advancing gene therapy at "breathtaking speed" particularly since 1966 when scientists cracked the genetic code.
Indeed, scientists are seeing recent successes in treating some single-gene diseases. In the November 2009 issue of Science, two young boys with a rare but fatal genetic disease called X-linked adrenoleukodystrophy were successfully treated using gene therapy in the sense that their disease was arrested, but not reversed.
Another recent but small study showed gene therapy improved the eyesight of 12 patients with a rare inherited form of blindness call ADA deficiency.
"Today, there are companies who can swab some cells off your cheek and they'll test for some 600,000 genetic markers. In reality though, only about 30 mean anything," said George, noting that some researchers are coming "full circle" and embracing less high-tech approaches.
"One thing we can do is exploit the information we can gather by knowing our family medical history."
In gathering medical history, George says it's important to focus on first- and second-degree relatives. First-degree relatives are your parents, siblings and your children. With them, you have a 50 percent chance of having genes in common. Your grandparents, aunts, uncles, nieces and nephews are your second-degree relatives. You have a 25 percent chance of having genes in common.
Your first cousins are your third-degree relatives. You have a 12.5 percent chance of having genes in common.
If someone close to you is adopted, George says "all bets are off."
In completing a family history, not only is it key to focus on first- and second-degree relatives, but it's important to get details, such as age of onset.
"A really key piece of information is age of onset. For men, we're all going to get prostate cancer if we live long enough," said George. But if family members have cancer at a young age "that is shouting out to me that maybe it is a predisposition.
"Collecting this information is the hard work. This is the painful task that you have to do with your family members."
Jennifer Davis can be reached at email@example.com.