What were the patterns of heart disease in Figueredo's grandparents? What difference does it make that Ramírez's father was diagnosed with stomach cancer when he was 69 years old, rather than at a younger age? At AARP Segunda Juventud's request, both men answered the questions in My Family Health Portrait and took the results to Dr. Jennifer Ibrahim, a clinical geneticist at St. Joseph's Regional Medical Center in Paterson, New Jersey.
Know the Risks and Take Action
Medical geneticists have begun to understand how genes carry chronic diseases from parent to child—perhaps silently at first, only to explode later. Technicians examine a patient's genetic material, but most people have a less expensive option: geneticists say they can assess risk by studying family health histories.
"We discuss family history with everyone who comes in, then we present options for testing," Ibrahim says. "Among people who are truly at high risk, particularly for cancer, about 75 percent opt for testing if they have insurance. But we see many individuals concerned about their family history...and we're able to assure them their risk isn't high enough to make the testing particularly useful." Instead, she may emphasize lifestyle changes or more than the standard medical vigilance.
Medical Mysteries Solved
After studying Figueredo's and Ramírez's family histories, Ibrahim says that both men are at higher risk than average for certain inherited diseases. For Ramírez, the major risk is for stomach cancer. When he began researching his family health history after his dad died of the disease, he learned—much to his surprise and dismay—that so had his dad's mother.
"It was a wake-up call," Ramírez says. When his father died, his mother told him to see a doctor because cancer ran in the family. "But I didn't pay attention," he says.
Ibrahim says that despite Ramírez's family history putting him at a higher risk than the general population for the disease, his risk is lower than it could have been. Both of his relatives were in their 60s when diagnosed. Had they been younger than 50, she says, Ramírez's risk would have more significantly increased. So even with stomach cancer in his family, Ramírez didn't need a colonoscopy at an age younger than 50. Ibrahim does suggest that when Ramírez has his colonoscopy, his doctors also examine his esophagus, stomach, and small intestine.
Danilo Figueredo's family health history, meanwhile, shows two areas of concern: heart disease and colon cancer. Only one relative, his paternal grandmother, had colon cancer. But she was diagnosed when she was in her 40s. That means Figueredo should have started having colonoscopies in his 30s. The rule of thumb, Ibrahim says, is to subtract 10 years from the relative's age at diagnosis. Figueredo also found widespread heart disease in his family. In addition, says Ibrahim, when it comes to heart disease, "There are obvious environmental factors. Someone with [Figueredo's] family history needs to address the genetic and the environmental."
In Figueredo's case, a culprit was poor eating habits. Ibrahim's advice: eat better and have his cholesterol checked regularly. Figueredo says he already eats healthier than his parents did. Now that he's connected the dots in his family's health history, he plans to watch his diet even more.
Most people never need genetic counseling, which can be expensive; check with your physician.
In the Family—But not Hereditary: You’ve got the same disease that’s plagued three generations of your family. Don’t be alarmed; it might not be hereditary. In an exclusive interview, Dr. Rodolfo Valdez explains environmental, cultural and behavioral factors that can put you at risk for certain diseases. Read more here.
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