Though some illnesses are random and many caused by the way you live your life, your family history can reveal your predisposition to certain conditions.
Some people take this to the extreme. If a parent died at a young age, they don't expect to live beyond that age . . . and they do nothing at all to change how they live. Some people have a false sense of security when their family history is good. Most women diagnosed with breast cancer have no family history. People can have strokes, diabetes, heart attacks and other cancers before others in their families.
Others don't think about their family history at all, don't do the screening tests they should or take proactive and preventive measures to remain healthy.
Those who don't learn from their family history may be destined to repeat it.
Consider Scrooge in Dickens' "A Christmas Carol." The ghost of Christmas Future gave him a glimpse of his future if he kept on behaving the way he had. Yet he was able to avoid that bleak future and create a more positive one by adopting new attitudes and actions.
Few of us will awaken completely transformed after one night with three bad dreams, but how we live our lives day by day and work periodically with our physicians can foster our potential for longer, healthier lives.
There are a few basic things you should know about family history. Genetically your closest relations (assuming you do not have a twin or clone) are your first degree relatives who each share half of your genes. They include your parents, siblings and children.
A grandparent, grandchild, niece, nephew, aunt, uncle or half-sibling is a second degree relative who shares only a quarter of your genes.
Your first cousins, great grandparents and great grandchildren are your third degree relatives. They each share only an eighth of your genes.
So obviously you are much more likely to share inherited health conditions with your first degree relatives. That is why doctors are most interested in the histories of your immediate family members.
However, if a condition has been diagnosed in multiple relatives across multiple generations, your odds of having the same condition are much greater. An example is colon cancer diagnosed in a maternal grandparent, maternal aunts or uncles, their children and your own mother.
Your risk is even greater if an inherited condition arises at a relatively young age. An example for a woman would be breast cancer diagnosed in her mother before menopause; for a man, prostate cancer in his father under age 50.
A family history of a sudden death, stroke or heart attack under the age of 50 strongly suggests a genetic factor you should know about.
Again having a family history of these conditions does not condemn you to suffer the same fate. They serve as an early warning to be more vigilant and to consult early and regularly with your physician. Early detection or intervention can change the course of a disease. Many are curable at earlier stages.
The standard screening for colon cancer begins at age 50 with either an annual stool test for occult or hidden blood or a colonoscopy every 10 years. The latter is much more expensive and not available for most of us through the publically funded system.
However, if you had a significant family history of colon cancer, the appropriate screen would be a colonoscopy every 5 years beginning 10 years before the age of your youngest affected relative.
With this system of screening, benign polyps are often removed before they become cancerous. If we had waited for the appearance of symptoms such as narrowing of the stools, severe constipation and progressive weight loss, we would catch colon cancer at a stage more difficult to treat.
If you have a family history of heart disease, stroke or sudden death at a young age, you should be screened for possible modifiable risk factors such as high cholesterol, high blood pressure, abnormal heart rhythms, valvular heart disease and diabetes. Early intervention with medication and lifestyle changes in many cases may prevent premature death or disability.
We usually start checking healthy males for prostate cancer at the age of 50. However, if a man's father or brother has been diagnosed with prostate cancer, we would normally recommend screening at an earlier age.
Likewise, if a woman has a family history of breast cancer in her sister or mother or across generations, she should discuss with her physician how much earlier than age 40 she should be screened with mammograms. She may also be eligible for the testing of the BRCA genes that predict a high likelihood for breast cancer.
Elevated cholesterol, diabetes and high blood pressure are common inherited conditions that are greatly modified by lifestyle measures including healthy eating and exercise. In many cases, these actions are combined with medications to prevent the health consequences, including premature strokes, peripheral vascular disease, heart disease, vision loss and kidney failure.
So your family history gives you and your physician invaluable information that can enable you to remain healthy and achieve your potential in life.
Dr. Davidicus Wong is a family physician at the PrimeCare Medical Centre. You can read more about achieving your positive potential for health at davidicuswong.wordpress.com.
