Examining the Roots of Your Family Tree

It was four years ago when I first thought long and hard about my mortality. I was 36, and I’d just had a scare: My mother had been diagnosed with a cancerous breast tumor. Seven years earlier, my father, at the young age of 59, had died of congestive heart failure.

The news of my mother’s breast cancer upset me so much that I decided to delve into our family medical history. I wanted to know what my own risk was for developing cancer and other diseases that had struck my parents and so many other family members.

None of my grandparents had lived to see age 60, and various other ailments had brought early death to numerous other relatives. One of my first experiences with sickness and death came when I was 7 when my uncle succumbed to lung cancer at age 33. Several years later, a cousin, age 13, died of leukemia.

As a kid, I thought all families experienced these tragedies. It was only as an adult that I learned my situation was somewhat uncommon. As a medical writer, I know that diseases run in families: breast and colon cancer, heart disease, high blood pressure, diabetes, depression, alcoholism and Alzheimer’s disease, among others.

After my mother’s diagnosis, I became obsessed with learning as much as possible about my genetic identity to find out what hereditary surprises might be in store for me. And for my three school-age children.

Doing the Detective Work

The first step in this quest was to create a “genogram,’ a family medical tree that goes back at least three generations. Genograms can reveal patterns of disease or illness, such as diabetes or hypertension, in your family.

I quickly realized that I lacked access to much of the family medical information I would need to complete my genogram. This was going to require more genetic sleuthing than I’d imagined.

The first person I spoke to, of course, was my mother, who told me all she knew about the heart disease and cancer that dotted our family tree. Although she was comfortable talking about other relatives, she was reluctant to discuss one of her own maladies--Marfan’s syndrome, an inherited condition characterized by unusually long limbs, abnormality of the eyes and heart irregularities. I knew she was tall (more than 5 feet, 10 inches), but I didn’t know she had some of the same symptoms of the syndrome that killed 1984 U.S. Olympic volleyball team star Flo Hyman.

I interviewed other relatives, including my two brothers, aunts and cousins. A few were embarrassed by my questions and barely hinted about the bouts of severe depression that one cousin and one uncle had suffered from. I explained why the project was crucial for our family and its future generations. I discovered, to my surprise, that every member of my immediate family--my mother and brothers--has hypertension. Before my queries, one of my brothers had never told any of us about his high-blood pressure.

When interviews with relatives do not provide enough information, another option is to search family heirlooms or records that may have been stored away. I found myself looking through an attic to locate long-forgotten but valuable photographs, records and mementos. Photographs can provide important information about physical characteristics, such as the weight and height of your relatives.

As you trace your family’s history, you will discover your relatives have left their own paper trail that may include birth, baptism and marriage certificates, school records, photographs, military records, insurance and employment records, real estate deeds, wills and, in some cases, death certificates. Besides gaining a better understanding of your entire clan’s medical profile, you may come across other juicy details. I discovered, for instance, that my grandparents had a common-law marriage. No wonder I never stumbled upon any old wedding photos!

If one of your family members has dabbled in genealogy, you should consult them to find out how to learn more about certain relatives.

As a rule, the earlier the onset of a serious illness, the more likely the condition was due to inherited genes. For instance, if your mother had breast cancer, heart disease or hypertension before menopause, your risk is higher than if she developed the disorder after menopause. Anyone who discovers two first-degree relatives with the same type of cancer or one first-degree relative younger than 50 with cancer or serious heart disease should consult with a physician or genetic counselor. (First-degree relatives--parents, brothers, sisters or children--share one-half the same genes.)

A variety of resources can help you in your search. State and federal government agencies maintain records that may assist you in tracing your family medical history. In California, the Bureau of Vital Statistics in Sacramento (telephone: [916] 445-2684) is a good starting point for birth, marriage and death certificates. Religious and funeral records can play an important role in your research. The Church of Jesus Christ of Latter-day Saints maintains a computer database of 60 million immigrants in its family history library in Salt Lake City. I used one of the church library’s local branches in my research.

So what else did I learn about my family medical history?

Her Biggest Risks: Heart Disease, Diabetes

Although there was a considerable history of cancer in my family, my biggest risks came from heart disease and diabetes. No two relatives had died of the same form of cancer--a strong indicator that there was no genetic predisposition to these illnesses. A genetic counselor set my mind at ease by telling me that my risk of developing breast cancer and other forms of cancer was no greater than the general population. But heart disease and diabetes showed up frequently in my genogram, suggesting that these illnesses could some day affect me.

If you want help in analyzing your health history, your doctor can refer you to a genetic counselor. You can also contact the National Society of Genetic Counselors at (610) 872-7608.

While some people might not want to know about their medical roots, I took this as an opportunity to safeguard my health and to make changes in my life to help reduce my risk of contracting certain diseases. These days I eat a low-fat, low-sugar diet, minimize my alcohol consumption, exercise regularly and keep a careful eye on stress levels. I have regular medical checkups and cholesterol screenings. Tracing my family medical history was clearly one of the most important projects I ever undertook.