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I'm less of a mess today re: my uncle than I was on Wednesday, but it still sucks. Latest update is that he's expected to live only a few more days. Cancer's a real shitter. And for the record, here is the family roundup:
Great-grandfather M—died of liver cancer, age 68, about 1976.
Grandfather B (M's son)—died of liver cancer, age 71, 1995.
[Grandmother A—died of leukemia, age 69, 1994. (Also had a sister who died of leukemia at about 16 in the 1930s.) This may or may not be related to the 100% incidence of cancer in her children, below.]
Aunt E—died of pancreatic cancer, age 58, 2003.
Father—died of esophageal cancer, age 64, 2012.
This uncle—beat colon cancer about 1994; dying of pancreatic cancer as we speak, age about 65, 2015. (That's right: it will have taken two kinds of cancer to kill him.)
So it's hard not to conclude that my cousins and my brother and I are doomed, you know what I mean? On the one hand, half our genetic material comes from their dad and our mom, respectively, so maybe we'll all have dodged that particular bullet. On the other hand, half my dad's and his siblings' genetic material came from their mother, and they all got GI cancers just like their father and his father anyway. So far there doesn't seem to be any genetic marker for the types of cancers that have laid waste to half my family tree—but isn't this too many people to be a coincidence? (Okay, n=5. BUT STILL. Non-drinkers, either non-smokers or never smoked heavily and quit in the 70s, and the cancers haven't been in the lungs, brain, skin, breasts, or repro areas—only in the GI tract. What is up with that.)
I said to my husband, heads up, this might mean I've got about thirty years left. Maybe by the time I get my cancer in my mid-60s they'll have come up with much better treatment options and my prognosis won't be as grim as everyone else's. What I'd like even better, though, is screening. The trouble with the GI cancers (besides their virulence—or, related to it, I guess) is that there's so much space in the abdominal and chest cavities that they have tons of room to grow and you don't know they're there until it's much too late to do anything about them. What we need is some kind of (ideally minimally invasive) annual-ish scan, like a full-body mammogram, that will have half a chance of finding things they don't like when they're still at a stage where they can be removed with a nail clipper and a swab of liquid N2. But if there is such scanning available, it probably relies heavily on radiation, right? And injudicious amounts of radiation may cause one or more of the types of cancers you're trying to look for and nip in the bud, right?
I can't win.
Great-grandfather M—died of liver cancer, age 68, about 1976.
Grandfather B (M's son)—died of liver cancer, age 71, 1995.
[Grandmother A—died of leukemia, age 69, 1994. (Also had a sister who died of leukemia at about 16 in the 1930s.) This may or may not be related to the 100% incidence of cancer in her children, below.]
Aunt E—died of pancreatic cancer, age 58, 2003.
Father—died of esophageal cancer, age 64, 2012.
This uncle—beat colon cancer about 1994; dying of pancreatic cancer as we speak, age about 65, 2015. (That's right: it will have taken two kinds of cancer to kill him.)
So it's hard not to conclude that my cousins and my brother and I are doomed, you know what I mean? On the one hand, half our genetic material comes from their dad and our mom, respectively, so maybe we'll all have dodged that particular bullet. On the other hand, half my dad's and his siblings' genetic material came from their mother, and they all got GI cancers just like their father and his father anyway. So far there doesn't seem to be any genetic marker for the types of cancers that have laid waste to half my family tree—but isn't this too many people to be a coincidence? (Okay, n=5. BUT STILL. Non-drinkers, either non-smokers or never smoked heavily and quit in the 70s, and the cancers haven't been in the lungs, brain, skin, breasts, or repro areas—only in the GI tract. What is up with that.)
I said to my husband, heads up, this might mean I've got about thirty years left. Maybe by the time I get my cancer in my mid-60s they'll have come up with much better treatment options and my prognosis won't be as grim as everyone else's. What I'd like even better, though, is screening. The trouble with the GI cancers (besides their virulence—or, related to it, I guess) is that there's so much space in the abdominal and chest cavities that they have tons of room to grow and you don't know they're there until it's much too late to do anything about them. What we need is some kind of (ideally minimally invasive) annual-ish scan, like a full-body mammogram, that will have half a chance of finding things they don't like when they're still at a stage where they can be removed with a nail clipper and a swab of liquid N2. But if there is such scanning available, it probably relies heavily on radiation, right? And injudicious amounts of radiation may cause one or more of the types of cancers you're trying to look for and nip in the bud, right?
I can't win.
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I'm wondering whether a genetic counselor could advise you a little more concretely, just from the medical perspective. I have a branch of the family where a certain cluster of cancer types are highly prevalent and they have had some genetic counseling help that's been good and has given them some strategy in terms of testing and such. Just throwing the idea out in case it seems like it might be worth checking out.
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I would also suggest not waiting until 50 for your first colonoscopy.
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