Duke Raleigh Hospital

Give Thanks for Your Health

And take time to start a dialogue about family medical history

By Linda Farkas, MD and Ben Hopkins, MD

Picture this: It’s Thanksgiving, and you’ve gathered with loved ones you may see just once a year. The table is set with the fine china, and a traditional turkey dinner with all the trimmings awaits. Maybe there’s even a fire in the fireplace. You’ve blessed the food, and everyone is ready to dive in, when suddenly …

Grandpa says, “Anyone up for a colonoscopy? Please pass the stuffing.”

Unlikely? Maybe, but it shouldn’t be, according to the U.S. Surgeon General, who has since 2004 declared Thanksgiving “National Family History Day.” The idea is: While you’re gathered with your family for the holiday feast, you may as well discuss illnesses that run in the family and what you can do to combat them.

Illness can be a delicate topic, and our specialty – colorectal cancers – may not be the topic that immediately springs to mind during a special meal. But, this is one conversation that could save lives.

Decorum in your family may dictate that you not blurt out, “How’s your colon?” So, here are a few ways to politely initiate the conversation:

• Go to the internet. (The teens in your family are likely to have their iPhones with them at the table, anyway.) Visit http://www.hhs.gov/familyhistory/ and use the Surgeon General’s declaration as a starting point.
• Get out the old family albums. Looking through photos of dearly departed relatives may bring up stories of how they lived … and how they died. If there’s hereditary illness – heart disease, cancers, mental illness, diabetes, etc. – put it out on the table. Talk about risk factors and how they can be overcome. (They can be overcome.)
• If you used a heart-healthy recipe for the side dish you made, brag about it. Share with your family what unhealthy ingredients you left out, what you substituted and what the health benefits are.
• Make a game of it. Use the online tool called “My Family Health Portrait” to create a family health tree.

Recognize that your family medical history doesn’t mean your future is carved in stone.  Just because heart disease (or colon cancer) runs in a family, doesn’t mean every individual is going to inherit it. Eating well, getting exercise, maintaining a healthy weight, not smoking and getting adequate sleep can help compensate for family history. The proven way to combat family history is recognition and vigilant and frequent surveillance.

For guidelines specific to colon health, know that:

• If you have a first-degree relative (parents, siblings or children) with colorectal cancer, you should start getting screened at age 40 – or 10 years earlier if your relative was diagnosed at age 50 or younger.
• Consider getting a first colonoscopy at age 40 if you have a first-degree relative who developed colon polyps.
• If there is a pattern of multiple cancers including colon, ovarian, uterine, gastric and sebaceous cyst cancers, ask your doctor about getting your first colonoscopy in your twenties.

This holiday season, consider going beyond giving thanks for good food and good health. Talk with your family about hereditary illnesses and what you can all do to prevent them.

M. Benjamin Hopkins, MD, FACS is assistant professor of  surgery in the division of surgical oncology at Duke. Linda M. Farkas, MD, FACS, FASCRS is associate professor of surgery in the division of surgical oncology at Duke. Both physicians are part of Duke Raleigh Hospital’s colorectal health program. Learn more about colorectal screening.