The Surgeon General's "My Family Health Portrait" -- a tool developed by 5AM and a team of collaborators -- was recently referenced in the the book "The End of Illness" by David B. Agus. Dr. Agus is professor of medicine and Engineering at USC Keck School of medicine. He is the founder of Oncology.com and served as attending physician and as head of the Laboratory of Tumor Biology at Memorial Sloan-Kettering Cancer Center. In "The End of Illness," Agus suggests that as a society we should change our view of health and wellness, and offers that we have been thinking about our bodies in an incorrect manner. One interesting concept the author addresses is how certain diseases and conditions can be addressed through early detection and changes to habits and lifestyle. Essentially, we shouldn't focus on the late stage solution for a particular condition if it is possible to prevent the condition to begin with. Agus suggests natural behavioral "prescriptions" -- such as wearing a comfortable pair of shoes and eating lunch at the same time every day -- can improve one's health. He also explores the positive and negative consequences of different drugs and the statistics behind the change in death rates of particular conditions over the last few decades as certain drugs have been introduced to the market.
Agus claims that the progress of curing cancer stalled out decades ago and that the only way we can currently fight cancer today is to catch it early -- or prevent it. Our society has been analyzing cancer in order to treat it rather than to prevent it. We should focus on preventing diseases and conditions at an individual level by examining our individual bodies and genetic makeup. Since the history and genetic makeup is much different for each person, our individual risks and preventative measures will be different. For example, a daily glass of red wine may decrease your risk of heart disease, but that same glass of wine may increase your best friend's risk of breast cancer. Personalized health plans should be created on an individual level with one's doctor and be based on many factors, including one's family health history.
Agus goes on to state that DNA says more about our risks than our fate. Just because someone is at higher risk for a certain condition based on a genetic test doesn't mean he or she is destined to have that condition. Understanding your family genetics and history can help you take personalized preventative measures specific to your risks. It is very important to create a family health history by gathering information from blood relatives, even the ones outside of your nuclear (immediate) family. Although it can be uncomfortable to discuss these things with grandparents or aunts and uncles, it could prevent you from having to take invasive tests or start you down a path of wellness that could positively change -- and perhaps lengthen -- your life.
Good family health trees are rare, but Agus notes the importance of capturing family health history to assess risks to certain conditions. The author lists My Family Health Portrait (MFHP) as "a free website--https://familyhistory.hhs.gov--that will help you to create a family health history and share it electronically with relatives and your doctor." MFHP allows users to collect information about their family members and store the information locally as an HL7 file or upload the information to Microsoft Healthvault so that other applications can access to the data. Hughes Risk Apps is currently in the process of integrating with MFHP by using Microsoft Healthvault as a data repository of family histories for patients at risk of breast cancer. The next release of MFHP will feature the ability to get a colorectal risk assessment based on the person's family health history and provide the user with helpful information that they can discuss with their physician. Later this year, 5AM and other collaborators will be enhancing the MFHP tool even further, adding a type 2 diabetes risk assessment calculator.
So don't forget to discuss the topic of Family Health History at your next family gathering or with friends--the outcome could be a lifesaver!
-Brian Pickeral, 5AM Solutions