What is my cancer risk? I wanted to know...

I went to NUH's Cancer Risk Assessment Clinic today. Two of my siblings currently have non-small cell lung cancer that has spread to the brain.

The elder of my two sisters (she died in the mid-1990s aged 62) had leiomyosarcoma, a rare cancer that affects soft tissue such as that in the intestines. My eldest brother, aged 74, was found to have pancreatic cancer last year and he died in the same year, although the cause of death was pulmonary embolism.

So that makes it four cancer siblings. Only two siblings have not been found to have cancer. I am the youngest.

So, what is my risk?

The "good news" is that there was not enough evidence to show a genetic profile. The senior consultant I saw, from the Department of Haematology-Oncology, patiently explained that, since all the sibling cancers were late-onset and not all the same type, there did not appear to be a "cancer gene" that runs in my family (my parents died of other diseases, not cancer).

Still, four cancers in the same family is cause for vigilance and she was careful to add that such a cancer gene cannot be ruled out -- just that the state of the art in medical science could not easily detect it. I could, say, go for a cat-scan of the lungs but she advised that such a scan -- with its attendant radiation -- was usually recommended for heavy at-risk smokers.

She discussed the p35 gene which normally acts as a tumour suppressor and which, if damaged or mutated, can provoke cancer. Lest I, a non-medical person, give the wrong info about the p35 and its connection to something called the Li-Fraumeni syndrome, here are two links which I found useful:

http://www.rcsb.org/pdb/101/motm.do?momID=31

http://www.bioinformatics.org/p53/introduction.html

What should I do? She said it was good that I will be having a PSA test later this year (I have an enlarged prostate), and urged me to do a colonoscopy by next year, the fifth anniversary of the one I did in 2008. Other than that... the usual, ie, exercise, healthy food (Oh dear, what about my char kway teow? She shook her head), etc.

Vital signs should be monitored, as should appetite and any change in bowel habits.

Ditto for my siblings -- who are all very much over 50 years old -- who should also continue to have appropriate blood tests and screenings at the recommended intervals. For us, if "it" happens, the idea is to catch it before it spreads.

The next generation, ie, our children, as they get into their forties and fifties, should make it a point to have such tests and screenings done as a matter of course. For them, prevention is better than cure.

I have another appointment with the good doctor in six months' time.