Last year, my primary care doctor suggested I take a MyRisk cancer screening test to evaluate my hereditary risk of developing several different types of cancer. Even though I was a little surprised, I shouldn’t have been. My mom died in 2001 from pancreatic cancer. It is the fourth leading cause of cancer-related deaths in the United States and has a survival rate of only 9%. While the exact causes of pancreatic cancer are not fully understood, research has shown that genetics play a role in the development of this disease. So, the suggestion by my physician to get a genetic cancer screen was reasonable. My feelings about getting the test completed, however, were tremendously complicated.
First, let me tell you about my mom. She was an amazing woman: intelligent, tough and supportive. Unfortunately, my mom did not know this about herself. As an older adult, I can see now how unhappy she was. I think this largely had to do with her poor health. Cancer was not her first brush with life threatening critical illness, it just happened to be her last.
My mom started having heart problems before I graduated from high school. From there, her health was one heartbreaking event after another—heart attacks, surgeries, vascular disease, more surgeries, diabetes—complications from diabetes. We spent a considerable amount of time in hospitals and clinics. She took a myriad of medications, had frequent, various wound care therapies, and was going blind. All before she was 60 years old.
Growing up, the rationalization, “bad genes,” was visited often. Thus, the subsequent poor health and chronic disease were inescapable. My mother often expressed her sense of powerlessness. To her, good health was a genetic gift bestowed upon a few. Even though, I, too, believed this for a long time, there is increasing evidence that suggests the state our health is not simply a product of our genetic code. Our health is more complicated than a biological algorithm of inevitability.
While genetics play a role in an individual's risk of developing certain diseases, it is now understood that lifestyle choices can have a significant impact on gene expression and overall health. Epigenetics is the study of how environmental factors, such as diet, stress, and exposure to toxins, can affect gene expression and influence the development of diseases, including cancer. Over the past several decades, advances in technology have allowed researchers to study the epigenome, or the complete set of epigenetic modifications on an organism's DNA. These modifications can affect how genes are expressed, and they have been linked to a variety of diseases and conditions, including cancer, diabetes, and neurological disorders.
There is growing evidence that lifestyle interventions can modify genetic risk profiles. One study published in the journal Nature Communications found that a healthy lifestyle, including a healthy diet, regular physical activity, and not smoking, was associated with changes in genetic risk scores for several types of cancer. Another study published in the New England Journal of Medicine found that lifestyle interventions, such as a Mediterranean diet and increased physical activity, were associated with a reduction in genetic risk scores for cardiovascular disease.
These positive choices are not specific to preventing cancer but all the biggest “killers” like cardiovascular disease, stroke, diabetes, and neurological diseases. Regardless of my genetics, my future health is the accumulation lifestyle choices I make daily. I will be “turning off” cancer genes with deliberate and consistent whole food, plant-based nutrition, cardio and strength training activity, effective stress management, avoiding toxins, social engagement, and sleep hygiene.
The ability to affect gene expression with proven, healthy lifestyle choices is my superpower!
I am stronger than I thought. I will decide what the rest of my life looks like. I am building a solid foundation on which “bad genetics” will not thrive! I often wish I could go back in time and tell my mom about her superpower and remind her of her strength. I wish she would have had the knowledge I have to build a happier, healthier, longer life.
I miss her.
So, did I take the MyRisk test? I did. I don’t know the results; I don’t need to know because I am more powerful than I thought.
References:
Nature Communications. (2019). Lifestyle and genetic risk scores for cancer. Retrieved from https://www.nature.com/articles/s41467-019-09186-4
New England Journal of Medicine. (2013). A randomized trial of a Mediterranean diet and a Mediterranean-style diet enhanced with nuts. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMoa1200303Meaney, M. J., & Szyf, M. (2005). DNA methylation: the nuts and bolts of memory. Journal of Neuroendocrinology, 17(4), 179-186.
Jones, P. A., & Baylin, S. B. (2002). The fundamental role of epigenetic events in cancer. Nature Reviews Genetics, 3(6), 415-428.
Weidner, C. I., Lin, J., Dhabhar, F. S., & Blackburn, E. H. (1998). Stress-induced changes in lymphocyte DNA methylation: a possible mechanism for the effects of stress on immune function. Psychosomatic Medicine, 60(3), 236-242.
Bird, A. (2007). Perceptions of epigenetics. Nature, 447(7143), 396-398.
Jaenisch, R., & Bird, A. (2003). Epigenetic regulation of gene expression: how the genome integrates intrinsic and environmental signals. Nature Genetics, 33(Suppl), 245-254.
Jones, P. A., & Baylin, S. B. (2002). The fundamental role of epigenetic events in cancer. Nature Reviews Genetics, 3(6), 415-428.
Maher, E. R., & Carson, J. L. (2009). Epigenetics: basic mechanisms. Cold Spring Harbor Perspectives in Biology, 1(1), a001607.
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