11 cousins give up stomachs after genetic testing

updated 1:54 p.m. ET June 23, 2006

LOS ANGELES - Mike Slabaugh doesn’t have a stomach. Neither do his 10 cousins.

Growing up, they watched helplessly as a rare hereditary stomach cancer killed their grandmother and some of their parents, aunts and uncles.

Determined to outsmart the cancer, they turned to genetic testing. Upon learning they had inherited Grandmother Golda Bradfield’s flawed gene, these were their options:

Risk the odds that they might not develop cancer, with a 70 percent chance they would; or have their stomachs removed. The latter would mean a challenging life of eating very little, very often.

All the cousins chose the life-changing operation. Doctors say they’re the largest family to have preventive surgery to protect themselves from hereditary stomach cancer.

“We’re not only surviving, we’re thriving,” said Slabaugh 16 months after his operation at Stanford University Medical Center in Palo Alto.

Advances in genetic testing are increasingly giving families with bad genes a chance to see the future, sometimes with the hope of pre-emptive action. People have had stomachs, breasts, ovaries, colons or thyroid glands removed when genetic tests showed they carried a defective gene that gave them a high risk of cancer.

But what about people whose families don’t have these rare, but powerful genetic defects? Experts say that someday, doctors may do DNA tests as routinely as they check cholesterol levels now, spotting disease risks that can be lowered. That day isn’t here yet, but progress is being made.

“We do not yet have a general DNA test that fits into that category, but we’re headed for it at a pretty good clip,” said Dr. Francis Collins, head of the National Human Genome Research Institute.

Predicting your health
By 2010, there might be several such tests, along with recommendations to help high-risk people avoid certain diseases, he said. (In fact, newborns are routinely tested now for some genetic conditions, but those tests generally focus on substances in the blood rather than DNA.)

To come up with a useful DNA mass-screening test, it’s not enough to identify a particular gene variant that raises the risk of a disease, experts said. There are other questions:

• Are there enough potential cases in the general population to make mass screening worthwhile?
• Is there good evidence that screening would improve health?
• Is the risk of disease high enough to make the test result useful?
• How useful is the test in various ethnic groups?
• Is there a way to lower the disease risk?

For now, “mass screening with DNA testing isn’t quite ready for prime time,” said Dr. Ned Calonge, head of the U.S. Preventive Services Task Force, which recommends steps people can take to prevent disease.

Who to test
The task force recently recommended against routinely testing women for harmful mutations in BRCA genes. Those mutations raise the risk of breast and ovarian cancer. But it endorsed such testing for women whose family histories show certain suggestive patterns of cancer — a situation like stomach cancer in the Bradfield family.

Slabaugh, who lives in Dallas, reunited with his many scattered cousins recently in Las Vegas just two months after the last in the group — Bill Bradfield of Farmington, N.M. — had his operation. Several hadn’t seen each other for decades while others met for the first time.

They gambled, went to shows and dined in the City of Sin.

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