Why do you need a Medical Family Tree? Your medical family tree records your family's health history, and can help you make informed decisions for health. In the course of creating your medical family tree, you must remember that only health professionals can accurately interpret and counsel you about your cancer risk. Even family trees that show several occurrences of cancer do not automatically imply high cancer risk. Your physician, often with the help of the cancer genetic professional, and determine the risk indicated in your family tree. You can gather the facts that will eventually show whether or not you and your family may be an increased risk for cancer. After you know your likelihood of cancer, you can decide what should be done about it. Getting Started To begin building your medical family tree, explore the health history and health habits of your family through four generations: you, your children, your brothers and sisters, your parents, and both your maternal and paternal grandparents. Include your aunts, uncles, cousins, nephews and nieces in this process too. Include miscarriages and children who died at a very young age. The facts about your own generation will probably be easy to uncover. You know your medical history and you can ask your siblings some basic questions that will tell you what you need to know about them. Learning about your parents, grandparents and other ancestors is likely to be more difficult. You may want to try to find and talk to your "family historian." Know your past, protect your future. He or she will probably have family documents and interesting family stories that may shed a lot of light on your family's medical history. If it appears that a pattern is starting to be uncovered, this information could be important. Medical histories can be documented through health records, birth certificates, death records, school papers or military records. You can use the worksheet to help you gather the following basic information. You should copy and complete a worksheet for each blood relative. 1. Name and relationship to you. It is also important to note if the person is a blood relative (like a half-sister or brother), or if you are related through adoption (like a step-sister or brother). 2. Date of birth and birthplace. 3. Nationality, occupation, marital status, name of spouse, maiden name. These pieces of information will help with tracing other important documents that assist with tracking health records and specifically, birth and death certificates. Some occupations may increase the risk of cancer and other health problems. 4. Date, age and cause of death. Finding out if a member of your family died of illness, or died in an unusually young age from a certain illness, is among the most important medical information you can collect. 5. General health history. 5a. Child-bearing history, birth defects, death of a child, mental retardation, miscarriage, etc. If any of this history is discovered, it's important to share this information with your family physician because it may be important to future generations. 5b. Behaviors. Try to find out if any relative smoked or drank excessively. 5c. Typical Diet/Activity Level. Diet is an important indicator of a person's health. For relatives with cancer, take note of high-fat, low fiber diets, for example, or of someone who lived a sedentary life. 5d. Surgical Operations. Certain surgeries in their cause may indicate serious underlying health problems. For example hysterectomy may be performed for uterine cancer or for abnormal bleeding as a woman ages. 5e. Health Problems/Age of Onset. Please include all health problems but recognize there is an important difference between something like a broken arm and a long term illness like colon cancer. If you do discover a cancer diagnosis in the family, the following information should be gathered. What type of cancer was diagnosed? In what organ or other part of the body did the cancer start? Who was your relative s physician? Where was your relative treated? Did your relatives develop other cancers? How old was your relative when the cancer was diagnosed? Is your relative still living? How old are they or how old were they when they died. 5f. Physical Description. Physical characteristics can be significant. Obesity, for example, is a basic risk factor for certain cancers and some other diseases.
Full Name: Relationship: Date of Birth: Birthplace: Ethnicity/Nationality: Religious Background: Occupation: (Heritage may have some effect on genetic structure.) Marital Status: Name of Spouse: Mother s Maiden Name: Date of Death: Age at Death: Cause: General Health History Number of Children: Death of a Child: Birth Defects: Other: Number of Miscarriages: Mental Retardation: Mental Illness: Behaviors: (i.e. smokes, drinks) Typical Diet / Activity Level: Physical Description: (Height, Weight, Complexion) Health Problems / Age of Onset / Duration of Problem: (i.e., Colon cancer; age 60; 5 years )
Drawing A Family Tree The medical family tree works best when drawn in the block style as shown below. In the family tree, each family member is drawn. Females are represented by circles; males by squares. When two people are in a relationship, (i.e. marriage), or horizontal line is drawn between their symbols. When the couple has children, a vertical line connects them with their offspring. Any blood relatives directly connected by a line are considered first degree relatives (parents, brothers or sisters, and children). Patterns of inherited illness in firstdegree relatives should always be discussed with a doctor. Any blood relatives who are two lines away are considered second-degree relatives (grandparents, aunts or uncles, nieces or nephews, or half siblings). Risk of inherited illness is related somewhat to their experiences, but not as much as that of first-degree relatives. However if both first and second degree relatives have a similar illness, this developing pattern may significantly increase illness risk. Inherited illness and third degree relatives, such as great-grandparents, gradients, great uncles or first cousins, is of interest but mostly in the way it helps define the family pattern.
What Does It All Mean? You have created a tool that can be used by your entire family to work with healthcare professionals to identify important patterns. These patterns may show you her other relatives whether or not there is an increased risk of developing cancer and other serious diseases. Family Patterns I think I'm at increased risk now what? Families with: One first-degree relative (parents, siblings, or children) with any of the red flags listed below. Example: a father with breast cancer. To first-degree relatives with any cancer. Example: a sister and mother both with breast cancer. Red Flags You can look for "red flags" in your own medical family tree. These flags may specifically signal an increase cancer risk for you and other family members. Cancer that occurs at an unusually young age. Example: prostate cancer at age 38, when it usually occurs at age 60 or older. Cancer that occurs in multiple primary sites within the same Oregon. Example: different tumors in the colon and different sections of the colon. Associated cancers and several close relatives. Examples: (1) breast cancer and ovarian cancer; (2) colon cancer, uterine cancer and ovarian cancer; (3) melanoma and pancreatic cancer; for breast cancer in thyroid cancer. A primary cancer occurring in paired organs. Examples: one breast cancer occurring in both breasts; to I tumors in both eyes. An individual who has had two or more primary cancers. Example: ovarian cancer diagnosed after breast cancer. An individual who has been diagnosed with a hereditary cancer syndrome. Example: Familial Adenomatous Polyposis. A rare or unusual tumor type. Example: Cancer of the small bowel or male breast cancer. An individual with 35 or more moles (not freckles). Ancestry of Ashkenazim Jewish/Eastern Europe. It's very important that you follow up when your concerns about your medical family tree. As we just discussed, chances are you have nothing to worry about, so it's better to find out then spend a lot of time worrying about nothing. When you talk to your physician, point out the patterns and "red flags" you see in your family history and explain your concerns. If your health care professional feels you may be at an increased risk, he/she will discuss the implications of this information. Many recent scientific research findings have made cancer genetic assessment and advice very complicated. You may wish to discuss your family history with the specialists, such as a physician or genetic counselor. These are offered as examples, not a complete list. If you discover any of these patterns or "red flags" in your family history, and don't panic! If you have questions or concerns, talk with your physician. Inheriting an increased risk to develop cancer, or some other serious disease, is rare. If there's a strong pattern in your family, recent scientific discoveries can help identify and guide high-risk
individuals.