A Family Affair

25 Nov 2015

By Linda Farkas

This Thanksgiving has given me much to reflect on;  myself changing jobs, my husband and I moving across country, one daughter completing her first year out of college and living in New York City, another daughter graduating from college and considering her next step, and a third  daughter deciding on where to attend college so she can change the world.  I find these transitions within my family to be gratifying and exciting!

This is also the first Thanksgiving after many years in which I have “no patients” as I transition to my new job. In previous years, in the 2-4 weeks prior to Thanksgiving, I would spend time determining recipes, finding time to shop, and figuring out where we would be for dinner.  In all these years, I would practice “traditional” Thanksgiving endeavors. But this was also the time of year I encouraged all of my patients and their families to discuss family health.

As a colorectal surgeon, I see many patients in their 60’s-80’s succumb to colorectal cancer. Yes, the great majority of these patients never had a colonoscopy at 50.  However, since my fellowship, I have heightened concerns for my 30-40 year old patients with cancer.  

While we were aware of the clinical diagnosis of Lynch Syndrome and Polyposis Syndromes, we did not have genetic testing until recently. Even with this screening technology, disease recognition still primarily requires a known family history to be truly preventative. The ultimate goal is to direct unaffected but at-risk patients to cost-effective individualized surveillance programs proven to saves lives.  This effort requires cooperation amongst the family.  

Thanksgiving is symbolic of traditions across America, but it was also declared as National Family History Day by the Surgeon General in 2004.  Over the next few months, as families gather, this is a ripe time to discuss the family tree.  Family discussions should not be exclusive to cancer, but also premature coronary artery disease, aneurysms, etc.

The US Department of Health and Humans Services has a printable form available in English and Spanish at https://familyhistory.hhs.gov/. This form should then be shared with respective physicians to assess any appropriate changes in screening to allow longer healthier lives for all at-risk patients.

Too often I hear from my patients with Lynch Syndrome:

“I knew my father had colorectal cancer. If I had known my aunts/uncles/cousins/grandparents had endometrial/colorectal cancer at < 50 years of age, then I would have…

  1.      started my scopes earlier.
  2.      done the “right tests”
  3.      prevented my cancer.”

I also agree with these comments. Therefore, this is the season to begin a new tradition by discussing our family trees with our families, if we have not already done so. We should extend this practice to our patients by encouraging them to do the same in these next months. Health is not achieved by our individual attempts to maintain our weight, exercise and avoid smoking–it is a Family Affair.

Linda Farkas Headshot


Dr. Linda Farkas is a faculty member at Duke Raleigh Hospital and Duke University Hospital practicing as a colorectal surgeon.  She received her medical degree from Loyola University Chicago Stritch School of medicine and has been in practice for 26 years.  

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