Prioritize health conversations with family members


Conversation around the dinner table doesn’t often include questions about personal health history. But according to UCLA genetic counselor Naghmeh Dorrani, there’s room for more family discussion about health.

That’s because despite the amazing advances in genetics, “The most important tool for genetic counselors continues to be family health history,” Dorrani says.

You may want to investigate whether a disease in your family — including certain cancers, amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) or diabetes — has a genetic link and could be passed on to you or your children. The results could indicate a need for precautions such as more aggressive screening.

In that case, your first step shouldn’t be a visit with a genetics counselor. “Going to a counselor with a phrase like, ‘I think my uncle had cancer, but I’m not sure what kind,’ is the equivalent of looking for a needle in a haystack,” Dorrani says.

Broach the subject of health privately Instead, your first step needs to be a conversation with family members. For some families, this is easy. Asking an open-ended health question could lead to hours of conversation. But for families that tend to be more private about sharing personal information, you might have to be a bit savvier to get answers.

“In these situations, consider pulling a family member aside and asking questions from your perspective,” Dorrani says. “Introduce your concern by saying, ‘I’m worried I might be at risk for cancer and wondered if you could tell me a little bit about what you went through.’”

If you aren’t close enough to the family member in question, solicit the help of another family member to help ask the question. Hopefully the door will open and you can dig deeper:

  • What were your symptoms?
  • At what age did symptoms start?
  • What is the name of the disease you were diagnosed with?
  • What kind of treatment(s) did you have?
  • Do you know if other family members had/have the disease?

Speaking with a genetic counselor Now that the hustle and bustle of the holidays has dwindled, make an appointment with a genetic counselor. Prepare to provide this additional information:

  • Your family tree (how many aunts and uncles, siblings, etc.)
  • Family ethnicity
  • Geographic origin of your family
  • Your insurance information

“After gathering information and talking with you, the counselor may have an inkling about what test(s) may be appropriate,” Dorrani says. “Typically, the person who has the disease will need to be tested so geneticists can look for a gene variant that may be related to the condition. After this step, other family members (including you) may be tested to look for the gene variant.”

This year, plan to make health conversations a priority. Once you’ve gathered the right information, the UCLA Division of Genetics will help you assess your risk for an inherited disease.