About

Six years ago, one of my older brothers, a practicing cardiologist, was diagnosed with two primary cancers a week apart. One year later he was gone. His cancer workup revealed he had a BRCA2 mutation, the gene mutation commonly associated with breast and ovarian cancer, but also associated with male breast, prostate, kidney, and pancreatic cancer, as well as melanoma. This should have come as no surprise given that my father’s two sisters, our aunts, and one of their daughters, his niece and our first-cousin, were all diagnosed with early breast cancer in their 30s, 40s, and 50s. In addition, our father was diagnosed with prostate cancer at age 79, alone not a major red flag. But it did surprise us because no physician had ever inquired about my brother’s and even till today, my now expansive (12 cases in all) family history of cancer. If a doctor had, and he or she understood the clinical significance of such early age cases of breast and other cancers on one side of the family, that doctor may have instituted increased surveillance, which could have found my brother’s cancers earlier when effective treatment may still have been possible.

Fortunately, I don’t have the mutation, not that any doctor has ever bothered to ask. However, it is ironic that my brother was diagnosed with hereditary cancer while I was the Chief Medical Officer of a primary prevention medical clinic in Florida and was widely touting the impact of lifestyle over genetics for living longer and healthier to tens of thousands of people through TV, radio and speaking presentations. My brother’s diagnosis gave me pause to reconsider my attitude toward genetic predispositions and a realization of the need to better understand the science. It also made me really ponder why doctors didn’t collect detailed family medical histories. After my brother passed, I closed my clinic and went to Stanford to pursue gaining that knowledge.

I recently completed a National Science Foundation funded program that allowed me to interview 25 primary care physicians from Florida to New York to California. They described how hard pressed they are for time to collect detailed family histories and perform valid risk assessments. Basically, they shared that very few of them are collecting sufficient family history to fully assess risk, and even among those trying to do so, the doctors admitted they are not doing it well. They collectively all know they need help if the situation is going to change and would be excited to embrace a solution that is clinically validated, integrated into their workflows, and easy for their patients to use.

This is why Soap Health is a mission-driven organization. We want to spare others from the pain and suffering of passing from or losing someone to a preventable or earlier identifiable genetically-driven adult diseases such as cancer and heart disease by enabling genetic risk assessment to take place in the 250,000+ U.S. primary care practices.