Seven 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 gain that knowledge.
I then completed a National Science Foundation funded program that facilitated my interviewing 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 early disease 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.
With 12 million diagnostic errors made each year, the most common among them missing early cancers and heart diseases, which cost over 100,000 lost lives and $750 billion, Soap Health’s mission is clear: spare people from the pain and suffering of passing from or losing someone to a preventable or earlier identifiable genetic or lifestyle driven adult disease such as cancers and heart diseases, drive down malpractice suits, and improve physician productivity by augmenting physicians’ capabilities to perform in depth risk assessments and improve early disease detection and diagnosis.