Genes: The lock and key to our destiny

As this issue is aimed at the role genes play in getting breast cancer, maybe we should look at the subject not as scientists, but consider what genetics means to us. We often consider people’s luck, behaviour and their social status when assessing their ‘good’ or ‘bad’ genes.

When loosely discussing genetic coding, we often hear or say things to cement what we believe. I am sure we all know some of them: “look at the mother to see what your wife will look like”; “he has bad blood in him”; and “she is so lucky, she got her father’s eyes”.

Only an uninformed fool would not see how genes affect and impact so many aspects in our lives. We look for genetic similarities in our children, our siblings and our family finding comfort that we belong because and we feel it is important to pass on our history and qualities to the next generation. However, there is a flip side to the coin. Things we would have preferred not to inherite also get included in the deal.

By 2012 it was established that 1 600 genes have been implicated in 1 221 conditions containing 23 144 variants, of which 65 were likely to be pathological variants which may play a role in causing disease. 

Inheritable breast cancer from the BRCA1 or BRCA2 mutation is amongst them. Does this mean our genetic coding is set in stone – is our unique code also our destiny? Before we all rush out to have our genes tested, we must remember that as a society, we have instinctively known this forever.

Society has chosen so many ways to remind us of our family history, be it our surname or our social and cultural lineage.  It is ridiculous to ignore the obvious medical risk resulting from of our family heritage, be it cholesterol, diabetes or cancer.  I believe genes are like cards in a hand of bridge. The cards we are dealt do not automatically make you a winner or a loser, a large part of it is how you choose to play the hand. So, what should we be doing? I am not talking about the medical and genetic counselling mandated by a risk of familial disease, I am talking about the things we can do to educate ourselves.

The first thing we can do is engage with others in the same boat, or with those who are researching why it is leaky. In a study on how we deal with genetics, 97% of those surveyed thought that it was important to know your family health history, but only 30% had ever collected health information from their family members!

There are thousands of books on beating the odds in a casino, yet we ignore the best chance we will have to beat the odds impacting our longevity. Lessening the chance factor in the genetic game of dice is a safe bet. Finding out about your family history is something you can do.

Apart from the fact that we are personally the most able and directly involved, a quest to find our roots can be quite an education. As an armchair detective, connecting the dots may give you ammunition and tools to affect your life. Having a common genetic history means you can share info on research, trials on drugs, you could even be part of the process of fleshing out the global understanding of a condition and more importantly, be part of a support base for others grappling with similar issues.

Although you may not personally reap the fruits of this process, people who are linked to your family could be helped. We must remember that the stud of family genetics is a double-edged sword, on the one hand you can benefit if you know your family history, on the other hand it means you have to share it with them to get the whole picture.

How ironic the way genes are both the lock and the key of our destiny.

The second way to be enlightened is just as logical. Dietary and carcinogenic factors will change some disease processes by preventive modification, but others will be inevitable. This seems to me, exactly what our moms meant when we were told to eat our vegetables!

Epigenetics (the other ways to express our genes apart from the DNA) is able to explain how identical twins with the same genetic makeup could differ so vastly. The environment could switch on or off the expression of our genes. We know that if you are pre-programmed to get a genetic disease no amount of wheatgrass smoothies will change that, but making the reasonable choices to try and not add further risks to your children will.

These epigenetic factors are believed to be the messengers linking generations even before the conception of the next generation. A diet including vitamins can now be directly linked to whether some genetic diseases will be switched on or not in an offspring yet to be conceived.

In addition, there are a few other things we can do to alter our lot in life. Clean living, exercise and helping others appear to be the cornerstones of life. Who saw that coming?

When Madiba had his DNA tested and his genetic code analysed in 2004, with surprising results, it was to show South Africans how similar, and  different we are at the same time. The Genome project is trying to use genetic and computational technologies to analyse historical patterns in DNA from participants around the world, in order to better understand our human genetic roots. If only for the purpose of whiling away an hour (waiting for a doctor or a bus) the fascinating world of genetics beyond medicinal reasons is worth following.

Here are some resources if you need further info:

www.southafrica.info/mandela/origins-centre-150306.html

www.youtu.bedTCj9tC1Pw

www.youtu.be/toRIkRa1fYU

Maybe there is truth in the adage: Family is not important.

MEET THE EXPERT

Rev. Doctor Gereth Edwards was a practicing plastic surgeon, co-founder of the Netcare Milpark Hospital - Breast Care Centre of Excellence and the Breast Health Foundation. He then refocused his life and qualified as a minister. He writes from both a scientific and humanities view.