Family Cuts Out Stomach Cancer Curse

Aug. 2, 2006 — -- It's known as the "Bradfield family curse," and it all began when Grandma Golda Bradfield and her children began dying one by one.

At first, Golda Bradfield's grandchildren, including sisters Kitty Elliot, Diane Sindt and Connie Gasaway, didn't understand how so many of their relatives could die of the same disease -- stomach cancer.

They were part of the third generation -- 19 cousins -- and all of them wondered who would be next.

Then in 2003, David Allen, the sisters' cousin, was diagnosed with stomach cancer.

Just days before he died, however, Allen left his cousins a gift in an effort to break the family curse and solve the medical mystery.

That gift was a vial of blood.

Allen's doctors took his blood and sent it to an expert -- David Huntsman, a genetic pathologist at the British Columbia Cancer Agency, who has decades of experience looking at families with hereditary cancer.

Huntsman was determined to solve the puzzle.

However, isolating one fault on the human genome is meticulous work that takes hours, days and weeks of painstaking precision.

Finally, the Huntsman team spotted the "spelling mistake": a mutation on a gene known as CDH1 that affects fewer than 100 known families in the world.

Grandma Golda Bradfield would never know that she had passed down the gene for one of the deadliest types of gastric cancer.

"If you carry one of these mutations and you do nothing about it, you have a 70 [percent] to 80 percent chance of dying of stomach cancer. By the time you know you have it, it's almost invariably too late to do anything about it," Huntsman said.

Because the gene is dominant, the remaining 18 Bradfield cousins had a 50/50 chance of inheriting the fatal mutation.

When the results came in, more than half -- 11 of the 18 -- were positive, including Elliot, Sindt and Gasaway.

There was one radical solution -- having their stomachs surgically removed. It seemed impossible to live without a stomach, but apparently, you can.

The stomach is a reservoir where food is broken down by digestive juices. When the stomach is removed, the small intestine is brought up and attached to the esophagus.

The top of the intestine then forms a pouch that holds and digests food just like a stomach -- only in smaller quantities.

As dramatic as it sounds, it was the only way to save their lives.

In the end, the 11 cousins who had tested positive for the mutation, including the three sisters, had their stomachs removed.

The operations took place a few days apart by the very same surgeon -- Jeffrey Norton, chief of surgical oncology, Stanford University Medical Center, Stanford Comprehensive Cancer Center.

The surgeries were just in time. The Bradfield stomach cancer is so sneaky, the sisters never knew until after their surgeries that hundreds of cancer cells and early tumors had been hiding in their stomach linings.

With a 70 percent to 80 percent chance of developing stomach cancer, the operations had saved their lives.

Still, living without a stomach isn't easy.

The sisters must eat small meals filled with nutrients several times a day, and avoid foods that are hard to digest, like raw vegetables.

Ironically, now, the sisters can't eat enough. For them, the challenge is to take in sufficient calories to keep weight on. Those who have stomach surgery usually drop to 15 percent below their recommended body weight and then stabilize.

Gasaway lost the most dramatic amount of weight -- more than 150 pounds.

"So, health-wise, there was a silver lining in all of this for me," Gasaway said.

For Gasaway, the curse has a longer reach. Her 23-year-old son, Brad -- Golda Bradfield's great-grandson -- tested positive for the deadly gene.

Doctors say he needs to have his stomach removed before he turns 30. That's tough for a welder whose favorite meal is steak.

In the future, gene therapy may be the solution to altering cancer genes.

In the meantime, the Bradfield family has a message for all of us: If cancer runs in the family, have it checked.