Patrick Strudwick had a tumour removed from his large intestine seven years ago, aged 30 . The question, at first glance, seems fairly simple: would you want to know your chances of getting cancer? In particular, whether you are carrying a faulty gene (or even several) that could make cancerous cells or a malignant tumour more likely. But when the opportunity arose to have genetic screening to find out if my DNA was flawed, this question merely triggered more: how would I cope if it turned out cancer was a near certainty? Though certain genetic tests are available on the NHS for people with a clear family history of a particular cancer — for example, if more than two members of your immediate family have had it — the private Spire Bushey Hospital, in Hertfordshire, has become the first to offer full screening for a range of cancers to people who may have had only one or two family members affected. Some genes they test for, in particular the faulty BRCA1 and BRCA2, have received a lot of publicity in recent years. Angelina Jolie discovered she carried a faulty copy of BRCA1, and singer Michelle Heaton found she had a mutated version of BRCA2. They opted for double mastectomies and hysterectomies to avoid the 60 to 90 per cent chance of developing cancer. But this new service screens for dozens of different genes linked to prostate, bowel, breast and ovarian cancers, which are among the most common in Britain, using ‘next generation’ gene technology to provide a full range of results within 12 weeks. There were various reasons why I decided to give it a go. Seven years ago, aged 30, I was lying in a hospital bed, heavily sedated after a colonoscopy to find the cause of months of abdominal pain, when my gastroenterologist delivered the news: . ‘We found an adenoma — a type of tumour — in your large intestine. It was about an inch long, but we managed to remove it.’ ‘OK,’ I replied from the fog of sedation. Though the tumour was benign, the doctor added: ‘The type means that it would likely have become malignant. Had we not removed this, you could have been dead by 40.’ Because such growths are rare for someone so young, I was told I would need to have colonoscopies every three years to (hopefully) catch any further abnormalities. Three years later, a scan found another polyp — smaller, benign, but still, more reason to worry. Another year on and I was lying in another bed, my own, when the telephone rang. ‘They found some cancerous cells,’ my father began. It was his prostate, a common cancer in older men (he was 67) and one with pretty good prospects for survival. But his uncle — my grandfather’s brother — had died of it. And my father’s tumour was one of the most aggressive kinds. He made a full recovery, but the worries lingered. Could there be a faulty prostate cancer gene on my father’s side? My mother was adopted and knows nothing of her family, so might there be bowel cancer genes on her side? Could there be two loaded guns waiting for me? Patrick (pictured) decided to have genetic screening for cancer to find out whether or not he is predisposed to particular strains of bowel and prostate cancer . The final push to take the tests came down to the memory of a dear friend called Beth. Gorgeous, fiercely clever, with a wonderful family and a promising career ahead, she died from malignant melanoma — skin cancer — on her back in 1999. She was 26. So, if there was anything I could do to catch cancer before it caught me, I’d do it, I decided. I booked an appointment with the hospital’s genetic counsellor, Vicki Kiesel. Her hour-long assessment included umpteen questions: ages of siblings, who’d had children, ages of grand- parents at death, who’d had which cancers and when; my medical history, why I wanted screening. Vicki was most concerned about the adenoma. ‘If there is anything in your family to watch for, it would be something called Lynch syndrome,’ she told me. ‘It’s a genetic mistake that makes people more likely to get bowel cancer. With it comes an increased risk of prostate cancer.’ Lynch syndrome can also trigger endometrial, stomach, ovary, brain and skin cancers. If I did have this gene, how great would be the risk of bowel cancer? ‘Up to about 70 per cent,’ she said. Spotting my panicked expression, she told me there were several things they would do to reduce the risks: ‘Colonoscopies every 18 months or so to catch any polyps before they become malignant, and daily aspirin.’ (A recent review of studies on aspirin by Queen Mary University of London concluded that a daily low dose for ten years can reduce the risk of colon cancer by 35 per cent.) ‘After the age of 40 we would also suggest regular PSA tests for prostate cancer,’ she said. If I had Lynch syndrome, my siblings would have a 50 per cent chance of having it, too, so I’d need to tell them. However, Vicki also explained that only 5 to 10 per cent of cancer occurs because of genes — most cancers have an environmental cause. And Lynch syndrome accounts for only 2 to 3 per cent of bowel cancer. The problem, I feel, with all of these statistics is this: they mean nothing if you are one of the few per cent affected. I opted to have screening for every gene we so far know about that can trigger prostate or bowel cancer — 12 genes in total — and went to have the blood taken. For the next ten weeks I refused to think about it, pretended it wasn’t happening and told no one. When I received an email from the clinic saying my results were back and did I want them in person or over the phone, I froze, completely unable to decide. Angelina Jolie (left) discovered she carried a faulty copy of BRCA1, and singer Michelle Heaton (right) found she had a mutated version of BRCA2, they both opted for double mastectomies and hysterectomies . I chickened out and asked for a phone appointment. During the few days before the call, I spoke to Colin Elton, a consultant colorectal surgeon at the Spire Bushey Hospital, to find out his take on how useful these tests might be. ‘There’s not enough awareness among GPs and hospital doctors of the benefits of genetic testing,’ he said. ‘Even if someone does have a family history of one type of cancer, and if they are sent to a genetic counsellor by the NHS, they still might not have the actual testing if the counsellor doesn’t think the chances are high enough. ‘But this screening gives people who might have only one parent or sibling the chance to test — and it’s one of the most common questions family members of cancer patients have: “will I get it, too?” ’ In fact, the NHS might not offer testing because only a small percentage of cancers are caused by genetic problems, says Shane McKee, a consultant clinical geneticist at the Belfast Health and Social Care Trust. He also casts doubt on the screening you can pay for outside the NHS, as family history does not need to be as strong in order to get the tests, which makes analysing the results harder. Another problem is there are likely to be 200 genes responsible for a significant risk of cancer, but we know of only half of them. Patrick (pictured) was incredibly relieved to learn that his genetic screening came back normal although he says he will do everything he can to lower the risks of cancer . Cancer Research UK also advises caution around genetic screening. ‘Knowing that you have certain genetic faults doesn’t always mean there’s any action you can take,’ says a spokesman. But Dr McKee is clear about the benefits of specific genetic cancer tests, particularly for bowel and breast cancers. ‘The objective is to see if we can identify people at increased risk at an early stage, so we can put surveillance programmes in place. Most cancers are treatable if they are caught at an early stage.’ It was this risk reduction that made any lingering doubts about taking the test vanish. I braced myself. Vicki rang with the news. ‘We’ve looked at the 12 genes and they’re all normal.’ ‘Thank God,’ I replied. As I hung up, the relief was almost overwhelming. Later, though, I reminded myself that this only puts me back to similar levels of cancer risk to anyone else and that I might still have a cancer-causing gene we don’t yet know about. I must still do what we all should to lower the risks: keep my weight down, restrict alcohol, don’t smoke and take exercise. I must remain vigilant — for me, for my family and for Beth.
Patrick Strudwick had an intestinal tumour removed  seven years ago . Four years later his father was diagnosed with prostate cancer . Patrick had genetic screening that tests for different types of the disease . His results were returned normal but he will remain vigilant from now on .