Mike Slabaugh doesn't have a stomach. Neither do his 10 cousins.
Growing up, they watched helplessly as a rare hereditary stomach cancer killed their grandmother and some of their parents, aunts and uncles.
Determined to outsmart the cancer, they turned to genetic testing. Upon learning they had inherited grandmother Golda Bradfield's flawed gene, they had two options: Risk the odds that they might not develop cancer, with a 70 percent chance they would; or have their stomachs removed. The latter would mean a challenging life of eating very little, very often.
All the cousins chose the operation. Doctors say they're the largest family to have preventive surgery to protect themselves from hereditary stomach cancer.
"We're not only surviving, we're thriving," said Slabaugh 16 months after his operation at Stanford University Medical Center in Palo Alto, California.
Advances in genetic testing are increasingly giving families with bad genes a chance to see the future, sometimes with the hope of pre-emptive action.
Slabaugh, who lives in Dallas, Texas, reunited with his many scattered cousins recently in Las Vegas just two months after the last in the group -- Bill Bradfield of Farmington, New Mexico -- had his operation. Several hadn't seen each other for decades while others met for the first time.
"Rather than live in fear, they tackled their genetic destiny head-on," said Dr. David Huntsman of the University of British Columbia, who found the gene mutation in the family.
The form of stomach cancer that runs in the Bradfield family, called hereditary diffuse gastric cancer, is extremely rare with about 100 families diagnosed worldwide.
The CDH1 gene mutation was first discovered in 1998 in a large New Zealand family with a history of stomach cancer. Those with the mutation have a 70 percent risk of stomach cancer.
It killed Golda Bradfield in 1960. She passed the faulty gene to seven of her children. Six died of the disease in their 40s and 50s.
The grandchildren learned of the defective gene after one of them, David Allen, died of stomach cancer in 2003. His doctor had sent a blood sample to Huntsman's lab, which confirmed the mutation.
Soon after, the remaining 17 got tested. Eleven who had the bad gene had surgery.
"I wake up every morning and think, `This is a free day. I get a bonus today,'" Slabaugh, 52, said.
During surgery, doctors remove the entire stomach and surrounding lymph nodes and attach the bottom of the esophagus to the intestine to create a pouch. Without a stomach, patients typically lose significant weight and must eat smaller meals more often.
While the stomachs of all six of the cousins who were operated on at Stanford looked normal before surgery, a study of the tissue revealed early tumor growths, said Dr. Jeff Norton, the surgeon.
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