DEAR DR. ROACH: I am a 62-year-old female who weighs 97 pounds and is 4 feet, 10 inches tall. I’m a non-smoker, non-drinker. I’m a mother of three, take no medications and have no medical issues except acid reflux.

My brother died of Ewing sarcoma at 6. My 10-year-old sister died of dysgerminoma. Mom was diagnosed with colon cancer at 47 and died at 52. Dad died of pancreatic cancer at 81 after being in remission from prostate cancer for five years. On Mom’s side, her sister and aunt also had colon cancer.

What screenings do I need? What screenings are needed for my two daughters, ages 41 and 43? My daughters’ paternal grandmother died of breast cancer at 72. My other siblings, a 56-year-old brother and 68-year-old sister, are healthy. — G.T.

ANSWER: With so many cancers in your family, I would strongly suggest a visit with a genetic counselor. The combination of colon, pancreatic and prostate cancer suggests a genetic syndrome, such as Lynch syndrome and BRCA 1 or 2, although your history isn’t classic for either of these. There are many less-common familial syndromes that increase the risk for various cancers, and we are gradually increasing our knowledge of them.

Some of the cancers you mention are not associated with any known syndrome, such as Ewing sarcoma, a primary bone cancer, and dysgerminoma, a rare type of ovarian cancer. It’s possible that your family has just been very unfortunate. Still, I would recommend getting more knowledge about any genetic risk you may have.

With this information, you can learn the right screening strategies for yourself, as well as obtain information that could potentially be valuable to your siblings and children.

Questions about breast cancer and its treatment are found in the booklet on that common subject. To obtain a copy, write: Dr. Roach — No. 1101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. ROACH: I would like to add to the information you gave F.G., who asked for a “healthy structured diet.” There is a wonderful website, www.ChooseMyPlate.gov, where one can enter a little information (height, weight, age, etc.), and get a healthy food plan customized to his or her requirements. If one needs a little more help figuring out an eating plan due to allergies or other medical conditions, another website, Eatright.org, has a link for finding a local registered dietitian. An RD is uniquely qualified to help with the development of a personalized eating plan, no matter what diet challenges one is facing. Eating healthy foods in the correct proportions is vital to one’s well-being, and everyone should know that there is a way to find out exactly what they should be eating. — N.J., RD

ANSWER: Thank you for providing these useful sources of information. I think these are helpful for people to get good information and suggestions about improving diet. I would emphasize that the choosemyplate.gov site is useful, but should be thought of as helpful suggestions rather than a prescription. For example, the emphasis on dairy may be inappropriate for some people.

Even though I disagree with some small points, the general emphasis on increasing vegetables and fruits, making at least half of grains eaten whole grains, and choosing some non-meat forms of protein all are choices that I think are likely to improve most people’s overall health. Professional advice from an RD is very helpful for those needing individualized guidance.

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