Gutless, and glad of it

How one family has broken its curse of stomach cancer

Richard Downs

By AMY ADAMS

As a child, Mike Slabaugh watched his mother, aunts and uncles die of stomach cancer. He lived in dread of getting cancer — never marrying and never having children because of his apprehension.

“I felt like this big cloud was hovering over me since I was 13 when my mother was diagnosed,” Slabaugh says.

But at 52 Slabaugh is alive and well, as are all but one of 17 cousins on his mother’s side of the family. And they’ve all stopped worrying about stomach cancer. There’s no way they’re going to get it. They’ve had their stomachs removed.

Over the past few years, the cousins have been tested for the rare cancer-causing mutation that runs in the family. Eleven of them, including Slabaugh, carry the CDH1 stomach cancer gene, and all the carriers had their stomachs removed, six of them at Stanford by surgeon Jeff Norton, MD. “The specter of gastric cancer is gone forever,” Slabaugh says.

The cousins became aware of the mutation that was responsible for their family’s cancer risk in 2003 when the first in their generation died of gastric cancer. Before his death, his doctor sent a blood sample to David Huntsman, MD, at the University of British Columbia, then one of few to offer a test for mutations in the CDH1 gene.

Although the cousin had died by the time the result came back positive, his wife sent a letter to his blood relations. In it she included information from UBC describing the mutation and recommending genetic counseling.

Linda Bradfield in Anaheim Hills, Calif., was among the first to get tested. She and her sisters Rita and Stephanie had blood drawn on President’s Day of 2004. Six weeks later they got the results. Rita and Linda were positive, Stephanie was not.

“I know it was hard for the genetic counselor to tell us,” says Bradfield. “Had there not been something we could do about it, I don’t know if I would have wanted to know.”

Luckily, Bradfield’s genetic counselor had recently heard a talk by the director of the Stanford Cancer Genetics Clinic, James Ford, MD, on preventing cancer in people with their mutation. Bradfield contacted Ford and came to Stanford to discuss treatment.

From Ford, she learned that the mutation conferred a 70 to 80 percent risk of developing stomach cancer. The best defense was offense: Take the stomach out of the equation. Bradfield had hers out Aug. 4, 2004.

Removing a stomach is major surgery, but the cousins have no regrets. “The way I approach life is different now,” Slabaugh says. “I don’t have stress anymore. Why should I?”

During the surgery, Norton attached the bottom of the esophagus to the intestine, eliminating the stomach altogether. Without a stomach, some foods that require a long time to digest, such as salads, fall off the menu entirely. Most other foods are OK in small quantities.

Bradfield says that after a slow start immediately following the surgery, she now eats almost anything. “You learn a different eating pattern,” she says. “You learn to chew, chew, chew.”

The cousins’ experience with genetic testing is one that is becoming more common as research yields increasing numbers of disease-causing genes and as genetics clinics expand their test offerings. They hope their story encourages others to get help. “Anybody with cancer in the family needs to go to a genetic counselor,” Slabaugh says.

Comments? Contact Stanford Medicine at

 Back To Contents