PICTURE OF HEALTH; FAMILY MEDICAL HISTORY MAY PROVIDE OUNCE OF PREVENTION.

Byline: Phil Davis Staff Writer

Cancer was Carol Daus' secret bogeyman.

Breast cancer threatened her mother, lung cancer killed her uncle at age 33, and there were whisperings in the family about a great-grandfather who died of stomach cancer in Germany. She wondered about her own risk.

What were the odds the diseases in her family's past could be passed down through the generations? What ``bad'' genes had her children inherited?

The 40-year-old free-lance medical writer spent a year interviewing relatives and tracking down death certificates to draw up a medical family tree that she hopes will help her steer clear of her family's genetic epitaph.

``After doing all this work, I realized that it is clearly heart disease - not cancer - that is my biggest enemy here,'' said Daus, who works out of her home in Huntington Beach. ``I lost my dad at age 59 due to a lot of heart-related problems. My mother also has high blood pressure. And my brothers both have high blood pressure. Then, as you get into my grandparents, all of them had heart disease and all of them died young.''

This wasn't just a personal quest. Daus compiled her efforts into a 240-page book - ``Past Imperfect: How Tracing Your Family Medical History Can Save Your Life'' (Santa Monica Press; $12.95) - that provides a detailed road map for other amateur family medical sleuths.

It's a hot topic. Interest in genealogy, charting a family tree, exploded in recent years as the Internet made accessing old records and finding lost people easier. And scientists are making breakthroughs in advance treatment of diseases such as colon cancer, diabetes and high blood pressure that can be passed down through the generations. Would-be parents frequently consult genetic counselors to assess the risk of passing a trait down to their children.

Monica Alvarado, a genetic counselor at the University of Southern California's Norris Cancer Center, said knowing about past illnesses in the family is invaluable to current and future generations who can alert doctors to be on the lookout for problems.

``It's something I encourage all parents to do,'' Alvarado said. ``I think family history is one of the areas that has been ignored by primary care physicians because we didn't fully understand the role genes played in common diseases. I think it's really about empowering yourself and your children. If you have that knowledge, you have the tools to do something about it.''

For example, a person with a history of colorectal cancer in his or her immediate family - a mother, father, sister or brother - has an increased chance of contracting the disease. But with early screenings, instead of waiting until age 50, there's a chance the cancer can be ``nipped in the bud,'' Alvarado said. Cancer treatments are most effective when the disease is in its early stages.

Be wary. Plunging into the past can expose some frightening possibilities.

``It does open a can of worms,'' Daus admitted. ``If you are dealing with cancer or Huntington's disease (a hereditary brain disorder), there are tests available to see if you have the gene. That takes it a step further. Do you want to know? For me, I would want to know. But it's a tough one.''

In a few cases, the choices are very tough. Some women with a family history of breast cancer choose to undergo a mastectomy, removal of the breasts, before there are any signs of the disease. It's a radical and controversial way to fight the disease.

Tracing the family medical tree is time consuming. Daus said she spent the better part of a year tracking down distant relatives and sending for various records. Medical records - especially mental health records - are tough to get. And there's usually some resistance from relatives who find medical questions too personal. Other afflictions, such as mental illness or alcoholism, are often taboo subjects.

``I think generally there is some level of discomfort in my family about, why learn something you don't want to learn? What good will it do?'' Daus said. ``Some of these relatives I hadn't talked to in quite some time. So to pick up the phone and ask them very personal questions, you have to really explain why it will benefit them as well. Fortunately, my family and I saw eye to eye.''

Another serious pitfall: inaccuracy.

``I think it's wonderful when people want to look into their family history, but they need to do it carefully,'' said Michelle Fox, genetic clinic coordinator at the University of California, Los Angeles. ``There's a lot of misinformation. There's the skeleton in the closet syndrome. The myth about what is wrong with someone in the family is often just that - a myth.''

For example, a relative who was mentally retarded might be described as having Down syndrome. A picture often proves that wrong because people with the syndrome have distinctive features. Pictures can tell a lot.

``To do this right, it's going to take a lot of time,'' Fox said.

Medical records are far more useful than family hearsay. Since privacy laws and ethics prevent doctors from sharing that information, it's up to a family member to go through the difficult process of obtaining the records.

Fox said it normally isn't useful to search beyond grandparents because medical records older than 25 years are nearly impossible to find. And Daus found in her research that ``softening of the brain'' was often used to describe dementia. Different terminology can make a proper diagnosis tough.

State public record laws also vary. Death certificates are usually available, but most states keep close tabs on birth records. Medical records are released only to the immediate family, so it's tough even to obtain a grandfather's medical records, let alone those of an uncle.

The good news is that the popularity of genealogy sleuthing means there are plenty of places to turn for help in finding record stockpiles.

``People start out in this for a lot of reasons, but once you've started, you're hooked,'' said Jane Mueller, head of library operations at the Southern California Genealogical Society in Burbank. ``When we start people in this, we tell them to start with themselves and their parents. You go from what you know to what you don't know. You try to get all the vital records you can.''

Daus and Alvarado suggest starting the search at a family reunion. It's the fastest way to talk to lots of people and recruit allies in the hunt for sometimes intimate information. The results can be shared within the family.

At a minimum, genetic counselors say everyone should compile medical information on themselves and their children. Keep a medical diary to document serious illnesses and allergies and get copies of the family medical records if you change doctors or move.

The information could prove useful as scientists continue to learn more about the mysterious relationship between genes and diseases.

``It's certainly the wave of the future,'' Fox said.

Daus found the hunt very satisfying. She doesn't see the discovery of a history of heart disease as bad news. It's one of those illnesses that can be fought with diet and exercise. She's watching what she eats, trying to cut down on stress and will probably start getting cholesterol screening for her three children sooner rather than later.

``It's not like I have a death sentence here,'' Daus said. ``I just feel that this is a guide in terms of what can go wrong. The unknown is what's scary. I think I learned more about what I shouldn't be afraid of - cancer. And heart disease is something I can have some control over. Some people might think this is frightening, but in the end it was just the opposite.''

CAPTION(S):

3 Photos

PHOTO (1 -- cover -- color) The Tree of Life.

(2) While investigating her family's medical history, Daus, lower left, was surprised to learn that heart disease poses a bigger threat than cancer to her health.

(3) Carol Daus - with sons Zach, left, and Michael and daughter Amanda - turned her year of research into ``Past Imperfect: How Tracing Your Family Medical History Can Save Your Life.''

David Sprague/Daily News