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Proc (Bayl Univ Med Cent). 2016 July; 29(3): 352.
PMCID: PMC4900795

Book Review: Cancer Family: The Search for the Cause of Hereditary Colorectal Cancer By C. Richard Boland, MD

Reviewed by F. David Winter, Jr., MD, MSc

Bloomington, IN:  AuthorHouse,  2015.  330 pages; hardcover,  $28.99. ;  paperback,  $19.95. . 

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I cannot imagine a stronger motivation to become a cancer researcher than to have most of one's family afflicted with cancer and many of them die prematurely. Fifteen out of 23 relatives in the Cancer Family would be found to harbor a defective gene, and many would die prior to age 50 of colon or endometrial cancer.

A “tightly-knit, highly supportive” Irish-Catholic family, they grew up under a family curse. They were said to be a close family and “when they got together, there was a lot of talking, laughing, singing and obvious love and affection for one another.” However, “the one issue that was not easily discussed was cancer.” This cast a shadow over the family that influenced them in many ways. Dr. C. Richard Boland explains that there were no fights in the family and everyone got along because “they all shared a common enemy—cancer—so why waste the effort?”

Not only was the family curse a threat to their health, but the “nasty history of eugenics” made them uncomfortable talking about their pedigree. Early in the author's research career, one of his professors, not knowing his family history, asked, “Do you think these people should be sterilized?” Controlling his anger, Dr. Boland replied, “I think that people in these families ought to be told about their possible risks, maybe preventive measures can be developed, and moreover, some people in these families might (just might) be productive in spite of their cancer risks.” He concluded the difficult conversation with an exclamation: “Also, this is my family.”

Dr. Boland did not start out to be a research scientist. He grew up in the 1960s with long hair and a healthy distrust of those in authority. A couple of innocent teenage pranks in high school, for which he was dealt disproportionate punishment, reinforced the concept. As with other pioneering scientists, most notably Albert Einstein (1), this skepticism of conventional wisdom would serve him well as he tried to untangle the family mystery.

Married while in medical school, he gives due credit to his wife for keeping him grounded and reminding him “of what things were most important.” Their decision to bear children (they would have three daughters), prior to discovery of the genetic mutation, must have led to interesting discussions.

Haunted by the death of his father to colon cancer, he did not begin his career in research until reaching the “miracle of 30.” He had actually not expected to live past his 20s. “The fact that I had reached age thirty in the context of my family history was a symbolic event for me.” Shortly thereafter, he decided to quit waiting for someone to solve the family cancer problem. His career focus shifted, and he focused on learning how to perform basic research. He found the experience humbling at first, saying that he felt he was “the dumbest guy in the room.” Thereafter, he mastered glycoproteins, learned a lot about genetics, and became an expert in oncogenes, tumor suppressor genes, and microsatellite instability. Along the way, he befriended and trained under a variety of the world's leading scientists. Almost coincidentally, his nephew would come to play a major role in solving the family problem.

The book reads as a mystery with twists and turns along the way. As a caution to the reader, the chapters on the research studies get deep into the woods. Budding researchers and geneticists may find these sections of interest, but others are likely to be overwhelmed. However, even when discussing complicated research, Dr. Boland writes with a jocular flair. You may find his comparison of DNA sequences to Indiana Jones' snakes fully amusing.

The story is also one of perseverance, careful observation, and deduction, though the author humbly gives equal credit to luck. He also illustrates that the pathway to success is anything but a straight line.

His scientific career shares bold experiences with other pioneering researchers. To obtain tissue for investigation, Dr. Boland “took one for the team” and was “sodomized in the name of science.” Actually, it was just a sigmoidoscopy but with a rigid scope. The lesser assaulting flexible sigmoidoscopy was just being developed by Dr. Bergein F. Overhold in 1963 and was not yet in widespread use (2).

Dr. Boland has helped to solve a horrible family affliction. He has also added to the science of genetics. Readers will find his story to be illuminating and engaging.

References

1. Isaacson W. Einstein: His Life and Universe. New York: Simon & Schuster; 2007. p. 551.
2. Legacy Leader Spotlight on Dr. Bergein F. Overhold. Ingenuity News. 2012;2(4):1–3.

Articles from Proceedings (Baylor University. Medical Center) are provided here courtesy of Baylor Health Care System