After my father died last year of pancreatic cancer at 72, I found myself thinking about a question that's easy to avoid when you're healthy: How much of my future is already written into my biology?
To find out, I enrolled in an executive health program at Human Longevity, a Silicon Valley clinic that combines full-body imaging, blood testing, and genomic sequencing to assess health risks and longevity. In total, the tests cost about $12,000.
What I learned was both reassuring and unsettling.
Over the course of about four hours, I underwent a battery of tests, including a whole-body MRI, extensive blood work, and genetic sequencing. The upside is that some of the results offered the news I was hoping for.
My MRI scans were clear, my arteries showed no calcification, and best of all, a blood test designed to detect signals from more than 50 cancers came back negative.
At the same time, however, the testing uncovered risks I hadn't expected.
The cancer results mattered most
Cancer was the thing I cared about most going into the process. During my follow-up consultation, I asked Dr. Keon Pearson, a clinician at Human Longevity, about my risk for pancreatic cancer, specifically.
He pointed to two encouraging findings: a normal CA19-9 (Cancer Antigen 19-9) biomarker result and a negative GRAIL Galleri liquid biopsy test, which is particularly sensitive for pancreatic, liver, head and neck, and esophageal cancers, Dr. Pearson said.
The good news was that he told me my test results indicated I had a 99% chance of being cancer-free.
When I later met with a genetic counselor to review my genome sequencing results, I learned that the clinic hadn't identified any of the high-risk inherited mutations it screens for across more than 2,000 conditions. That included hereditary cancer syndromes.
For someone whose father died of pancreatic cancer, that was a relief.
The numbers that surprised me
Some of my results were less straightforward, however.
At 6-foot-4 and 246 pounds, my body mass index measured 30.1 kg/m², which technically places me in the obese category. Pearson quickly pointed out that BMI doesn't tell the whole story.
My body-fat percentage came in at 23.6%, slightly above the clinic's preferred range for men. At the same time, my skeletal muscle index was so high that Pearson told me it was "one of the highest I've seen."
My bone density was also strong, ranking at least in the 84th percentile. My coronary artery calcium score was zero, meaning no calcifications were detected in my arteries that could otherwise raise my risk of heart disease.
Still, there were areas where Pearson said I could improve.
My liver-fat measurement of 3.1% fell within the normal range, but he said it was above what he would consider optimal for longevity.
Then there was the one marker I couldn't simply fix with diet or exercise.
Pearson told me I had elevated lipoprotein(a), or Lp(a), a cholesterol-related particle that is genetically determined. Elevated Lp(a) is associated with stiffer heart valves and a raised risk for heart attack and stroke.
"It's probably six times more dangerous pound for pound compared to LDL cholesterol," Dr. Pearson said.
"It's not sensitive to your diet. It's not sensitive to exercise," he said. Essentially, this number won't budge without prescription drugs.
The DNA results I wasn't expecting
What I didn't expect was my genetic test results.
I learned that I'm a carrier for several recessive genetic disorders, including phenylalanine hydroxylase deficiency, better known as PKU.
PKU is a genetic disorder that prevents the body from breaking down the amino acid phenylalanine and, if not treated, can build up and cause severe brain damage. It's the reason why foods and drinks with aspartame, an artificial sweetener that contains phenylalanine, have a warning label.
Because I carry only one copy of the gene variant, I don't have the disease, and my wife doesn't carry it, so our children were not in danger.
Then we got to the neurological risks.
My genetic counselor explained that I carry one APOE3 gene and one APOE4 gene. According to Human Longevity's analysis, that raises my lifetime risk of Alzheimer's disease above the general population. But all of my grandparents made it to the end of their lives without dementia.
"I will just say that my initial reaction to this is somewhat alarmed," I told the genetic counselor during the consultation.
The report also placed me in the 99th percentile genetically for Parkinson's disease risk. The counselor emphasized that the absolute lifetime risk remained relatively low — about 2.7%.
Then, after all of that, I got one final piece of good news.
I carry a variation of the FOXO3 gene, which researchers associate with a greater likelihood of living past age 90.
That finding immediately made me think of my maternal grandfather, who lived to 98.
The experience didn't tell me how long I'll live. No test can do that.
What it did reveal was something more practical: which risks appear hardwired into my DNA, and which ones still respond to the choices I make every day.
Some of the cards are already on the table. What I do with the hand is still up to me.
