Imagine being told as a child that you carry a genetic time bomb, a condition that could one day turn your body against you. This was the reality for Felicia Lee, who at just 12 years old, learned she had Familial Adenomatous Polyposis (FAP), a rare genetic disorder that causes thousands of polyps to form in the colon and rectum, dramatically increasing the risk of colorectal cancer. But here's where it gets even more compelling: Felicia not only battled this condition herself but also took extraordinary measures to ensure her daughter wouldn’t inherit the same fate. Through the power of in-vitro fertilization (IVF) and pre-implantation genetic testing, she broke the cycle of hereditary suffering. But is this the ethical choice for everyone? And this is the part most people miss: as medical technology advances, who gets to decide where we draw the line between prevention and intervention?
FAP is a silent threat, affecting roughly 1 in 8,000 people worldwide. It’s caused by mutations in the Adenomatous Polyposis Coli (APC) gene, which normally acts as a tumor suppressor, regulating cell growth. Without intervention, individuals with FAP face a nearly 100% risk of developing colorectal cancer, often at a young age. For Felicia, this meant undergoing a prophylactic colectomy at just 15, removing part of her colon to prevent cancer. She even wore a stoma bag to school—a secret she kept hidden under her uniform, a testament to her resilience.
But here’s the controversial part: while Felicia’s decision to use IVF and genetic screening saved her daughter from FAP, not everyone agrees with this approach. Some argue it raises ethical questions about ‘designer babies’ and the potential for genetic discrimination. Should parents have the right to alter their child’s genetic makeup? Or is this a necessary step in the fight against hereditary diseases? We’ll explore this debate later, but first, let’s dive into Felicia’s journey.
Felicia’s story began when her father, a member of the Singapore Armed Forces, was diagnosed with FAP after returning from overseas training. Cascade testing—a process of screening at-risk family members—revealed that Felicia, her younger sister Alicia, and two cousins also carried the mutated gene. This early diagnosis was a lifeline, allowing them to take preventive measures before symptoms appeared. Associate Professor Joanne Ngeow, who heads the Cancer Genetics Service at Singapore’s National Cancer Centre, emphasizes the importance of such testing: ‘Early detection can save lives, especially for conditions like FAP where the risk of cancer is so high.’
As a teenager, Felicia experienced frequent bowel movements and was referred to Professor Tang Choong Leong, a senior colorectal surgeon. A colonoscopy revealed thousands of polyps, some large enough to block her colon. The surgery and temporary stoma bag were just the beginning of her battle. Yet, Felicia’s determination never wavered. She adapted to a new diet, avoiding spicy foods and dairy, and even continued her co-curricular activities, though with some adjustments.
Years later, when Felicia met her now-husband, Cedric Ng, she knew she had to share her story. ‘I wanted him to understand the risks, especially if we were going to have children,’ she recalls. Together, they chose IVF with pre-implantation genetic testing, ensuring their daughter Phoebe would be free from FAP. The process wasn’t easy—two rounds of IVF, a challenging pregnancy, and post-birth complications—but the result was worth it. Phoebe, now one, is healthy and FAP-free.
And this is the part most people miss: Felicia’s story isn’t just about her triumph over a rare disease; it’s a glimpse into the future of medicine. As of October 31, Singapore has expanded its list of approved genetic conditions for pre-implantation testing to 169, offering hope to countless families. But with this progress comes questions: Where do we draw the line? Should genetic screening be accessible to all, or is it a privilege for the few? And what does this mean for the future of humanity?
Colorectal cancer, often called the ‘silent killer,’ is the leading cancer in men and second in women in Singapore, with approximately 1,200 new cases diagnosed annually. Regular screening is crucial, especially for those over 50 or with a family history. Yet, Felicia’s story reminds us that sometimes, prevention goes beyond screening—it’s about rewriting the genetic code itself.
As we celebrate Felicia’s courage and the advancements in medical science, let’s also pause to reflect: Are we playing God, or are we simply using the tools at our disposal to save lives? What do you think? Is genetic screening a step too far, or the next logical step in healthcare? Share your thoughts in the comments—this is a conversation we all need to have.
