Pam's Journal: It's In The Genes
November 10, 2002
Editor's Note: 7NEWS Meteorologist Pam Daale is grateful to all of the viewers who have expressed their best wishes as she wages her fight against breast cancer.
Daale has chosen to use TheDenverChannel.com as her way of keeping the public updated on her health. New journal entries will be posted weekly.
When I think about the genetic traits I've inherited from my parents, I'd
have to say the most noticeable things come from my dad. I was always a
tomboy (Mom says I even cut off the bows on my first bra because I thought
they were too foo-foo). I loved driving the tractor during baling season.
One of my favorite childhood activities was to take the syringes that my dad
used for vaccinating cattle and "vaccinate" "sick" crickets with my cousin.
I spent lots of time down by the creek near our house looking for minnows
and bringing home all sorts of plant life. And now as an adult, I hold a
job that is predominately held by men. Mom gave me some good stuff too,
like being able to cook and bake, although I'll never do it as well as she
does.
A couple of weeks ago I discovered something else that I may have gotten
from one of my parents. If you have or know someone who has breast cancer
you've likely heard of the BRCA1 and BRCA2 genes. I have a mutation in the
BRCA1 gene, and it's not 100 percent certain that it came from either parent. It's
possible that I had a spontaneous mutation which means it just kinda
happens.
Yes, my mom did have breast cancer 16 years ago, but hers was very
different from mine, and doctors admit they're a little baffled by that.
And, my mom and I are the only ones on either side of the family to have
breast cancer. (I believe it's about 80 percent of women who get breast cancer
have no family history anyway!) My mom never did the gene test, and it
could have come from my dad too!
So, what does it mean when you've been tested positive for a mutation in one
of the BRCA genes? By the age of 70, you have as much as an 87 percent risk of
getting breast cancer. But wait, there's more. If you have the BRCA1
mutation, your risk of ovarian cancer increases by as much as 44%, and with
BRCA2 it's as much as 27 percent higher. (All my info, by the way, is coming from
a newsletter put out by Myriad genetics of Salt Lake City, UT.)
Okay, so I already have breast cancer. I was in that 87%. What now? Does
it even matter?
YES! Not only is there a high risk of getting one diagnosis of breast
cancer, I also have as much as a 64% risk of getting a second breast cancer.
Now, I never did very well in my statistics classes in college, but even I
can see that those odds don't look all that appealing. Sure there's a
chance I won't ever get another cancer again. But one thing I'm certain of
is that I don't want to have to go through chemotherapy again. I'm not
miserable because of the treatments, but I'm not completely comfortable
either.
What choices am I left with?
1) Do nothing
2) Have a final lumpectomy/lymph node biopsy with radiation and leave
it at that
3) Have a bilateral mastectomy (and reconstruction) with the lymph
node dissection and radiation
4) Have a bilateral mastectomy (and reconstruction) with lymph node
dissection and radiation, and remove the ovaries (oophorectomy)
Obviously, choice 1 really isn't an option.
Choice 2 is a possibility, but I'd have to be very diligent in my self
exams, have more than regular check-ups, and pray that I don't get another
cancer, or that we can catch it so early that I don't have to have chemo.
Choice 3 would give me a much better peace of mind about getting another
breast cancer, but choice 4 all but eliminates my chances of getting either
another breast cancer or ovarian cancer. In fact, if I go with choice #4,
my chances of getting ovarian cancer basically drop to nill because there
are no ovaries to get cancer in. My breast cancer recurrence risk drops to
only about 2%. I'm liking those odds.
I had a consultation with my surgeon last Friday to discuss all these
things. I went into her office thinking I didn't want to be sliced and
diced any more than was necessary. I knew I needed more surgery, but I
wanted it to be as minimal as possible. But after hearing the discouraging
recurrence odds and the ovarian cancer risk, I'm leaning toward option #4.
After all, it's one-stop-shopping! I don't think it will be 3 surgeries for
the price of one, but I do like the idea of getting it all over with at
once.
There's much more to be said on this topic, but I think it will have to wait
for another journal entry. Something else my surgeon said that surprised me
was that unless a newly diagnosed breast cancer tumor is very small, women
are having to go through chemotherapy. Not only is finding your lump early
important to your survival, it's also important if you don't want to have to
go through chemo. So are you getting to know your breasts?!
Until next time...
Pam Daale
The Happy Cancer Patient
You can e-mail Pam Daale at Pam_Daale@TheDenverChannel.com.
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Previous Stories:
-
November 3, 2002: Pam's Journal: Emotional Rollercoaster
October 28, 2002: Pam's Journal: Chemo, Take Three
- October 26, 2002: Oct. 25, 2002: Hero Helps Move Women Through Cancer Journey
- October 22, 2002: Pam's Journal: The Hair Thing
- October 21, 2002: Pam's Journal: An Uneventful Week
- October 18, 2002: Spa, Fitness Center Pampers Cancer Patients
- October 7, 2002: 54,587 Join Race For The Cure
- October 7, 2002: Pam's Journal: The Race
- October 7, 2002: Pam's Personal Race For The Cure
- October 4, 2002: Pam Tells Of Her Chemo Progress
- October 4, 2002: Pam's Journal: Never More Than You Can Handle
- October 1, 2002: Pam's Journal: Chemo, Take Two
- September 21, 2002: Pam's Story: My Battle With Cancer
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