Wednesday, November 10, 2010

Third Time Is A Charm

In families with a long history of breast cancer, there commonly exists an inherited genetic mutation which increase a person's susceptibility to breast and ovarian cancers.  These are known as the BRCA1 and BRCA2 genes.  From my layman's point of view, these genes are responsible for ensuring that there are no defects in a cell's DNA after that cell divides.  If there is, these genes commit cell suicide and thereby prevent it from replicating the damaged DNA further.  In people with defects in the BRCA1 or BRCA2 gene, this tumor suppressive behavior is damaged and that allows for the unregulated growth of cells, which is how you would characterize cancer.

Not long after Linda was diagnosed with breast cancer, she was tested for the BRCA1 and BRCA2 mutations and it came back negative.  It was a huge relief not only for her but also for our daughter who would likely have inherited this trait also.  Had it come back positive, a bilateral mastectomy and complete hysterectomy, along with chemo and radiation, would have been the proper course of therapy to minimize her risk of recurrence.

In the absence of the BRCA defects, and the initial IIB staging, our course was neo-adjuvant chemo, a lumpectomy, more chemo and radiation w/ chemo.  However, when the cancer came back a second time in the summer of 2009, a full bilateral mastectomy was the right path to take.  At the time, due to the nature of the 2nd cancer, Linda's oncologist suggested that something "odd" was going on in Linda's body which was forming these tumors.  Although she was BRCA negative, there may be some other gene defect that science has yet to discover causing the cancer.  She suggested that Linda think about a hysterectomy to reduce her risk of ovarian cancer which is closely associated with BRCA+ breast cancers.

Never being one to shy away from a fight, Linda decided to have a hysterectomy in October of this year.  We were happy with our allotment of progeny and the baby factory had long since shut down after her first chemo so this decision was purely a prophylactic measure to remove the parts where this cancer could grow.

Two weeks after surgery, on Oct 16th, while enjoying our Saturday morning coffee in bed, we received a call from Linda's ob/gyn surgeon.  They found a 2mm cancer in her right ovary.  She said Linda must have someone looking out for her because by the time they usually find ovarian cancer, it is too late.  Her decision to have the hysterectomy may indeed be the best decision she's ever made (aside from her decision to mate with me of course).  Dr M. hooked us up with the city's top ob/gyn oncologist to discuss our next steps and set the appointment for early November.

We met with Dr. T yesterday.  The first thing we learned was that this cancer wasn't a metastasis of the breast cancer.  Over the intervening 3 weeks, the thought of a Stage IV breast cancer metastasis literally kept me up at night, so it was a relief to hear that.  The second thing we learned was that they almost never see ovarian cancers at this early stage.  It was so early in fact that they have had a hard time figuring out what kind of cancer cells these are.  The initial pathology has identified them as both "border-line" and "clear cell", which according to the oncologist doesn't make sense.  They are either/or, but rarely ever both.  He has sent the tissue to Baltimore for a second opinion.  From our 1 hour long meeting, we learned that "border-line" ovarian cancers are non-invasive whereas "clear cell" cancers are high-grade and aggressive.  He believes that the second pathology will come back as "border-line" but can't make a final diagnosis until he gets the results back in 2 weeks.  He also believes that even if it is "clear cell", we caught it early enough that it hadn't had a chance to, as he put it, "sprinkle its seeds around the abdomen like a dandelion".  In either case, he doesn't think chemo is in our future, unless it comes back as "clear cell" which may introduce that option.

So we sit here and wait to see what our future holds.  We have beat cancer twice before, and with Linda's courage and your thoughts and prayers, I have no doubt we will beat it again for a third time.

1 comment:

Anonymous said...

Cured of TNBC!
I want to take this time out as a cancer survivor to encourage women out there still suffering from this with my story on how i got a cure. The sad news about it is that i was diagnosed on my 36th birthday in 2008 and with stage 3 TNBC which after i made research was a very aggressive form of cancer at that point i decided and told myself i was going to die and that the end has finally come. All my life i never thought of having breast cancer because i was very active and i worked out at the gym several times every week and my diet was okay. In my search for a cure after 6 years of diagnosis and even after chemo which i did twice spending thousands of dollars but to no avail, until a church member told me all about Dr Aleta a herbal doctor that specializes in treating TNBC, who could help me with a permanent cure, i doubted this at first but i later gave it a try following her methods and instructions. It took 3 months and after it all i felt normal but still went for diagnosis and i was clean today i am proud to say i am a cancer survivor no nodes and i am totally free the new diagnosis confirmed it. Do not die in silence or ignorance reach her on don't be shy just speak to her today.