Tuesday June 18, 2013
Photo © Getty Images
Melissa Etheridge and Angelina Jolie have a little something in common. Both celebrities carry the BRCA1 gene mutation, which puts them - or others with that mutation - at a higher risk than average for ovarian and breast cancer. That commonality was highlighted during a recent interview that singer/songwriter Etheridge gave to Washington Blade, when she was asked to comment on Jolie's revelation about her prophylactic double mastectomy.
Before we get to that though, let's set the stage for this highly-quoted comment. Etheridge is a breast cancer survivor - diagnosed in 2004 and treated with a lumpectomy and chemotherapy. Who can forget her at the 2005 Grammy Awards, bald and radiant, singing under the spotlights? Jolie is a breast cancer previvor - never diagnosed, no lump, no symptoms, who chose to have both breasts removed to reduce her risk of dying from hereditary breast or ovarian cancer. She has become a poster child for genetic testing (oh my, what a poster!) and hopes to bring greater accessibility to other women who may need a genetic test. Both women have made headlines about their health and lifestyle choices.
Etheridge did not call Jolie a coward for having a preventative mastectomy. Here's the quote: "I have to say I feel a little differently. I have that gene mutation too and it's not something I would believe in for myself. I wouldn't call it the brave choice. I actually think it's the most fearful choice you can make when confronting anything with cancer." Melissa Etheridge is making it clear that each person responds in their own unique way to a breast cancer diagnosis or to getting the results of a genetic test. She went on to say that, "My belief is that cancer comes from inside you and so much of it has to do with the environment of your body. It's the stress that will turn that gene on or not."
Scientists are actually rather tight-lipped about the possibility of a link between stress and breast cancer. We can't just take a biopsy of your stress levels and examine them under a microscope - but we can do that with a core of breast tissue. Dr. Margaret Lewin thinks that people who are highly-stressed may be making bad choices about diet, exercise, and other risk factors which are actually the culprit in raising anyone's risk for cancer. Nobody gets to select their own genes, but they can make healthy decisions about lifestyle.
As far as I can see, there is no Melissa-Angelina fight going on over breasts versus no breasts or even reconstructed breasts. They are just very different people who have been through a hard personal choice, and have gone public about their respective journeys. We can learn from both of them - be proactive about your own health, learn all you can, make well-informed decisions.
Tell your own breast cancer survivor story right here!
Friday June 14, 2013
|X-ray Structure of the BRCA1 BRCT mutant M1775K
A.N., Ladias, J.A., Foulkes, W.D.
In a landmark ruling, the U.S. Supreme Court handed down its ruling on the patenting of isolated human genes, such as BRCA1 and BRCA2 - the mutations which predispose a high risk of breast and ovarian cancer. This breaks a patent held by Myriad Genetics since the 1990s on the breast cancer genes, but does not affect the patents that Myriad holds on the BRACAnalysis test.
Patents are usually granted for inventions, but as Justice Clarence Thomas wrote, "Myriad did not create anything." The company did do research that served to isolate the BRCA genes from other genetic information, and they developed a test for patients who may be at high risk for breast cancer due to a strong family history of the disease, but the human gene itself may not be patented. The court was unanimous in its decision on this issue, while noting that synthetically-produced DNA would qualify for patenting in the future.
This decision throws the door wide open to other doctors, scientists or companies which want to expand their research and use of the BRCA genetic mutations, and hopefully - speed the search for cures for breast cancers. It also means that other biotech companies can develop BRCA tests - and patients will have less expensive options for genetic testing. Myriad's BRACAnalysis test can cost $3,340 - a price that many health insurance carriers will cover - but one that not all oncologists will order, unless there is good reason.
Cheaper genetic testing, more study and use of genetic information, and greater hope for a cure. Thanks Supremes, we're glad you stepped up to the plate and ruled on our behalf. Now let's hope that this helps break the dam on funding and innovation for research and development of better treatments, effective prevention, and the cure.
Tuesday June 11, 2013
|Nipple Delay Mastectomy Incisions
Art © Pam Stephan
Back in May, Angelina Jolie revealed that she had undergone a double mastectomy with immediate reconstruction. She based that decision on her inherited gene mutation BRCA1. Although she had no signs or symptoms of breast cancer, she had lost both her mother, Marcheline Bertrand to ovarian and her aunt, Debbie Martin to breast cancer. One detail that surfaced was Jolie's choice of a nipple delay procedure - surgery that took place about two weeks before her mastectomies.
For women that can safely keep their nipples after a mastectomy, there are several techniques to spare the nipple. A nipple delay is not a routine procedure for a prophylactic mastectomy. Nipple delay, which most women might call "mastectomy delay" is more commonly used for women who have already had some plastic surgery done to the breast, such as a breast reduction mammaplasty, which would leave scar tissue.
A patient who is a good candidate for a nipple delay procedure may have a choice between two sites for her incision. It may be beneath the breast or on the edge of the areola. A plastic surgeon can work to minimize the resulting scar, so that the reconstructed breast looks very natural. The patient will need to observe good scar maintenance after the surgery, and must stop smoking in order to ensure proper healing of the skin. If you're interested in the benefits of nipple-sparing and want to understand more about the nipple delay procedure, here's an article all about different aspects of the Nipple Delay Surgical Procedure.
Monday June 3, 2013
Some reviewers will tell you that Linda Crill's book, Blind Curves, is about rebellion. It speaks otherwise to me: of recovery and reinvention. Sure, it looks hot and risky for an attractive 57-year old widow to slip on leathers, throw a log over a hog, and roar off along the Pacific Coast. But let's put this in context.
Linda has been on both sides of the cancer war - as caregiver to her husband of 12 years, and as a breast cancer patient. Bill was diagnosed with a deadly form of cancer in his lungs and given a short time to live. Linda stuck with him until the end, after which she tried to grieve and start over. Eighteen months later, she hadn't made much progress, so she took action. She asked herself: "What will make your heart sing?" This question resulted in a sort of bucket list that included: learn to ride a motorcycle. It didn't fit the old Linda and it wasn't safe or comfortable. This decision required a transformation from the outside to the inside. She took a class, got the right clothes, borrowed a bike, and went off with 3 friends on a 10-day road trip. Every foot of the way, she faced challenges and emotions that she could not run away from - but this sparked her recovery as it resulted in her personal reinvention.
Blind Curves takes you along on Linda's journey - both the winding road of the Pacific Coast as well as the twists and turns of a wise and vulnerable heart. If you've ever tried to recover from a cancer diagnosis, or been a cancer caregiver, this book will have something that speaks to you. Life is such an unpredictable journey, with so many risks and choices. As one of her fellow travelers observes, "But it's facing the fears and overcoming them that gives us the freedom to experience life."