Tag Archives: Genetic Testing

How Important is Family History

We have all been to appointments and been asked hundreds of questions about family history. It is annoying and something that I didn’t pay much attention to until recently. History is used to know if you are at a greater likelihood of certain diseases such as heart disease, diabetes, and even some cancers. I want to talk specifically about knowing your family history of cancer.

At the very beginning of the IDC journey, I was asked about family history relating to cancer. I had to have conversations with both my parents to learn that, as it turns out, every one of my biological grandparents had cancer. All different types and all at different stages in their lives. Are they related? Does that make me more prone to getting it myself? I had so many questions.

The most recent bought with cancer my family faced was my maternal grandmother. Though she was never officially diagnosed, that I am aware of, we believe that she had and most likely died from breast cancer. I was upset for a long time that she had hit a lump and opted to never tell anyone because she didn’t want treatment forced on her. I battled internally with anger and thinking how selfish that was for those down the line genetically. I was able to let go of the anger and hurt, but it took time. Even sometime after she had passed. It is not something I have openly discussed, even with my mom. I have mentioned it at times and told her if she ever did that to me I would slap her. I hope that we have an understanding now!

Anyway, I get the reason she kept it a secret. Treatment is hard. She was ready to go home. She didn’t want the brutal fight. I respect that. What I didn’t respect at the time were the potential implications that would have on her daughters, grand-daughters, and great-grand-daughters. Had there been a definite known history of breast cancer I might have been screened at an earlier age. I did unofficially know and I could have said something to my doctors, but I didn’t. I do not blame her for my cancer. I do not blame her for me not getting a mammogram until now. That I somewhat blame on science. They said I was too young for cancer and didn’t need routine mammograms until 40.

I say all that to share what I have learned in the past two months about family history and genetics. The first appointment I had with my oncologist we discussed genetic testing. She agreed that due to my “young” age and a family history of cancers in the reproductive system it would be wise to be tested. The testing was simple. We worked with a genetic counselor to do a family tree. In that, we outlined everyone in my immediate family going back to my grandparents. This would include my grandparents, my parents, aunts and uncles, my siblings, and all our kids. She asked about known cancer for each person and we put that in their box on the tree. We then went and had a simple blood draw done. The test was looking at, I believe, 95 different genetic markers known to be associated with cancer. 95!

The results took a few weeks to come back. At that time we discussed with the counselor how very few come back positive. I may have my numbers all wrong, but I believe she said that only 19 percent of cancers are genetic. The rest are caused by environment or unknown reasons.

When the results came back they showed that I was negative for all genetic cancer markets. My cancer was not genetic. I was relieved. There are a lot of important people in my life and I was happy to know that I and, most likely, my siblings, did not carry genetic cancer genes. We cannot say whether my nieces and nephews do or do not because they will have very different DNA. We cannot even be 100 percent sure my brothers do not, because even though we share the same parents, their DNA is unique. But the likelihood they do is very small.

To sum it all up, my cancer is not genetic. All the family history of cancer is more than likely just a coincidence. We have no way of knowing for sure. All I can advise you to do is ask your family about the history of cancer in your family. If you feel there is a lot, or even if there is just one case, ask your doctor about genetic testing. It can be tricky to get insurance to cover the cost, but it might be worth an out-of-pocket expense to piece of mind.

The genetic counselor did say that people who are adopted or do not know their family history are actually easier to test because the leg work done before in gathering all the information is not needed. If you have no idea what your history is, go be tested. It may help provide answers.

MRI results and Treatment Plan

The MRI was complete and I was back home by 9:30 am. I was very tired due to the Xanax I had taken so I laid around the rest of the morning and everyone finally convinced me to stop dozing on the couch and move to the bed. I slept several hours and woke up feeling some refreshed but was groggy most of the day.

Around 2:00 that afternoon Dr. B called me. I was a bit surprised that it was the actual doctor, but I am beginning to see that is common in this clinic and I love that. She told me that the MRI results were back and the breast was much what we were expecting. The left was clear and looked great. The right “has a lot going on, but we knew that”. Then she said something I wasn’t expecting. “The MRI shows some suspicious spots on your liver”. What? My liver? She quickly stated that it was probably nothing, but we should further investigate. This was a bit of a blow, but I refuse to think negatively. I am trying to not worry unless I have factual evidence of something I need to be worried about. Dr. B said she would schedule an abdominal CT and I still needed to meet with the oncologist later in the week.

Thursday comes. Time to meet a new doctor. I was scheduled to see Dr. K at Texas Oncology. She would be overseeing the actual cancer treatment. I was more nervous about this appointment than I thought I would be. I already knew it was cancer. I already knew it was Stage II, but I was still nervous about what the oncologist would say. When we arrived we were quickly taken back and into another conference room. Chris has a way of making things manageable by cracking jokes and talking about anything other than why we are there. He knows what I need and when I need it. (Funny story coming to a future post)

Dr. K came in and we jumped right into things. She first asked how I was handling the diagnosis. I told her that part of me was relieved it was “only stage II”. It feels so weird to say that, but it is truly how I feel. She started off by going over the MRI results in more detail. She brought up the issue with the liver and said we needed to cross ever T and dot every I, so I should have the abdominal CT and a bone scan as soon as we could get insurance approval just to rule out that the cancer had spread. In the way she talked, this is just a formality and that she doesn’t believe it has left the breast, but we won’t know until those results come back. I told her how frustrating the waiting was and that I wanted to get an answer as soon as possible. For the past month it was been have an appointment, wait a week, and I’m over that. She completely understood and said we would do this as quickly as possible, but we would be proceeding with the plan as if the cancer has not metastasized. That works for me. I just want to get this ball rolling.

She talked a lot about working towards “a cure”. She said that if the cancer is still confined to the breast and even the lymph nodes, a cure can happen. If the cancer has spread to the liver or anywhere else, we can treat, but there is no cure. So we have to pray that it has not spread!

We then moved into discussing the type of cancer I have and the treatment plan that would work best. Every cancer is different and there are several different types of breast cancer, each needing a specific type of treatment. My specific cancer is Estrogen receptor positive (ER+) Progesterone receptor positive (PR+) and HER2 negative. This means that my cancer is fed off of estrogen and progesterone. She told us that I would need surgery, chemotherapy, radiation, and hormone therapy. Initially we didn’t think radiation would be needed, but based on the size of the cancer, she said radiation would be in my best interest. I will go in more detail as each phase begins, but in general the treatment plan is:

Surgery, a single mastectomy, slated for September 16. I have opted out of any type of reconstructive surgery at this point due to the length of recovery and extra doctor visits required in reconstructive surgery. While in surgery for the mastectomy they will insert a port to be used for chemotherapy. I will have, hopefully, a one-night hospital stay and come home the next day.

I will be allowed about a week and a half to two weeks of recovery from the surgery before chemo starts. There are three different chemo medications I will be given, in two phases. Two medications every two weeks for four cycles (Two months).. The third medication will be given every week for 12 weeks (Three months). The start of each round of Chemo will be based on my blood counts and if they are low then chemo will be postponed until they go up. It may not be exactly five months to complete chemotherapy.

After chemo is complete radiation will begin. The frequency of this caught me off guard. She said it would be Monday through Friday for six and a half weeks. WHAT?!? It is a total of 30 treatments. It sounds like so much, but they told us that the treatment is very fast. “It takes longer to walk back to the room than it does to do the treatment”. A month and a half of daily visits is doable.

If everything goes as planned and there are no complications, I should be complete with chemo and radiation in six and a half months. This puts me finishing around mid-April.

The final step is hormone therapy. She said that in the first phase of treatment she would put me into temporary menopause to stop the estrogen production in my body. This would be a monthly injection. Then I would be on a hormone medication that is a daily pill. The length of that treatment is dependent on ho well it works. The second phase of hormone therapy will then take away the monthly injection and I will have a different type of oral hormones to take. The entire hormone therapy treatment will last 10 years. TEN YEARS! I am okay with this. I’m sure it will be interesting seeing how my body deals with the hormones and I’m sure there will be unpleasant side effects, but if it keeps the cancer from returning, it is worth it!

You may be asking what’s next? First up is genetic testing and then pre-op appointments for surgery. Genetic testing is already underway and I will tell about that entire experience when the results are in. I had the blood drawn on Friday and it takes two to four weeks. I am looking forward to seeing what my DNA has to say about my cancer risks. And I look forward to sharing with all of you what I have learned about our DNA throughout this process.

With this post you are now up to date! I cannot promise that I will get a blog post up the day of appointments, but Chris and I will get updates out as soon as awe can.

Prayer Request: A friend recently went through a cancer journey of their own. They asked everyone to set an alarm on their phone and pray for them at a specific time each day. They chose their birthday as the time to set the alarm. I really like this idea. I am going to ask you all to set your alarms for my 8:11 am or pm or both and pray for me and my family. Specifically, pray that the CT scan and bone scan come back normal and that the cancer is confined to the breast. Pray for my boys who have many questions and are learning what is to come with their mom. The older boys are old enough to know what is going on, but baby boy won’t understand why mommy can’t pick him up and take care of him post-surgery.

Cancer is about more than just the patient. So many in my life are going through this battle with me and they need prayers just as much as I do. Thank you all for following this journey. Thank you for the cards, calls, texts, emails, social media posts, and comments on this blog. I feel your support and know that your prayers are being heard! God is already doing great things through this journey.