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Jacqueline Kravette

Jacqueline Kravette

Posted: November 17, 2010 01:28 PM

"So, Doctor, you're telling me that I have an 80 percent chance of getting breast cancer and a 50 percent chance of ovarian cancer?" I asked.

This felt eerily reminiscent of my early childhood years. I frequently remember hearing my mother ask our relatives, "Can you believe she has to do another round of chemo?" That is how almost every holiday dinner started. Everyone discussed who was the latest person battling cancer and where was she in the treatment process.

For however long I can remember, there was always that ominous threat of the "C" word. I don't believe there was ever a family get-together without the mention of cancer.

My family carries the mutated BRCA1 gene. We ALL have this gene, but my particular family has a mutation on this tumor suppressor gene. There was always a 50/50 chance that I would have BRCA, explained to me by Ora Karp Gordon, MD, Director of the GenRisk Adult Genetics Program at Cedars Sinai Hospital and author of "Positive Results - Making the Best Decisions When You're at High Risk for Breast and Ovarian Cancer." After my mother got breast cancer, I started asking questions. The answers I discovered were daunting and terrifying. My grandmother died at 46, her sisters at 24, 38, and 57 from either ovarian or breast cancer. Only one sister is still alive after many, many bouts with cancer. My grandmother's generation had been riddled with breast and ovarian cancer and it was becoming evident in the next generation. My own mother got breast cancer in her forties; her two cousins had breast cancer (one died at 50) and her sister died at 63 of primary peritoneal carcinoma, a form of ovarian cancer. It wasn't until my great aunt was tested that we knew cancer didn't "just run in our family" but many of us carried the BRCA1 gene. Already in my generation two cousins have had breast cancer.

I tested positive for the BRCA1 gene. This meant that my breast cancer risk was as much as 80 percent but the general population's was 12 percent and there was an over 50 percent risk of ovarian cancer versus a 1.4 percent risk for those without BRCA, according to Gordon. There was not a thing I could do to change that. I was an exercising, non-smoking, vegetarian. I had always been healthy. I was told that it did not matter. The usual precautions that everyone else could take did not affect this gene; I was powerless over my destiny. Apparently this was known as the "Ashkenazi Jew" gene. Incidences of this familial breast and ovarian cancer were found in 2.5 percent of the Ashkenazi Jewish population and that makes up 10 percent of all hereditary cancer, explains Dr. John Jain, head of the Santa Monica Fertility Center. He further clarifies, "Ashkenazi Jews are just the best record keepers ... this gene is actually present in the general population but the Jewish community just kept the best track of it."

Many in my family put their heads in the sand, going to the doctor the way a normal person would for early detection. Others just avoided the topic completely and didn't get tested. I, however, was obsessed with being free and not being a slave to the potential ticking time bomb that could be inside of me.

There were many "choices" that I made after discovering my positive sentence. I braved the uncertain waters stoically and refused to think or feel what I was going through while I was preserving my life. Almost catatonically I went through procedure after procedure to ensure the safety of my body, my life, and my future. Although this is a huge feat, it was still for ME. I was lucky enough to have insurance that allowed me to proceed, a support system that stood by me, and enough of a sense of self to withstand it. But wasn't there something that I could do to help and make sure nobody else would have to go through what I did?

My path of seeking to preserve my own life led me to Dr. Jain at the Santa Monica Fertility Center who is interested in protecting everyone's lives. He is at the forefront of eradicating familial cancer -- and I was to be the first guinea pig.

 
 
 
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03:44 PM on 11/22/2010
Thanks for sharing your story, and I am interested in what preventative measure you are taking with Dr. Jain.

As you pointed out, we all have two copies of the BRCA1 gene and two copies of the BRCA2 genes. Approximately one in 400 women and men have inherited a BRCA1 or BRCA2 mutation, resulting in a predisposition to certain cancers. Among people of Ashkenazi Jewish descent, one in 40 women and men -- almost ten times the number of the general public -- have a mutation.

It is also important to note that although breast and ovarian cancers are most commonly associated with BRCA 1/2 mutations, prostate cancer and melanoma can also occur. That is why is it so important to collect your family health history and learn what it means for your own health.
Jordanna Joaquina, MS, CGC
Co-Founder/Director of Genetics
www.InheritedHealth.com
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Nalini Chilkov
02:26 PM on 11/21/2010
Knowledge of genetic risk factors allows us to practice prevention. The BRCA1 gene is an error in DNA (gene) repair mechanisms. So how to we protect our DNA from damage and help these inefficient repair mechanisms? It is important to look not only within conventional cancer research but also within Integrative Cancer Therapies and develop collaborative evidence based approaches that include the use of herbal medicines and nutraceuticals which we know offer protection to our DNA and can enhance genetic repair. We must use ALL resources and healing technologies to protect women from this deadly genetic trait.
03:39 PM on 11/20/2010
I am sorry to hear about how the BRCA-1 gene mutation has ravaged your family, and placed you at elevated risk for both breast and ovarian cancer. I should note that while the lifetime risk of these two cancers is indeed very high in BRCA gene mutation carriers, there is considerable data showing that the same breast cancer prevention measures that are recommended for other groups of high risk women also lower the risk of developing breast cancer among BRCA gene mutation carriers.

I wish you the best in your quest to remain cancer-free.

Robert A. Wascher, MD, FACS
Author, "A Cancer Prevention Guide for the Human Race"
10:54 AM on 11/19/2010
I would love to hear more about your experience. My maternal grandmother had breast cancer twice and eventually passed away as a result; my mother was diagnosed in her early forties and beat the disease. She tested for BRCA1 and 2, my sister and I were so relieved when her results came back negative. To this day I don't know how I would make the impossible choices you are being forced to make and I would really like to hear the rest of your story. Stay strong.
01:22 AM on 11/19/2010
I knew someone with this gene. Ignorant people were always telling her she "didn't have cancer yet, so why sorry about it?" My Mother is a three time cancer survivor. I can't possibly fathom what you and your family have been through. I hope your stoutness in attacking this issue will smolder a trail for you and your BRca1 successors. The Hufffington Post and the author should be commended for shedding some light on this issue. I'm interested to know how Dr. Jain treats this...
12:34 AM on 11/19/2010
On the frontier of finding individualized solutions to cancers as they arise, is the battle against adrenal cancer. I Am One in a Million - RARE is the personal story of Lisa Penry Hirons’ fight to live. The story is told with her friend, author C.M. Rubin, who lives in New York City. Lisa, who lives in Maidenhead, England, has Adrenal Cortical Cancer. She has had surgery, chemotherapy and has now begun an experimental drug therapy lasting 42 days. There are approximately 600 new cases per year of Lisa’s Cancer in the U.S.(Adrenocortical Carcinoma: ACC), which developed in one of her adrenal glands. The adrenal glands are responsible for making steroid hormones (aldosterone, cortisol and adrenaline) that enable the body to respond to stress. Lisa’s cancer is both very rare and highly life threatening. Adults rarely have obvious symptoms, so they often are not diagnosed until the cancer is large and has spread. Although adrenal cancer can be treated in adults, it usually comes back. Once it recurs, it is almost always fatal.

Dear Cathy:

I woke up knowing I had to take a whole new cocktail of drugs this morning.
Alex said just do it, we’ll get through this together, like we have so far;
other couples have gone through worse and come out the other side and so shall we!

Please read more at www.cmrubinworld.tumblr.com
10:21 PM on 11/18/2010
I really like this article and I knew nothing of this gene before I read it. I would really like to know if more is coming soon? Now you have me suspended and wanting to hear the rest. Thank you for informing me of the BRCA1 gene and I look forward to hearing more.
05:04 PM on 11/18/2010
An interesting and important piece. I think there are many women out there who share your condition - both who suffer silently and who dont even know their own situation.
thebigbike
ran away to be a cowboy
11:04 AM on 11/18/2010
I am sure I'll be pillioried as cruel and insensitive and uncaring. but.. as far as the "family" future goes, what about not having children?
07:03 AM on 11/18/2010
I HAVE to know what happened nex!!
08:38 PM on 11/17/2010
Wow, what a great article! You are a very brave woman, I know I wouldn't have been as strong as you if I was in your shoes. I hope I get to hear more of your story and what you went through. Very inspiring :)
08:30 PM on 11/17/2010
WAIT! Where's the rest? seriously, what are the details of the study that may eradicate the gene? So many need to read this and may want to also participate. Please continue...
06:25 PM on 11/17/2010
You are very brave to have gotten tested and kept your head above the sand. I truly hope for a day where the BRCA1 gene is no longer hanging over people's lives. Tell us - what does Dr. Jain's research involve?
04:45 PM on 11/17/2010
I can't imagine what it must be like to know that you are fighting these odds and witness your potential fate in the family around you. Sounds terrifying.

What is the path to preserve her own life she is persuing with Dr. Jain?

I have clients and friends who also have this gene and I will be passing this article to them, but Im sure they will want to know the specifics of what is out there on this path. Is this an experimental treatment?

I would love if there was more information of this.
04:29 PM on 11/17/2010
Wow! What a great article. I feel for the first time after reading this that I truly understand more about this topic. The writer was fortunate enough to have the type of insurance that allowed this,but I'm sure some people are not so lucky.
I look forward to more articles from this person, she had a great way of keeping it informative and interesting to read as well.