Cancer. It seems so prevalent. Or it does to me, considering both my grandmothers have gotten breast cancer, making it more likely that I will one day get breast cancer as well. And considering going through my news feeds, about 1/4 of the topics are about cancer in some way, shape or form. Two things are making me write this blog now. First, a study that just came out of Israel about BRCA genes (I'll get to that later, don't worry), and my shadowing experience on Monday.
I shadowed a radiation oncologist on Monday. So basically, I followed around a physician that prescribes radiation treatment following the diagnosis of cancer. I somehow managed to call the only woman radiation oncologist in the city (there are apparently six total), and so most of her patients are breast cancer patients. I got to see a lot of women dealing with the after effects of getting this cancer.
But one intrigued me the most. She hadn't had chemotherapy yet, because they hadn't yet determined whether or not she needed it (long story there, I'm not going into it), so she was planning on radiation treatment just in case she didn't get chemotherapy. Well, she was also getting her cancer cells screened for the BRCA genes.
There are two BRCA genes (1 and 2), and they code for an increased susceptibility in getting breast cancer, as well as ovarian cancer. The physician I shadowed said that she once had a patient that got breast cancer, then later got a completely new ovarian cancer, and that made it highly probable that she had both genes, though she had never been tested. Many women, I've heard, opt to get double mastectomies (complete removal of the breast tissue) upon hearing that they test positive for one of the genes. Many insurance plans will not cover breast cancer in women who choose to keep their breasts after hearing this news. As such, it's a very life-changing test to get.
This makes me wonder. I might have a breast cancer gene, considering both my grandmothers have gotten the disease. If I get tested, my insurance may refuse to cover treatment, should I test positive for the genes and refuse to give up my breast tissue. That's an incredibly scary possibility. Especially with the high cost of treatment. Surgery to remove the cancer tissue, chemotherapy to kill other cancer cells, and radiation treatment to prevent it from coming back, plus physical therapy to keep my muscles working. Then there's complications like lymphedema (swelling of the arms) and other pains.
Should we put that much stock in two genes that may or may not cause cancer? Especially since the survival rate could mean a better chance of survival with these genes? Or will these findings change the way the genes are looked at all?
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My first point I'd like to make (that I made in an entry last year) is that there would be a whole hell of a lot more research done on the topic if the BRCA 1 gene weren't patented.
If I remember correctly, the BRCA 1 gene tends to cause breast cancer in Ashkenazi Jewish women (of course this is based on research I did last year).
But you do present an interesting predicament: if you do get tested and test positive. Is pre-emptive treatment worth it if it only might be a chance? I think our vice president would say yes...
--Mike
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Those damn patents... They made medicine more expensive and prevent use of so many research methods...
That would certainly explain why the article I read was very specific about picking Ashkenazi women out of Israel.
Genetic testing is just very iffy all together. Too bad I've never actually had to deal with these predicaments first hand... they'd make great ethics essays for my applications...
~C
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As the daughter of a family with cancer in the genes, this sort of thing is pretty interesting. Genetic testing might be super awesome, especially if it can be done pre-birth... but what if it is found? What does a person do? If our current governing puppet has his way, abortion will be illegal. Even in the case of dire need. Who suffers?