Saturday, February 19, 2011

Mouthwash and genetic testing, an interesting combination.

Two things worthy of note. I had another breast MRI this morning. You remember, the one where you lay on your belly with the girls hanging through these medium-sized holes and they shove you into a tube where you lie with your arms stretched up above your head. This one wasn't so bad as the first one. First of all, this time when I walked into the room, there were two women standing there waiting for me. That was refreshing. There are women that work in Radiology after all! And second, this time I didn't have a needle lodged in my chest. It's not so comfortable to lie on your stomach with one of those.

I should have results on Tuesday. I'm really interested in these, they they will indicate even better than the mammogram I had a few days ago how well the tumor responded to the chemo treatment. I asked my oncologist what would have to happen for me to get out of radiation treatment without increasing my risk of recurring cancer in the years to come. She said that I would need a "complete pathological response." That means that basically, when they do the mastectomy and test all that breast tissue and the lymph nodes they pull, that they are unable to find any Cancer cells left at all anywhere. That's what we're shooting for. That the chemo took care of everything. I'll still need to do the mastectomy, but I'll get out of radiation. It's already looking good considering the fact that the mammogram showed absolutely nothing, but then a mammogram shows nothing on a cellular level and I've learned not to put a lot of faith in those from past experience, so we won't know for sure until surgery.

I also had some genetic testing done yesterday. That was interesting. I had to document a lot of my family history and any incidents of cancer and what age everyone died at. Then they needed a DNA sample from me. I wondered how there were going to take it. I assumed more blood, but then thought, maybe not, maybe they only need a strand of hair like on CSI...,. oh wait, that might be kind of difficult.  They did it differently that I expected. She brought in a little bottle of scope mouthwash and told me to gargle and spit it into a little tube. They needed 20 ml so I had to gargle and spit several times. The last time she told me to run my tongue along my gums and try to get as much of the remaining saliva out of my mouth into the tube to give them as much DNA as possible. Doesn't that paint a pretty picture? She said the mouthwash kills the cells, but the DNA is intact so it still works. Crazy. Oh well, at least I didn't have to get poked. Not that that is really a big deal anymore.

Anyway, I'm doing the genetic testing for two reasons. First, because it will help the other women in my family, and second because it will help me decide whether or not I do a single or bilateral mastectomy.  Here's how it works. The genetic testing will tell me for sure whether or not I am genetically predisposed for breast cancer. They are looking for the BRCA1 and BRCA2 genes, that I would have inherited from my mom or dad. Most likely from my mother since there seem to be more cancer on that side of the family. Thanks mom. Anyway, BRCA1 and BRCA2 are actually mutations of other normal genes. If I have it, then that means that my sisters, daughter and neices all have a 50% chance of having it. The boys do too, but it's not so much an issue for them (does slightly increast the risk of prostate cancer for them, but it is miniscule) except that they can pass it on to their daughters making it more likely for them to develop breast cancer. So if I have it, they will have a little more information and know that they need to be a little more aggressive in their breast cancer screenings. They can even be tested as well to see if they have the gene for sure.

I'm also doing it because of the chance of cancer showing up in the other breast. If I don't have BRCA1 or BRCA2, there is about a 2 percent risk that I will develop a new cancer in the other breast later in life, in which case I may only need to do a single mastectomy. If I do have one of those genes, the chances of a new cancer in the other breast jumps to 50-80%. So if I test positive, they're both coming off for sure. I'm not doing this again. The girls and I have been close for quite a long time now, but I'll have no problem getting rid of them if I have to. They have, after all, tried to kill me. All my loyalty went out the window the day of diagnosis. Besides, I'm going to get new and improved girls. More about that later.

4 comments:

His and Her Treasures said...

Best Tee shirt I have seen is one that says "Of course they are fake. the real ones tired to kill me.
Good luck. I'll be interested in your genetic testing results. the Huntsman institute has been working with me about the BRAC1 & 2 genes but I can't afford to have it done right now.

Librarian Girl said...

I've seen that t-shirt too. I like it. Unless I misunderstood, I think that once the mutation is identified by one family member, the testing for other members of the family is significantly cheaper. So, if I test positive, hopefully all my cousins and sisters and neices will be able to do the testing without it being such a huge financial burden.

Sarah said...

You seem so positive about everything keep it up you are inspiring! Hope all goes well with your testing.

Unknown said...

I am so proud of you. You say you have favorite doctors, but I'm sure you are a favorite patient. I love that you don't trust them implicitly and that you are asking any and every question that you want to know. I couldn't expect any more of Librarian Girl. Love you! ~Josi