It's been a difficult past three months. Three losses within three months. Death is always hardest on those of us that are living. The three ladies that passed are now at peace. They will forever Shine On.
I spoke at one of the Remembrance Ceremony early this month. She was a beautiful angel and full of life. There is so much we can learn from her. There is so much we can learn from all of them.
I'm at such a loss of word that I'm uncertain where to begin with this post or should I just end it? Life is so precious and fragile. Dr. Litton was correct. We all need to go live our life!
Some thing that I've done that has never been on my bucket list but I guess I can add that to my bucket list is that I rode on a motorcycle when I told myself that I would NEVER get on one unless it was an emergency or my last resort. To date I've ridden on one three times now. What a year for adventure! I've gone paragliding and now motorcycling!
I guess I need to end this post since I'm all over the place. This Saturday is the Mamma Jamma Ride and I ride in memory of all my ladies that will always shine on and will always have a special place in my heart.
My name is Runi and I was diagnosed November 16, 2005 just a few weeks shy of my 29th birthday. I was repeatedly told that I was too young and too healthy to have breast cancer. Cancer is not prejudice to anyone regardless of age, race or socioeconomic. This is my story and I hope people learn a great deal from it. Feel free to contact me if you have questions or want to simply talk.
Thursday, October 25, 2012
Monday, October 15, 2012
Step One: CHECK!
The results of the P53 came back much quicker than I expected which was a very nice surprise. I think it just took 8 or 9 days. I've just been too swamped to post anything. It was negative! Yay! This is huge because those that are HER2+ or Triple Negative breast cancer tend to have the P53 mutation. I just really hope I'm BRCA1 negative too.
This means I'm NOT at a higher risk for other host of cancers. If I'm able to have children, I will not pass this along since I do not have this genetic mutation. I can check off step one!
I have a visit with my gyno next month for a routine check up and to see if we can get a better gauge of my ovary functions.
This wonderful news was much needed during a crazy time and when I've experienced loss. More to come.
This means I'm NOT at a higher risk for other host of cancers. If I'm able to have children, I will not pass this along since I do not have this genetic mutation. I can check off step one!
I have a visit with my gyno next month for a routine check up and to see if we can get a better gauge of my ovary functions.
This wonderful news was much needed during a crazy time and when I've experienced loss. More to come.
Tuesday, October 2, 2012
Dreams
We dream all the time but most of us will not remember our dreams unless we write them down upon waking. My sleep is much improved now that I'm a year out of Tamoxifen but the quality still fluctuates with time due to hormonal fluctuation. I've had some vivid dreams recently. They are so vivid that I did not write them down but I remember them.
After I got back from MDA I had a dream that I was pregnant! Last night I had a dream that my P53 test came back positive! I don't know if it's the deeper sleep that I'm getting or if I haven't had time to really think about the impact of the P53 test but both were freaky! I remember at one point in the night wiping away tears.
It's been a week since I had my blood drawn for the test. I'm hoping the results will come in by the end of this week or early next week. I decided to wait for the results before making my appointment with the gyno even though I need to see her for my yearly anyway. I'm waiting and all the while hoping I haven't opened Pandora's box. Maybe Dr. Litton was correct that genetic counseling was a good idea. It's about bedtime and I hope I dream of something nice...maybe something that doesn't even have to do with cancer. Maybe I can dream of fat chubby puppies or my sweet niece and nephews!
After I got back from MDA I had a dream that I was pregnant! Last night I had a dream that my P53 test came back positive! I don't know if it's the deeper sleep that I'm getting or if I haven't had time to really think about the impact of the P53 test but both were freaky! I remember at one point in the night wiping away tears.
It's been a week since I had my blood drawn for the test. I'm hoping the results will come in by the end of this week or early next week. I decided to wait for the results before making my appointment with the gyno even though I need to see her for my yearly anyway. I'm waiting and all the while hoping I haven't opened Pandora's box. Maybe Dr. Litton was correct that genetic counseling was a good idea. It's about bedtime and I hope I dream of something nice...maybe something that doesn't even have to do with cancer. Maybe I can dream of fat chubby puppies or my sweet niece and nephews!
Monday, September 24, 2012
Post MDA Visit w/Dr. H
So I've recycled a photo that I've posted earlier this year of Dr. H. This is my oncologist that came to see me the day after I was diagnosed on her day off. She encouraged me to see a doc at MD Anderson because I asked her six months ago during my last check up with her about fertility. She wanted me to see if the MDA folks would find it safe for me or give me a green light if that was the path that was chosen for me.
Today we checked with my insurance company and thankfully they will cover the P53 test. Step 1 check! Its not a standard test so no one really knows when the results will come in but I can only assume it will be about 10-14 days. Step 2 will be to see Dr. Neyman to see if we can tell how my ovaries are doing in terms of egg production.
The outcomes of Step 1 and 2 are super important but so is Step 3, if not the most important:
Step 3 will be to find my life partner. Regardless of step 1 and 2, my hopes and dreams would be to find my life partner. I have a small window of opportunity to possibly conceive naturally BUT I also know that this cannot be rushed and this is a journey that I will not do on my own. Many single moms are rockstars and Dr. H told me that "Aren't we all single moms?" but it's not something I would choose to do on my own from the get go.
I thought this year would be the first year not to reach my deductible but I think I'll hit it by the time I finish up w/ Dr. Neyman. More to come!
Monday, September 17, 2012
Live Your Life
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9/17/2012 I finally made it to MD Anderson |
Anyway, I got my case reopened thanks to an email to my oncology nurse. I was able to switch case managers and to tell them my story so it didn't happen to anyone after me. Needless to say, things went smoothly from that point on. So smoothly that I've been highly impressed by MDA besides that incident.
I got to spend the weekend with Blanca. I didn't get in until that afternoon because there was a benefit for one of our ladies that passed last month. The benefit was amazing and raised about $4000. I had a great time hanging out and catching up with Blanca and her daughter Izzy who is cute as a button.
Fast forward to this morning. I got to MDA early to make sure I found it correctly. Besides, I haven't met my deductible yet for this year so this visit was going to cost me about $500 so I didn't want to be late for it! The directions they gave me was great and so was my GPS. Information center was great and before I knew it I arrived! Some photos as proof.
From start of registration to the nurse that walked me out was an amazing experience. Everyone was courteous and prompt. It was only Dr. Litton the breast, fertility and genetics specialist that I had to wait for about ten minutes. Of course, I had to undress from the waist up and opening to the front. Robe is below and so is the funny story of the sign I forgot to snap a photo of:
In a nut shell:
She doesn't think I am BRCA+ but would like me to consider the BART or P53 test. I've heard of P53 and remember asking Dr. H about it long time ago but forgot what was said about it. Anyway, she would rather me do the P53 over BART since I'm HER2+ and BRCA is usually TNBC.
Studies shows it's safe for breast cancer patients and ER+ ladies to have babies 2-4 years after treatment. (Or may have been diagnosis. Darn, forgot. But regardless I'll fall into that guidelines.) Of course there are not guarantees but she doesn't see why I shouldn't if I wanted to have a baby.
She does not believe in follow up scans or tumor markers. In my case, she would want to run a complete breast and abdomen/pelvic CT scan to ensure there isn't a micrometasis anywhere prior to getting pregnant. I told her this was not immediate since I haven't established my life partner so she said to have it done before I was serious about this. Of course this is pending P53 results.
She feels 5 yrs of Tamoxifen is enough and that no more is needed nor is an oopherectomy!
I have a small window of opportunity where my eggs would be viable and producing but we know once women hit 30's that it drops significantly and even more so since I had chemo. So my initial thinking that I have up to 5 years might be wrong. We didn't establish the numbers in years but I am probably producing less eggs that an average 35 year old.
My body is forever changed. I need to consume about 75% of the calories I consumed prior to treatment and for the rest of my life. I guess I shouldn't beat myself over the head over those last 10 lbs.
Basically she answer ALL of my questions and would have answer more if I thought of more. I seriously was aiming for 25 minutes with her. I was in there with her for about 45 minutes. I was with the nurse for about 10-15 minutes. Needless to stay, I'm a happy camper.
As Dr. Litton left the room she told me, "Live your life." With that, I'm back in Austin and am enjoying a cocktail. I have an appointment with Dr. H next Monday to discuss everything and see how much this P53 test costs. If that is all clear and my CT scans are clear and I find my partner in crime I have a green light. I also feel good about keeping my ovaries at this point in time unless more data comes out.
Guess it's time for me to LIVE MY LIFE! Cheers!
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Fancy, this is how an actual cancer center works...especially a world renown one. |
In a nut shell:
She doesn't think I am BRCA+ but would like me to consider the BART or P53 test. I've heard of P53 and remember asking Dr. H about it long time ago but forgot what was said about it. Anyway, she would rather me do the P53 over BART since I'm HER2+ and BRCA is usually TNBC.
Studies shows it's safe for breast cancer patients and ER+ ladies to have babies 2-4 years after treatment. (Or may have been diagnosis. Darn, forgot. But regardless I'll fall into that guidelines.) Of course there are not guarantees but she doesn't see why I shouldn't if I wanted to have a baby.
She does not believe in follow up scans or tumor markers. In my case, she would want to run a complete breast and abdomen/pelvic CT scan to ensure there isn't a micrometasis anywhere prior to getting pregnant. I told her this was not immediate since I haven't established my life partner so she said to have it done before I was serious about this. Of course this is pending P53 results.
She feels 5 yrs of Tamoxifen is enough and that no more is needed nor is an oopherectomy!
I have a small window of opportunity where my eggs would be viable and producing but we know once women hit 30's that it drops significantly and even more so since I had chemo. So my initial thinking that I have up to 5 years might be wrong. We didn't establish the numbers in years but I am probably producing less eggs that an average 35 year old.
My body is forever changed. I need to consume about 75% of the calories I consumed prior to treatment and for the rest of my life. I guess I shouldn't beat myself over the head over those last 10 lbs.
Basically she answer ALL of my questions and would have answer more if I thought of more. I seriously was aiming for 25 minutes with her. I was in there with her for about 45 minutes. I was with the nurse for about 10-15 minutes. Needless to stay, I'm a happy camper.
As Dr. Litton left the room she told me, "Live your life." With that, I'm back in Austin and am enjoying a cocktail. I have an appointment with Dr. H next Monday to discuss everything and see how much this P53 test costs. If that is all clear and my CT scans are clear and I find my partner in crime I have a green light. I also feel good about keeping my ovaries at this point in time unless more data comes out.
Guess it's time for me to LIVE MY LIFE! Cheers!
Wednesday, September 5, 2012
Fast Down and Dirty on Babies after Breast Cancer
I thought this was well written and to the point. I have my appointment with MD Anderson later this month and thought this came in a timely manner. I'm hoping my appointment with them will be insightful rather than a short 15 minutes of, "You're healthy. Keep up what you're doing and just go for it! See ya!"
Babies After Breast Cancer: What are the Options?
August 26, 2012
by Amy Jacobson, RN NP-BC UCLA LIVESTRONGTM Survivorship Center of Excellence
by Amy Jacobson, RN NP-BC UCLA LIVESTRONGTM Survivorship Center of Excellence
What are the options available to breast cancer survivors who were unable to take steps to preserve their fertility at the time of diagnosis? The answer to this question depends on the treatment received. For example, Ductal Carcinoma in Situ (DCIS) treated with surgery and radiation will likely have no affect on a survivor’s ability to conceive and carry a pregnancy. However, if a woman is taking Tamoxifen pregnancy is contraindicated due to the risk for birth defects. A woman who received chemotherapy that affects the ovaries (such as Cyclophosphamide or Adriamycin) and becomes prematurely menopausal may be unable to have a biological child, but could carry a pregnancy to term through fertilization and implantation of a donor egg (if she is not taking Tamoxifen or other endocrine therapy). If she doesn’t have a partner, she could utilize donor sperm. Reproductive specialists throughout the country offer women the opportunity to choose egg and sperm donors based on their physical characteristics, educational accomplishments and even what they enjoy doing in their spare time. Adoption is also a possibility, through private agencies, international channels and foster care.
But all of these options come with a cost, both financial and emotional, that a survivor may not be aware of. Most health insurance plans do not cover fertility treatments (even for cancer patients), and a donor pregnancy may cost more than $10,000. Private adoptions often include legal fees and medical coverage for the expectant mother, and the mother has the right to withdraw her consent to give up her child at any time. And, cancer survivors may carry the extra burden of fears of cancer recurrence.
So, it is important for the survivor who wants to start a family to not go it alone. Googling late at night can be overwhelming, and reading message boards filled with horror stories and secondhand information can also result in emotional overload. Establishing support with a qualified counselor or clergyperson for the journey ahead is critical. Finding a reputable reproductive specialist is also important, particularly one who has experience with women who have been through cancer treatment. Completing a realistic budget before proceeding is critical, so that emotions don’t dictate finances.
A good place to start is myoncofertility.org, which offers quality patient resources on fertility after cancer. They also have a toll free help line at (866) 708-FERT (3378) to answer questions about fertility after cancer. Another great resource is Fertile Action (www.fertileaction.org), a non-profit organization started by breast cancer survivor Alice Crisci to assist with decreasing some of the financial burden associated with fertility preservation/treatments for both the newly diagnosed and post-treatment patient. Fertile Hope also has a searchable resource guide that includes adoption agencies, mental health professionals and surrogacy agencies on their website at www.fertilehope.org.
References:
1. Niemasik, EE, Letourneau, J., Dohan, D., Katz, A., Melisko, M., Rugo, H. & Rosen, M. (2012) Patient perceptions of reproductive health counseling at the time of cancer diagnosis: a qualitative study of female California cancer survivors. Journal of Cancer Survivorship. doi: 10.1007/s11764-012-0227-9
Wednesday, August 29, 2012
Update on Gene Patenting Case
If you've been following me for a while, you probably remember that I am a plaintiff in the ACLU vs. Myriad Case on Gene Patenting as of May 12, 2009. To review, Myriad owns the patent on the BRCA1 and BRCA2 test to see if people carry the BRCA1 and 2 genetic mutation. Weird, right? How can a company own patent rights on genes? Unfortunately, thousands of genes have patents on it. Anyway, back to the BRCA genes. If you carry the mutation, it increases the chance of breast cancer and ovarian cancer by more than half. My stance on it is that I am BRCA1 positive but with a variant of uncertain significance. What does that mean you say? It means that my variant was seen in only two other women, both of whom are Asian. One of them had breast cancer and the other does not. So it makes it 2:1 ratio of Asians with breast cancer. For those of you that studied statistics, you realize that there is not a large enough sample population to really decide whether or not I truly have the BRCA1 mutation. No other researcher or companies can test my genes with this patent. Many underrepresented minorities end up with this ambiguous variant of uncertain significance.
I think, I hope I don't carry the mutation but I just don't know for sure. I still have to consider my ovaries so that is a big deal. Anyway, this is how I got involved with this case so I think you're all caught up. But if you're very intrigued and would like to really follow this case from the beginning you can check out ACLU's site. Another divided 201 decision from the courts of appeals on August 16th. Circuit Judge William Bryson dissented, saying, "the court's decision, if sustained, will likely have broad consequences, such as preempting methods for whole-genome sequencing, even though Myriad's contribution to the field is not remotely consonants with such efforts."
Myriad wins gene patent ruling from US appeals court
By Jonathan Stempel
Thu Aug 16, 2012 4:23pm EDT
(Reuters) - A U.S. federal appeals court has once again affirmed the right of Myriad Genetics Inc to patent two genes linked to breast and ovarian cancer, after the U.S. Supreme Court told it to take another look at the hotly contested case.
A 2-1 panel of the U.S. Federal Circuit Court of Appeals in Washington, D.C., on Thursday upheld the biotechnology company's right to patent "isolated" genes known as BRCA1 and BRCA2, which account for most inherited forms of breast and ovarian cancers.
But the court denied the company's effort to patent methods of "comparing" or "analyzing" DNA sequences.
Women who test positive using Myriad's gene test, called BRACAnalysis, have an 82 percent higher risk of breast cancer and a 44 percent higher risk of ovarian cancer in their lifetimes.
The lawsuit against Myriad and the University of Utah Research Foundation, which hold the patents on the genes, charged that the patents are illegal and restrict both scientific research and patients' access to medical care.
The American Civil Liberties Union, which brought the case, argued that patents on human genes violate the First Amendment and patent law because genes are "products of nature."
But Circuit Judge Alan Lourie, writing for the court majority, said, "Everything and everyone comes from nature, following its laws, but the compositions here are not natural products. They are the products of man, albeit following, as all materials do, laws of nature."
Thursday's decision in the ethically charged litigation came five months after the U.S. Supreme Court, in a case involving a blood test developed by Prometheus Laboratories Inc, unanimously ruled that companies could not patent observations about natural phenomena.
A week later, the Supreme Court set aside the Federal Circuit's July 2011 decision favoring Myriad and directed that court to review the case again in light of the Prometheus ruling.
Myriad's patenting effort has drawn opposition from groups such as the American Medical Association, the March of Dimes, the American Society for Human Genetics and the Association for Molecular Pathology.
In a brief arguing against patenting genes, Dr. James Watson, co-discoverer of the double helix structure of DNA, said he feared the court failed to appreciate the fundamentally unique nature of the human gene, which stores information necessary to create and propagate life.
"It is a chemical entity, but DNA's importance flows from its ability to encode and transmit the instructions for creating humans. Life's instructions ought not be controlled by legal monopolies created at the whim of Congress or the courts."
Nevertheless, the appeals court accepted the argument of Myriad supporters that denying patent protection could stifle innovation by the Salt Lake City-based company and others.
"Patents encourage innovation and even encourage inventing around; we must be careful not to rope off far-reaching areas of patent eligibility," Lourie wrote.
CRITICS DISAPPOINTED
In upholding Myriad's main patent claims, the Federal Circuit again reversed much of a 2010 ruling by U.S. District Judge Robert Sweet in Manhattan.
"We have viewed this as the most important (part of the) decision for Myriad and therefore view the appeals court reversal as a clear positive," Cowen and Co analyst Doug Schenkel wrote. He rates Myriad "outperform."
Roughly 20 nonprofit groups, medical organizations, doctors and individuals challenged Myriad's patent claims, and it is unclear whether an appeal is planned.
Thursday's "extremely disappointing" decision "prevents doctors and scientists from exchanging their ideas and research freely," ACLU lawyer Chris Hansen said in a statement. "Human DNA is a natural entity like air or water. It does not belong to any one company."
Myriad's argument is that when it isolates the genes by removing them from the body, this process changes their chemical structure, and the company's test looks for this distinct chemical form.
Gregory Castanias, a partner at Jones Day representing Myriad, said in a phone interview: "We're very pleased that the panel has continued to recognize that isolated DNA molecules are products of human ingenuity, and are thus eligible for patent protection."
Supporters of Myriad have also said denying patent protection could slow advances in personalized medicine, which uses genetic tests to identify specific therapies for individual patients.
Biotech patent attorney Tim Worral of Dorsey and Whitney said in a statement the implications of the decision extended to most corners of the biotech industry.
"Although the decision will probably be appealed to the U.S. Supreme Court, the biotech industry is breathing at least a temporary sigh of relief," Worral said.
For today, he said the decision is "a win" because much of the value associated with DNA-based inventions are based on the notion that DNA claims are patentable.
Circuit Judge William Bryson dissented from Thursday's decision, saying it "will likely have broad consequences," and perhaps pre-empt methods for whole-genome sequencing.
Sandra Park, an attorney for the ACLU, said the Myriad patents have allowed the company to "maintain a monopoly on BRCA testing in the United States," noting that women have only one option for discovering their genetic risk for breast and ovarian cancer.
And the test does not look for all of the potential causes of hereditary breast cancer, she said.
Park said in recent months, the National Comprehensive Cancer Network issued revised treatment guidelines about BRCA genetic testing, suggesting that all women should also be tested for large rearrangements on the genes. Myriad's $3,000 test does not look for those changes, so doctors have to order a second, $700 test, which insurance companies may or may not pay for.
Park said the ACLU needs to consult with its clients before deciding whether to appeal to the U.S. Supreme Court. It has 90 days in which to do so.
In afternoon trading, Myriad shares were down 13 cents at $24.86 on the Nasdaq. They traded in a range of $23.07 to $25.24 within a half-hour of the Federal Circuit's issuance of its decision.
The case is Association for Molecular Pathology et al v. U.S. Patent and Trademark Office et al, U.S. Federal Circuit Court of Appeals, No. 2010-1046.
(Additional reporting by Julie Steenhuysen in Chicago; editing by John Wallace, Dan Grebler and Bernard Orr)
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