Family History of Cancer; BRCA mutations; The Second and Third Sisters

By Larry Puls @Larrypulsauthor

Sisters with Ovarian Cancer; Family History of Cancer

A year had passed. I had not forgotten the young woman who lost her battle to ovarian cancer. Her smile was still visible and I could almost recall her laugh. Thirty-two-year-old patients are particularly memorable. So few women die that young due to gynecologic malignancies. Many of the details about her final days were still fresh on my mind. In many ways, the more tragic the scenario, the more you remember. But her death in my career was not in vain, for I learned much about the chronic use of chemotherapy and its long term side effects. Things you don't always learn in training. She changed my style of practice. Her bone marrow death in the midst of treatment has to this day, influenced my use of drugs, their duration and their dosing, well past her life—even now. Her death I believe, has helped me help others.

Family History of Ovarian Cancer; A Tale of Three Sisters

By Larry Puls @larrypulsauthor

Family History of Cancer, Ovarian Cancer

By the early 90’s, oncologists had obviously observed for some time that certain families were far more affected by various malignancies than others. They knew intuitively that a gene, or genes, tied these cancers to the families, but that genetic component couldn't be readily identified by testing. Today, advances in the study of genetics is changing all of that, allowing us to frequently identify who might be at an increased risk for cancer, even before they develop one. The rapid discovery of new deleterious (bad) mutations allows us to identify individuals who are at an increased risk and to tell them what that risk is over the norm. Knowing this presents us with an opportunity to screen more effectively, to potentially intervene before the cancer starts, to counsel multiple generations within a family, and often prevent certain at risk members from losing their own lives secondary to a malignancy.