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Thread: What should I tell my daughter about screening?

  1. #1
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    What should I tell my daughter about screening?

    Hi.

    My mother died of early-onset ovarian cancer at age 47 (6 year battle -- she was a fighter).

    Due to a recent scare with prostate cancer (again, it would have been early-onset as I'm 46) I had genetic testing. I came back negative for known BRCA1 and BRCA2 germline mutations. It did come back positive for a rare, unknown pathology BRCA1 mutation -- virtually nothing is known about it, and it could be completely benign.

    Now, I have a 21-year old daughter. The advice from the genetic counsellor was that even though she is very unlikely to have a BRCA mutation (her mom has no history of breast or ovarian cancer) that she should be consdiered at higher risk than the general population and might want to start a conversation about screening.

    How should I broach the subject with her? As far as I know, screening shouldn't happen until 30ish? Am i right in understanding that? Does my mother having early-onset ovarian cancer really increase her risk? Should I have a conversation with her about breast cancer too?

    Thanks so much in advance.
    Age 46 - Toronto, Canada

    Prostate volume late 2012 - 23cc
    First PSA test at 44 (April 2017) -- Total PSA 2.9 (age-adjusted threshold < 2.5), Free PSA 16%. Prostatitis ruled out by urinalysis, bacterial culture and a course of Cipro

    Second PSA test at 45 (May 20180 -- Total PSA 5.2 (age-adjusted threshold < 2.5), Free PSA 7%
    Velocity and doubling time are of concern to uro

    Bx August-2018, negative, no BPH, no prostatitis -- completely unremarable in all cores

    Conflicting opinios on prostate size. Bx pathology says 20cc. DRE estimate is 40cc. 2012 prostate size by ultrasound was estimated at 23cc.

  2. #2
    Moderator Top User jorola's Avatar
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    Hi fellow Canadian,
    My understanding is 10 to 20% of breast and ovarian cancers are due to inherited gene mutations. Still I think the best think for your daughter to do is to discuss this with her doctor and OBGYN.
    I think if you are concerned just go ahead and talk to her. Just be upfront and honest with her. Let her know it is unlikely she has the gene but best she go talk to her dr about. She can take it from there and can follow up with her dr.
    Wife to husband with squamous lung cancer stage 3 b
    dx - April 20/14
    tx started May 20/14 - radiation and chemo
    June 23 - chemo finished
    June 24 - tumor 1/3 the original size
    July 4 - radiation finished
    July 8 - PET scan shows tumor almost gone, lymph nodes back to normal
    Married July 19/14
    Sept 9/14 - repeat can shows tumor continues to shrink more, no new spots. New coughing and pain due to chest infection or side effect of radiation.
    Sept 19/14 - not infection but pneumonitis, place on dex for 4 weeks
    Oct 22/14 - now off of dex and facing even more symptoms of withdrawal
    Dec 16/14 - pretty much nothing left but a scar
    April 7/15 - ditto scan and screw you stats
    Oct 6/15 - more scarring but still cancer still gone
    Feb 2016 -scan the same
    Aug 2016 - more of the same
    Aug 2017 - and ditto
    Aug 2018 - 4 yrs NED

  3. #3
    Experienced User
    Join Date
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    Posts
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    Quote Originally Posted by jorola View Post
    Hi fellow Canadian,
    My understanding is 10 to 20% of breast and ovarian cancers are due to inherited gene mutations. Still I think the best think for your daughter to do is to discuss this with her doctor and OBGYN.
    I think if you are concerned just go ahead and talk to her. Just be upfront and honest with her. Let her know it is unlikely she has the gene but best she go talk to her dr about. She can take it from there and can follow up with her dr.
    Thanks, Jorola. I had the discussion. It was awkward. I assured her that this doesn't mean she'll get cancer. And I did push the same point as you: she should talk to her health practioners about it.

    The BRCA1 is the wildcard that make our situation a little different. If it was a known variant, I believe she'd automatically get screened...but a VUS?
    Age 46 - Toronto, Canada

    Prostate volume late 2012 - 23cc
    First PSA test at 44 (April 2017) -- Total PSA 2.9 (age-adjusted threshold < 2.5), Free PSA 16%. Prostatitis ruled out by urinalysis, bacterial culture and a course of Cipro

    Second PSA test at 45 (May 20180 -- Total PSA 5.2 (age-adjusted threshold < 2.5), Free PSA 7%
    Velocity and doubling time are of concern to uro

    Bx August-2018, negative, no BPH, no prostatitis -- completely unremarable in all cores

    Conflicting opinios on prostate size. Bx pathology says 20cc. DRE estimate is 40cc. 2012 prostate size by ultrasound was estimated at 23cc.

  4. #4
    Moderator Top User jorola's Avatar
    Join Date
    May 2014
    Posts
    1,631
    Sorry it was awkward. Still I know you would agree better that than not discussed. Now she can have her drs do what they need to to see if she has a higher risk or not and do what they need to from an early age with her. May she not have the gene and always remain cancer free.
    Wife to husband with squamous lung cancer stage 3 b
    dx - April 20/14
    tx started May 20/14 - radiation and chemo
    June 23 - chemo finished
    June 24 - tumor 1/3 the original size
    July 4 - radiation finished
    July 8 - PET scan shows tumor almost gone, lymph nodes back to normal
    Married July 19/14
    Sept 9/14 - repeat can shows tumor continues to shrink more, no new spots. New coughing and pain due to chest infection or side effect of radiation.
    Sept 19/14 - not infection but pneumonitis, place on dex for 4 weeks
    Oct 22/14 - now off of dex and facing even more symptoms of withdrawal
    Dec 16/14 - pretty much nothing left but a scar
    April 7/15 - ditto scan and screw you stats
    Oct 6/15 - more scarring but still cancer still gone
    Feb 2016 -scan the same
    Aug 2016 - more of the same
    Aug 2017 - and ditto
    Aug 2018 - 4 yrs NED

 

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