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Speaker 1: From House Towards dot com. Hey there, and welcome to
Speaker 1: the podcast. This is Kristen and Mrs Molly. Molly. Breast
Speaker 1: cancer has been in the news a lot this week
Speaker 1: and it's heartbreaking news, honestly. Um. There was a ten
Speaker 1: year old Hannah pale al Slam who was diagnosed with
Speaker 1: breast cancer, and then there was some follow up news
Speaker 1: of an eight year old girl who was diagnosed with
Speaker 1: ovarian cancer, and it really caught a lot of women's
Speaker 1: attention because we think of breast cancer ovarian cancer is
Speaker 1: something that really affects people maybe our mother's age, um,
Speaker 1: but it is in fact something that can happen to
Speaker 1: two girls this young. So that kind of got me
Speaker 1: thinking about breast cancer and why so prevalent among women,
Speaker 1: and um, what else is going on with with prevention?
Speaker 1: Right And at the same time that all of this
Speaker 1: uh sad news was coming out, there were also reports
Speaker 1: that the a c l U had UH sort of
Speaker 1: organized a lawsuit against MARYA Genetics, which holds the patent
Speaker 1: on the breast cancer genes breast cancer gene one and
Speaker 1: breast cancer gene two, which from here on out we're
Speaker 1: just gonna say Braca. UM. The lawsuit challenges the patents
Speaker 1: that this company holds on these two genes, which occur
Speaker 1: naturally in the body. UM about of human genes are patented,
Speaker 1: so they're not the only ones that have patents, but UM,
Speaker 1: since married was the first to sequence this gene, they've
Speaker 1: had this patent on it for a few years. And
Speaker 1: a CLU says this is unconstitutional, right because Mary Genetics
Speaker 1: has used UH this patented gene in order to develop
Speaker 1: testing for BROCA there it's the only company right now
Speaker 1: that is legally allowed to conduct testing for Brocco one
Speaker 1: and Broca two and UH. The a c l U
Speaker 1: is concerned about quality assurance and whether or not more
Speaker 1: competition in the marketplace would lower the cost barrier and
Speaker 1: all those factors surrounding it, because breast cancer is so
Speaker 1: prevalent among women, right and especially these you know you
Speaker 1: were talking about how you're concerned, especially about younger women,
Speaker 1: and I think that they're the ones who would be
Speaker 1: most interested in getting a genetic test to find out
Speaker 1: if they are carriers of Brocco one and Broca too. Basically,
Speaker 1: you can have a blood test, they'll sequence the your
Speaker 1: DNA and if you carry an altered form of this gene,
Speaker 1: then your chance is just skyrocket that you will have
Speaker 1: breast cancer. Uh. You know, all women walking around today
Speaker 1: in the world, there's a thirteen percent chance of breast cancer.
Speaker 1: But if you're carrying this gene, you're three to seven
Speaker 1: times more likely to developed breast cancer. And what's striking
Speaker 1: about it is with this gene, you don't get an
Speaker 1: old age. You get it long before menopause. Right, Um,
Speaker 1: Because you're as you age, your chances for for breast
Speaker 1: cancer steadily increases to where when you hit fifty you
Speaker 1: have a one in fifty chance of developing breast cancer.
Speaker 1: But like you said, if you are a Bracca car carrier,
Speaker 1: there's a much higher chance that you will develop it
Speaker 1: long before menopause. So let's talk a little bit more
Speaker 1: about what this gene test entails and who all should
Speaker 1: get it, because not every female should just walk into
Speaker 1: the doctor's office and ask for the Brocca gene tests. Right.
Speaker 1: It's too expensive to do that, um. And basically it's
Speaker 1: not like all the can't breast cancer in the world
Speaker 1: is caused by Bracca. Of the about a hud American
Speaker 1: women learn their breast cancer each year, only five to
Speaker 1: ten percent of those cases are hereditary, which would mean
Speaker 1: that they had a gene that caused the disease. So
Speaker 1: the Brocca gene test is reserved for women who would
Speaker 1: be in these higher risk groups. And uh women for instance,
Speaker 1: who might who might be more risk for having this
Speaker 1: gene mutation would have a personal breast cancer diagnosis, a
Speaker 1: family history of breast cancer at a young age, and
Speaker 1: two or more close relatives, a family history and more
Speaker 1: than one generation a male relative with breast cancer, because well,
Speaker 1: we can't forget that while it is rare, men can
Speaker 1: develop breast cancer as well. Um a family member bilateral
Speaker 1: breast cancer as in breast cancer in both of the
Speaker 1: breast um, and a family member who has both breasts
Speaker 1: and a variant cancers and women of Eastern European Jewish ancestry, right,
Speaker 1: So those are the high risk groups. And if they
Speaker 1: so choose, a lot of people don't really want to know.
Speaker 1: You know, essentially, you know, you find out interesting things
Speaker 1: about your d n A if you choose undergo genetic testing,
Speaker 1: you're basically finding out things you know you might have
Speaker 1: a getting. You could go in and find out your
Speaker 1: carrier for this gene or you're not, which is already
Speaker 1: going to cause some maybe drama and your family if
Speaker 1: you know your sisters a carrier and you're not. But
Speaker 1: then you've got to decide if I am positive for
Speaker 1: this gene, what am I going to do about it?
Speaker 1: Because it's not just because you carry this gene, it's
Speaker 1: not a guarantee you are going to have cancer, right,
Speaker 1: It just means that you have a much higher risk
Speaker 1: probably for developing breast cancer or ovarian cancer. And one
Speaker 1: of the things that the Mayo Clinic really urges women
Speaker 1: who are thinking about getting the gene testing is to
Speaker 1: meet with a genetic counselor and really go over the
Speaker 1: potential psychological impacts of getting genetic testing, because, like you said,
Speaker 1: I mean, if you find out that you are a
Speaker 1: carrier of this mutation, you are then going to have
Speaker 1: to make some very tough decisions about your body, right Christen,
Speaker 1: So let's let's talk about like, let's say you get
Speaker 1: the positive test result that you have the Brocka gene,
Speaker 1: what are your options. Let's go over those real quick, okay, um.
Speaker 1: The first thing that you can do, which is I
Speaker 1: guess the least invasive step that you could take would
Speaker 1: just be increased screening. You might bump your clinical breast
Speaker 1: exams to every six months and having mammograms every year,
Speaker 1: and your doctor might actually recommend that you have breast
Speaker 1: m r eyes, which are more detailed look inside of
Speaker 1: the breast to to keep a um keep a closer
Speaker 1: watch on whether any cancer could be developing. And then
Speaker 1: at the other side of the spectrum, probably the most
Speaker 1: invasive thing you could do would be to remove essentially
Speaker 1: all your breast tissue in order to reduce the chance
Speaker 1: that a tumor would develop in that tissue. So basically
Speaker 1: you'd have a profanitive bassectomy um and this would reduce
Speaker 1: your breast cancer risk by about um. And then you
Speaker 1: also have an option of removing healthy fallopian tubes and ovaries,
Speaker 1: which would reduce your breast cancer risk by about and
Speaker 1: reduce your risk of developing ovarian cancer by about But Molly,
Speaker 1: those are those are pretty extreme surgeries to make before
Speaker 1: you even know that you have surgery. In this article
Speaker 1: that we were reading in the New York times of
Speaker 1: kind of tracking This um thirty year old woman's decision
Speaker 1: to have a preventative mess sack to me, really gave
Speaker 1: insight into um, how much you have to think about,
Speaker 1: like what kind of a burden it is like talking
Speaker 1: to your family about it. This woman, UM had a
Speaker 1: pretty strong family history of breast cancer. Her mother had
Speaker 1: breast cancer. She watched her go through chemotherapy, and she
Speaker 1: was just terrified that she would have to go through
Speaker 1: the same thing and ended up choosing to get the
Speaker 1: preventative mestick to me, but it certainly wasn't you know,
Speaker 1: an easy decision to come to rite part of the
Speaker 1: thing you're gonna have to consider, especially if you're at
Speaker 1: that young of age. I believe she was thirty three
Speaker 1: and she was unmarried. Uh. You know, women have a
Speaker 1: lot of issues tied up in their body about what
Speaker 1: makes them attractive, what makes them you know, essentially feminine,
Speaker 1: and your breasts and your ability to have children are
Speaker 1: two of those main things. So she was dating a
Speaker 1: guy at the time. I was trying to sort of
Speaker 1: uh sess out how he felt about plastic surgery, and
Speaker 1: you know, if she would have breasts that weren't real
Speaker 1: that wouldn't be able to breastfeed one day. So it's
Speaker 1: a very loaded decision to have to make based on
Speaker 1: a you know, based on a test result that doesn't
Speaker 1: say necessarily you're gonna have cancer, but it does say
Speaker 1: you have an extremely high chance of having cancer. And
Speaker 1: there is one other option. It's called chemo prevention, which
Speaker 1: is basically where you start taking the drugs that you
Speaker 1: would take if you were undergoing breast cancer treatment as
Speaker 1: sort of a preventative measure, and then maybe one day
Speaker 1: they hope that they will be able to do gene
Speaker 1: therapy perhaps alter these genes. But this gets back to
Speaker 1: why there might be a patent on this, uh, because
Speaker 1: what can happen sometimes when you have this test is
Speaker 1: instead of getting the positive or the negative, you have
Speaker 1: an ambiguous result. Right. Um, there was a study that's
Speaker 1: found that about ten of women undergoing bracket testing had
Speaker 1: ambiguous or uncertain test results. They don't know whether it's
Speaker 1: positive or negative. So that just kind of leaves them
Speaker 1: back the drawing board. So in that case, you know,
Speaker 1: for any other medical procedure where you get sort of
Speaker 1: a you know, ambiguous result, you'll be able to have
Speaker 1: another test. But that's sort of the problem. One of
Speaker 1: the problems at heart of this A c l U
Speaker 1: lawsuit is because Mary Genetics is the only company that
Speaker 1: has this has the right to administer this test, there's
Speaker 1: no sort of second opinion available to women, and Mary
Speaker 1: Genetics are the only labs that are legally allowed to
Speaker 1: to perform the testing. And while there haven't been any
Speaker 1: studies that have said that uh, other labs doing kind
Speaker 1: of backup testing would improve um the rate of false
Speaker 1: positives and false negatives. UM, the A c l you
Speaker 1: thinks that it should still be an open option, right,
Speaker 1: they should be able to get that second opinion. Or
Speaker 1: let's say, you know a lot of women go in
Speaker 1: and their concern based on their family history, they're convinced
Speaker 1: they have this gene and then they get a negative
Speaker 1: almost like you still can't believe it until you have
Speaker 1: some sort of further proof, right, and even if you
Speaker 1: get a negative, we can't forget that, uh, no matter
Speaker 1: what every woman has about a chance brockagene or no
Speaker 1: brockagene of developing breast cancer. So just to review, now
Speaker 1: that we know why you might want to take this test,
Speaker 1: and no sort of your odds and your options. We'll
Speaker 1: just go over real quick again, why it would matter
Speaker 1: if this gene had a patent obviously, Uh, you know,
Speaker 1: the treatment for breast cancer is very extreme. It's hard
Speaker 1: on the body. Obviously, people think that if you know
Speaker 1: what the breast cancer gene is, you can do a
Speaker 1: lot of work in terms of research of prevention and cure.
Speaker 1: And right now Myriad is basically sitting on this gene.
Speaker 1: They're probably doing their own research, but a lot of
Speaker 1: scientists would like to get in on that action, right
Speaker 1: And Molly didn't didn't you read an article and CNN
Speaker 1: that was saying that that even though a lot about
Speaker 1: of sequenced genes are patented, the court kind of sillocking
Speaker 1: this as its test case. That's where what a lot
Speaker 1: of legal scholars think is that you know, because you
Speaker 1: know so many women are affected by this, and you
Speaker 1: know men have lost the spouse to this, daughters to this,
Speaker 1: that why wouldn't you open up the breast cancer gene
Speaker 1: when when breast cancer is so prevalent um and and
Speaker 1: just to go over those stats again, um cancer and
Speaker 1: younger women under thirty is rare, accounting for about one
Speaker 1: and a half percent of all breast cancer cases. But
Speaker 1: then at the age of forty our chances go up
Speaker 1: to one and two. By fifty we've got a one
Speaker 1: in fifty chance, and if we live to be eighty five,
Speaker 1: the odds of developing breast cancer are one in eight.
Speaker 1: So it's pretty staggering. This case is definitely wanted to
Speaker 1: keep an eye on. We don't know how it'll shake out,
Speaker 1: and you know who have the issue. Thing here is
Speaker 1: also priced. They don't know if the price of the
Speaker 1: exam would be lowered by competition on the market, but
Speaker 1: for reasons of that quality assurance for the research. That's
Speaker 1: why the a c l U is saying that people
Speaker 1: should have the ability to have access to to a
Speaker 1: gene that is already in their body. Right, Molly and
Speaker 1: I think that if we were talking about breast cancer,
Speaker 1: even if you aren't in the high risk group and
Speaker 1: might want to consider getting the Brocka gene testing, I
Speaker 1: think that it is worth mentioning that women in our
Speaker 1: twenties and thirties should have a clinical breast exam as
Speaker 1: part of a periodic health exam by health professional, preferably
Speaker 1: every three years, and after forty that breast exam should
Speaker 1: happen every year in addition to mammograms. Because a twelve
Speaker 1: percent chance Molley is nothing that you want to gamble with.
Speaker 1: Question not so. If you want more information on breast
Speaker 1: cancer and the breast cancer jeans, head on over to
Speaker 1: house stuff works dot com. And if you have any questions, comments,
Speaker 1: or suggestions for me and Molly, we'd love to hear
Speaker 1: from you. You can send us an email at mom
Speaker 1: stuff at how stuff works dot com for more on
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