Young
carriers from A-Z =Part I
· Genetic
testing ( Cynthia Hadford)
o
Genetic counselling is for
interpretation, information, and support
o
Try to figure out where you sit on the
scale of risk
o
Determine risk factors, and if you would
benefit from information of test results
o
6-8 weeks for test results to come back
o
Suggest doing a “Pro” “Con” list when
deciding about testing
o
Asking yourself am I ready to know this
information, is it a good time?
o
When coming to see and genetic
councillor bring questions, personal support, and accurate family history.
· Surgical
menopause ( dietician from the Grey nuns Hospital)
o
80% reduction in cancer risk with
ovaries removed
o
50% reduction with breast cancer risk
when tubes and ovaries removed.
o
Most common menopausal health issues:
heart health, brain function, bone health, depression, anxiety, moodiness, dry
vagina, hot flashes, night sweats, memory issues.
o
Surgery procedure: 3 day recovery in hospital
can be done laproscopically abdominally, or vaginally. 3-8 weeks out of work,
light bleeding (like menstruation) for 6 weeks, NO sex for 8 weeks, there is an
immediate rollercoaster of symptoms, due to the abrupt onset of menopause.
o
Estrogens role in body parts: brain,
bone, heart, liver, uterus, vagina, ovaries, eyes, bladder
o
Hot flashes can last up to 3-4 years
o
Managing symptoms can range from
lifestyle changes ( dressing in layers, having access to fans) all the way to
HRT (hormone replacement therapy).
o
With hormone therapy it is less harsh on
the body because it only replaces 1/10 of the estrogen in the body, not the
complete array of hormones that the ovaries provide.
· Personal
story
o
Young women lost almost all the women in
her life, assumed that they were BRCA, did the surgery’s and found out later
that she didn’t even carry the gene, her story was brief but she encouraged us
to find her during one of the breaks and speak about her unique perspective.
· Insurance
(broker from Calgary)
o
This lady was not specifically geared
for hereditary issues but she said she is the middle man between us and the
medical over writers of insurance companies.
o
Doing a trial application is the first
step. It’s a lot worse to be rejected in full application than a trail one
o
See your insurance brokers, no banks for
information and discussion about insurance options.
o
They deal with all sorts of insurances;
life, critical, disability, long term care, etc.
Young
carriers from A-Z =Part II
· Fertility
options (Dr. Motan)
o
300,000 oocytes at puberty
o
1000 at menopause
o
Ovulate 300-400 in life
o
Cancer therapy destroys eggs, creates
mentral irregularty, causes acute ovarian failure, pre-mature ovarian
failure/insufficiency, if done before 35 yrs old 50% will resume regular
menstruation
o
Fertility preservation
§ Tissues,
drug induced, shielding ovaries, moving out of the way
o
S1P
§ Rising
star in preservation of ovaries, drug in animal trials
o
Chemical menopause
§ Decrease
cell death, decrease in the blood vessels to the ovaries, potentially could
protect stem cells (Could become anything in body)
§ $300-400/month
§ More
protective in less than 40 years old
o
Freezing
§ Embryo’s,
mature eggs, ovarian tissue, primordial eggs
§ Not
as beneficial over 35 yrs old
o
Verification
§ -2000*C/sec
freezing, creates “Glass”
§ 99%
survival rate
§ 2-4
weeks to stimulate ovaries for IVF (in-vetro fertilization)
§ Two
options to harvest eggs; natural cycle (no drugs) or GnRH antagonist cycle (the
natural hormones that creates reproduction cells)
o
Egg freezing
§ >60%
success rate, 7 days to mature eggs
o
Ovarian tissue freezing
§ $30,000
or more for procedure
§ 9
centers in North America
§ The
grafts lifespan is 6-84 months
§ Laparoscopic
removal of ovaries
§ Grow
the eggs in the forearm, away from any radiation to the areas.
o
Stem cells
§ Stage
of development into any cell in the body
§ Can
be cultured to become ovum’s
o
Facts:
§ Pregnancy
protects against cancer
§ IVF
cycle costs: $5,500-7,000/ round
§ Freezing
embryo’s cost: $900
§ Embryo
cryopreservation cost: $600
§ Sperm
donor cost: $1,000
§ BRCA
has shown no increased risk with doing IVF cycle to gain ovums.
· Naturopathic
medicine and diet (Calgary naturopath)
o
Uses info from Chinese medicine, herbs,
and iodic medicine, to treat disease
o
Disgnosis based on energy
o
Back in the day teeth were considered a
ststus of health, it was well known not to eat “white man food”
o
Tea is served before meals in oriental
restaurants to improve digestion
o
Meat is best digested when under cooked
o
Do not reheat food= 40% decrease in
nutrients when food is going cold, eat it hot.
o
Over cook beans and grains
o
Double cook to decrease the gasses that
you get from grains and beans.
o
Soak beans, nuts, seeds for better
digestion, les gas aswell
o
Cook with spices, relax the digestive
system, relax the reproductive organs as well
o
Variety is the spice of life… don’t cut
things out completely because you will develop a sensitivity to the change
o
Ideal meals; large breakfast, smaller
lunch, minimum supper
o
It was well known in ancient wold that
the engagement period between the weddings was used to feed the bride/mother
organs of animals so her children were strong. That is how they survived
weakness did not survive.
o
Use lots of colourful foods in your
meals
o
A reason to live…live longer!!!
Expert
panel
· Dr.
Capstick
o
Good news:
§ Allard
high risk clinic at Lois Hole hospital
o
Bad news:
§ The
name should really be HBFTOCS Hereditary breast and fallopian tube and ovarian
cancer society…not HBOC anymore lol.
§ Breast
cancer is the 2nd largest killer of women ( first is lung), 5th
killer is ovarian, no data for fallopian tube cancers, why? Because the pre
cancers start on the fallopian tubes.
§ Probably
going to discuss the removal of the tubes as prophylaxis
§ Unfortunately
not enough data to support this!!!
o
Pending news
§ HRT=>
debates to decide on the topic…getting close
§ Women
who are BRCA previvors are reasonable candidates for the HRT is control of
symptoms of menopause.
§ Women
who HAVE HAD cancer comfort is in ER-
cancer survivors to use low dose estrogen
§ Triple
negative cancers are already at high risk of reccurance so HRT is not
recommended.
· Dr.
Krause/Dabbs
o
Clinic
§ Consists
of the nurse navigator Shelly
§ Pharmacist
§ Booking
clerk
§ Dr.
Krause and Dabbs
o
Goals for clinic
§ Get
all done, one stop shop radiology and clinic visit all in one, with no wait for
results.
o
Serving 550+ patients
o
Screening available through clinic
§ Breast
MRI
§ Ultrasound
§ Mammography
o
Funny saying “fallopian tuba” a “tuba
ligation”
o
PARP- the newest jump to determining the
way to personally treat cancers at a genetic level, still in tria stage.
· Dr.
Mehling
o
Immediate reconstruction push though BRA
day awareness, it is $$ cost effective, preferable for young women especially,
easier ( less of a scar), more aesthetically beneficial.
o
Better training available now to do the
immediate reconstruction
o
Tools and option available
o
Alberta and Sask are only two provinces
that don’t have a “collaboration immediate reconstruction” two riches provinces
are where are the only ones who don’t have it, what is our excuse?
o
Present a solution not just a problem…
You can help by comeing to BRA day Oct 16, 2013 at Tom Baker Cancer center auditorium
5-7 pm Rm# CC104
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