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paper.docxDear Auntie Daisy
In a response to your letter asking me for my opinion on your daughters and whether they should get breast cancer genetic testing or not. First of all, let me explain how breast cancer starts and develops. Cancer cells are cells that have a mutated gene, meaning that the gene is disordered, that forces the cell to divide continuously and indefinitely, thus creating a tumor that gets larger and larger causing malfunctions in the body. In our cells, we have what’s called proto-oncogenes, which are genes that primarily regulate the cell division and keep cell division organized. When this gene gets mutated, creating oncogenes, cells begin to divide indefinitely without being regulated and thus, form a cancer tumor. Don’t worry, though, because we still have another gene in our chromosomes that accounts for suppressing the tumors and slowing it’s growth rate so the tumor doesn’t keep getting larger so quick. The problem is when this gene decides to get mutated and this is when things start getting bad, the tumor that was caused by the mutation grows fast and becomes all wild and unmanageable that it spreads some of it’s cancerous cells to the blood stream and, consequently, into the rest of the body.
In the breast, specific genes that aid in the protection against breast cancer are called BRCA1 and BRCA2. These genes are a form of tumor suppressor genes that detect malfunctions in the DNA and try to correct these malfunctions through the proteins both genes make, ultimately leading to a less chance of getting breast cancer. When either one of the genes BRCA1 and BRCA2 gets mutated, the proteins that are made that keep correcting DNA disorders are either not being made correctly causing them not to work efficiently, or no longer to be made in the cell (National Cancer Institute, 2014). In this case, it’s just a matter of time until a mutated DNA gene commands the cell to grow infinitely. I think now you are able to understand what BRCA genes are and how, if mutated, can lead to much more increased chances of developing breast cancer.
Moving on to the causes of breast cancer. It is well known that breast cancer can be inherited from parents to children, and it is true that a large percentage of people who have close relatives who were diagnosed with having breast cancer do actually have higher chances of getting breast cancer. The more relatives with breast cancer, the higher the risk of actually getting this disease is. What many people don’t know, on the other hand, is that inheritance is not the main cause of breast cancer. There are many other causes, for instance, some hormones are proven to have a direct connection with the chance of getting breast cancer. So having an increased amount of this hormone called ”oestrogen” causes a higher risk of getting breast cancer. This hormone is produced over the course of having menstruation cycles throughout life, the longer the period between puberty and menopause, which is when a woman begins to have periods no more; the higher amount of this hormone is produced. Having an increased weight is also linked with the production of that hormone too. Some researches have also found that alcohol raises the chance of breast cancer. Some other factors do increase this chance like aging; most breast cancer patients are over 50 years old (National Health Service, 2012).
I will now inform you about some of the cons and pros of the BRCA genetic testing. One of the pros would be that the sooner a breast cancer gene is diagnosed, the higher the probability of finding a treatment for it is. Also, as your two daughters get the BRCA genetic test, if god forbids they do have the high possibility of developing breast cancer, they are able to get some drugs that are called chemoprevention medications. These medications, although having some side effects, do decrease the risk of getting breast cancer significantly and are to be considered. One form of chemoprevention medications is called tamoxifen. Although being very effective, it does have some side effects like nausea and other simple side effects. But there are also some serious but uncommon side effects like getting other kinds of cancer.
The cons of not getting a genetic testing, on the other hand, are three that I’ve found. One is the emotional aspect and how people who result positive can deteriorate and have an emotional breakdown. This leads to the second con, which is the ability of emotions to manipulate one’s medical decisions, and the inability to make proper medical choices. The third con would be associated with health insurance and how some insurers discriminate between people and require some to work really hard to get this kind of insurance that matches their situation (Lee-Frye, 2008). If I were to advise your daughter about genetic testing, I would say that it isn’t needed since none of our family members showed breast cancer before. They can do just like you did; just getting a diagnostic screening would be sufficient. The hassle and problems caused by getting a genetic testing are not worth it as sometimes tests are not adequate to determine if it’s BRCA gene mutation or another misleading gene that leads to more complications and surgeries that don’t have to be done.
A couple of years ago Angelina Jolie had a double mastectomy, which is the removal of both breasts due to having a high chance of getting breast cancer (Kluger & park, 2013). In her case, I think that 85% chance is high and she did the right thing by removing both breasts. But as for other women who have far less extreme case than that, there are alternatives such as the treatment tamoxifen and one breast or even partial breast removal where most cancer cells are located. The reason behind this is a mastectomy would leave scars in the body of a woman. In Jolie’s case, the cancer could have easily spread to other body parts and be fatal. Now it seems like a lot of women would opt for a double mastectomy just to be “proactive” as Jolie did just because they think of her as a role model. If one of my family members had breast cancer I would recommend getting a doctor consultation as this could be helpful. But for most cases I think tamoxifen would be the right treatment as the side effects are mostly minor and would only last for a period of time.
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