Kathleen Bloom was happy to turn 50. After all, her mother had lived only to 41, and her grandmother died at age 54.
For someone with a family history of breast cancer, Bloom was always aware of the disease that could one day strike her next.
“I always felt that there would be something that (my sisters and I) would be looking for, even when we were young,” the resident of Tehachapi, Calif., said.
The cancer took Bloom’s mother and grandmother. One of her sisters was diagnosed with it at 36, four years before most women are advised to start getting mammograms.
But it wasn’t until Bloom noticed a lump in one of her own breasts that she went to the UCLA Cancer Genetics Program for answers.
The program offers genetic testing and counseling to patients with family histories of any type of cancer, and who might have genes that greatly increase their risk of getting the disease, said Joyce Seldon, a genetic counselor at the Jonsson Comprehensive Cancer Center and director of the program.
“You don’t just see your typical cases of (cancer),” Seldon said. “We’re specialized in focusing on high-risk … patients.”
Genetic counseling involves more than just taking a test to see whether a lethal gene is present, Seldon said.
There are many factors that contribute to a person’s risk for cancer, such as family history, lifestyle and age. Genetic counselors look at all of these at once, she added.
“The interpretation of the test is very different without a genetic counselor,” Seldon said.
But for a patient who tests positive for a lethal gene, the implications can be great, Seldon said.
After Bloom received chemotherapy in 2002 and recovered from cancer, she tested positive for BRCA1, a gene that leaves patients with a high risk of developing lethal breast or ovarian cancer, according to the National Comprehensive Cancer Network’s practice guidelines.
Although Bloom no longer had physical signs of cancer, the gene’s presence made getting cancer again a tangible risk.
The day the results came out, she and Seldon had a long phone conversation about discussing treatment options and doctors who could help her with the next steps, Bloom said.
One option the program provides for people like Bloom is getting a mastectomy or oophorectomy, surgeries that remove breast tissue and ovaries before there are signs of the disease. Patients go through intensive breast reconstruction and hormone therapy afterward, Seldon said.
Patients who opt for this choice can lower their risk of cancer greatly, Seldon said. But many women struggle with weighing the loss of these body parts against the potential benefits, she added.
For Bloom, the decision to get both surgeries seemed obvious.
“I wanted to be around longer for my children,” Bloom said. “(My thoughts were), “˜How do I minimize getting breast cancer again?'”
Family members of patients react to the option in different ways, Seldon said. She’s seen a father insist that his daughter have a mastectomy so he does not have to bear the pain of losing another loved one to hereditary cancer.
Or, in Bloom’s case, a son asking his mother post-surgery why she would remove parts of her body that no longer had signs of cancer development.
But Bloom does not regret the choice to remove her breast tissue and ovaries.
“I seemed to be always thinking, “˜I would do whatever it took to try to increase my … quality of life over having breasts for the sake that they’re breasts,'” Bloom said.
Through the program, Bloom found a team of surgeons at UCLA who specialize in breast reconstruction, mastectomy and oophorectomy, specifically for cancer patients.
“It was all done at UCLA,” Bloom said. “I wouldn’t have gone anywhere else.”
Bloom has been cancer-free ever since her surgery. Come January 2011, she will be a 10-year cancer survivor, she said.
The support and resources she received from the program were personal, individualized and have kept her alive, she said.
“I found a team of doctors that treated me as a person, not a statistic, and made me comfortable with my treatment and care,” she said.