Terri Wingham (Breast Cancer and BRCA1)
The phone rang. Shrill and persistent as it echoed through our house. I heard my Dad’s voice as he shared the news that had arrived in the mailbox at the end of our gravel driveway earlier that day. His tone made me crane my head to listen. I figured out my grandmother must be on the other end of the line, but from the desk in my bedroom, I couldn’t decipher why he was talking about results and genetics. Or what any of it had to do with my grandmother and her two sisters having ovarian cancer in the 1980s.
Later that evening, he sat my sister and I down in the living room and told us that he and other members of our family were one of the first 10 families in Canada studied for the BRCA1 gene mutation. That day, he got the results confirming that he was a carrier. A carrier? A mutation? He went on to talk about my aunt with breast cancer and the news my second cousin had been diagnosed with breast cancer at only 27 years old. My teenage brain grappled with what this all meant. I studied his pursed lips and the grave expression on his face as he apologized and said he may have passed down an inheritance neither of us wanted.
“I want you both to get tested when you’re 19. We need to get ahead of this thing,” he said. It all seemed a little abstract to me as I asked to be excused to study for my biology test the next day.
Fast forward a couple of years. My sister flew in to see me on a rainy weekend in the fall of ‘99. Instead of gossiping about boys or trading stories about our college adventures, we drove two hours, through low cloud and sleet, to sit across from a genetics counselor who asked us questions like, “how will you feel if one of you has the marker and one of you doesn’t?”
I didn’t like her. Or the brown carpet stretched up a foot or two onto the walls where crown moldings should be. Or the way the counseling process seemed to last an eternity. I just wanted the results I knew were there—inside the file on her desk. The office felt claustrophobic and my palms began to sweat.
How will you feel if one of you has the marker and one of you doesn’t? What if you are the one who has it? What if you are the one who doesn’t?
In retrospect, I knew she was only doing her job and trying to prepare me. But at the time—in spite of her kindness—I channeled the anger I couldn’t feel at my Dad’s family or the universe directly across the desk at her.
I can’t remember if she gave us the results together or separately. I just remember the shock, my numb responses, the onslaught of words coming out of her mouth like “screening” and “prophylactic mastectomy.” When she finally stopped talking, my legs nearly gave out from pins and needles, but I stood up, pasted on a smile, and robotically thanked her for her time.
As we drove back through the corridor of grey skies, I remember looking over at my sister and saying, “I’m glad it’s me, not you. Don’t worry, I’ll be fine.”
For the next 10 years, I grappled with anger and confusion about what to do. I couldn’t bring myself to cut off my breasts to remove my risks. Ever since my parents brought my baby brother home from the hospital when I was 9, I wanted to be a mom and I equated motherhood with breastfeeding. So, I did what any terrified girl would do in her 20s. Always planning to get married one day, I rolled out “the talk” about my high risk and the option to get a preventative surgery after kids about six months into every relationship. As you might imagine, this never went well.
During this era, I started seeing a genetics oncologist, Dr. Pike, at the B.C. Cancer Agency. I met her at the age of 23 and saw her every six months after a mammogram or an MRI. Each appointment, when she asked if I had considered my options, she would smile reassuringly when I either told her about a new relationship I hoped would get me closer to marriage and kids or when I teared up over my latest heartbreak. Her kindness became a beacon during some of my darker moments.
The screening itself was a double-edged sword. It reassured me that if cancer happened, we would catch it early, but every single time I slid into the MRI machine or stood with a technician squeezing my breasts between cold plates and telling me how young I was, I felt my chest tighten and I wouldn’t take a proper breath again until I got the “all-clear”.
In some ways, my cancer diagnosis at the age of 30 still came as a shock. The universe had not granted me the loving partner and the family I had wished for, which only seemed like a fair trade for cancer. On the other hand, it felt inevitable. At least I could face the monster that had lurked in the shadows for more than a decade. And, a monster it was. The knowledge of the genetic predisposition didn’t make chemotherapy any less hellish, nor did it ease the incredible physical pain of my double mastectomy and reconstructive surgeries. But it did save my life. My triple negative, grade 3 tumor was snuggled up so tightly to my chest wall that a mammogram did not detect it. The first core-needle biopsy came back negative. I believe I am here – writing these words 10 years later because a radiologist at the B.C. Cancer Agency didn’t feel 100% confident that she had gotten the right tissue sample during the core-needle biopsy and ordered a follow-up MRI guided biopsy. With the type and grade of breast cancer invading my body, I believe if I hadn’t had access to my genetic family tree, I would have not discovered my cancer in time.
Even with this perspective, life still isn’t simple. The day I went in for my final breast reconstruction surgery, I learned my second cousin—who had become my rock through cancer—had been diagnosed with stage 3C ovarian cancer. My gratitude for being healthy and alive and my sadness about her diagnosis—coupled with my fears of a future ovarian cancer diagnosis—forced me to ask myself some tough questions.
What if I die young? How can I make my time on earth really count? How might I honor the synchronistic chain of events that led to my family being chosen for a study, decades before a test like this entered the mainstream?
I chose to carve out a new path for my life. I left my career as a professional headhunter and created A Fresh Chapter —an organization dedicated to healing the emotional scars of cancer through volunteering, perspective-shifting experiences, and programming designed to reframe adversity and redefine what’s possible.
I am still grappling with my genetic legacy and continue to face difficult decisions. Even though my dreams of motherhood hadn’t become reality, I made the choice to get a prophylactic oophorectomy in December of 2016. At the time of this writing, I am still weighing the pros and cons of removing my ovaries. I’m only 40 years old and it’s not a simple choice, as either path is littered with potential risks and complications.
Information is both power and a burden. I don’t carry it lightly.
Terri Wingham is the founder and CEO of A Fresh Chapter, a nonprofit that empowers cancer patients, survivors, and caregivers to move beyond the isolation and trauma of cancer to discover renewed confidence, possibility, and purpose in their lives. Today, she spends most of her life living out of a suitcase while running programs around the world.
Millie's Story (Previvorship, Breast Cancer & Ovarian Cancer)
In 2012, I had already been working as a Nurse Practitioner in oncology for over 16 yrs, when I got a call one evening from my sister Catherine letting me know she had found a lump in her left breast and it was cancerous. While feeling a chill immediately wash over me I managed to ask how could she know it was cancerous when she was only just telling me now she found it?! She explained to me, in a small voice that she hadn’t “Just” found it…. She had found it a week or so week before, had it biopsied and hadn’t wanted to worry me by telling me until after having the results. And this was the day she received her results. It was also unbeknownst to me, the day my life would forever change in ways I could never have imagined. Catherine was 48 years old.
Just 2 months later I received a call from another sister whom I could barely understand because of her crying. She had called to tell me her daughter – my niece,Valentina – had been diagnosed with ovarian cancer after complaining for months about bloating, loss of appetite, pressure in her lower back lower back, changes in her bowel movements, and tiredness. She was only 22 years old.
By now my head was spinning, and my world crumpling… My niece lived several hours away from me and so I could only call to find out updates and visit when I could on weekends. Meanwhile, I made sure that I was at every doctor’s appointment I could possibly make with Catherine who lived closer. I helped her in any way I could by taking notes, and keeping track of all the when’s, where’s and how’s that were being thrown at her. She leaned into me and I stayed by her side through the chemo, surgery and radiation to follow.
I celebrated with her when the treatments were all done, and cried with her when 1 year later the cancer returned – rapidly metastasizing through her body even while starting a clinical trial.
During this same year, I watched from a distance as my niece went on to develop breast cancer and ultimately metastasis to the brain.
In 2014, Catherine passed away quietly in hospice care and my heart broke into a thousand pieces as I stood by her bedside holding her hand while she took her last breath. The day before she passed she asked to promise that I would get genetic testing done. She herself had planned on it but died before she could do it.
Two years later through a routine mammogram screening I was found to have extremely dense breasts. I already had a history of fibroadenoma, Type 1 diabetes and was of an ethnicity known to have a higher incidence of breast cancer. This combined with my detailed family history of cancers prompted my doctor to refer me then to a genetic counselor for testing. Finally I was keeping my promise to Catherine, and while no currently identified gene mutation was found, I was still classified as high risk of developing breast cancer myself. I was referred to a breast surgeon for continued follow up. I am now on an aggressive surveillance protocol requiring a yearly MRI with contrast, 3D mammogram and ultrasound. My breast surgeon let me know that new pathogenic gene variants are being found all the time and I will need to repeat the genetic testing at least every 10 years. She also let me know that it would have been easier to identify a gene mutation if Catherine or my niece had their genetic testing done (which neither had).
I was told that should my breast tissue become even slightly more dense I would need to consider chemo-preventive medication in addition to my surveillance regimen. This information has changed the trajectory of my life as I embarked on my own personal health journey to take back control of the direction of my health.
Determined to learn more about how I could move forward in a way that nourished and supported my health as a whole person and position myself for the best outcome possible, I enrolled in and completed an integrative and functional nutritional program.
Through this program I expounded on my clinical knowledge of oncology and learned more deeply about aspects of health that impact the human body down to the cellular level. I learned how the power of nutrition, active living and stress management actually worked to minimize inflammation, regulate hormones and support a healthy immune system so that even those with known gene mutations, or as yet, unknown variants such as myself have a better chance of survival.
Since then, I have dedicated myself to helping other women with hereditary or familial risk of breast cancer by offering hands-on support to them during their doctors appointments, helping them achieve healthy lifestyle changes and by connecting them with resources they need to move forward.
To learn more about Millie and her services visit : www.meliawellness.com
Isaiah's Story (Osteogenesis Imperfecta)
Osteogenesis Imperfecta. OI. You knew nothing of those big words or that acronym before Isaiah.
At your 20-week ultrasound, you were anticipating finding out your baby’s gender. You’d just recently started feeling little kicks and flutters; you were elated. Your baby was growing big and strong. (Or so you thought.) You watched your baby on the screen, too distracted by your excitement to notice the ultrasound technician’s silence and grimace on her face as she focused on measuring bones. You were too preoccupied by that beautiful little heartbeat to see your baby’s curved and broken arms and legs.
You now understand she was scared for you. She was scared for your baby. And she didn’t know quite what was going on.
You were asked about dwarfism running in your family. Your heart picked up its pace. You were told your baby was in the 5 percentile of growth. Your head began to tingle. You didn’t expect to hear the word “lethal” to describe anything to do with your baby, but when the doctor said “it could be a lethal form,” you began sobbing.
Oh, Vicky, it’s going to be OK. You are one of the lucky ones; “lethal” doesn’t describe Isaiah’s OI. You will have that baby, your son, who you have already fallen so in love with.
Things are going to be hard at first. You’re going to hear a lot of new terms like “tachcypneic” (meaning your baby breathes fast), and Pamidronate (the medicine your son will get to help strengthen his bones).
You’re going to learn about oxygen saturation and how to place an NG tube down your son’s nose so he can eat.
Don’t panic. Isaiah is strong.
And so are you and Dave. You will find support groups full of people who you will later consider family, and they will help you, teach you, befriend you. They will help you find a specialist who will fight along side you when Isaiah will go into respiratory failure. He will help you get the best care possible at what you will later believe is the best hospital in the world.
Isaiah isn’t his OI.
It’s going to be OK. I promise.
Rachelle's Story (HSAN1E)
I have lived my whole life playing a genetic version of Russian roulette. In this version the gun is half loaded, leaving me with a 50/50 chance of getting hit.
Round and round the cylinder spins….pull the trigger…
As far back as I can remember there has always been a rare disease in my family. It had no name, treatment or cure. It was so rare that none of the doctors knew what it was. As a little girl I remember wondering what happened to my grandpa on my mother’s side. When I asked I was told, “he died from the family disease.” One summer when I was about twelve years old my mother took me to visit a great aunt of mine. I saw she was using a walker. I asked what was wrong with her, “She has the family disease,” I was told. A few years later as a teenager my mom’s sister came to live with us. I asked why, “she has the family disease” I was told. This was the first time I would see the “family disease” first hand.
These are the basics of the rare “family disease.” The first symptoms start when the person is in their 30’s. It is passed down from parent to child. It starts with hearing loss, then sometime after that comes the peripheral neuropathy causing the person to have balance issues. Then the dementia begins. From then on, it just gets worse. In the end the person is bed ridden, unable to speak, and unable to feed themselves. Their organs begin to shut down leaving nothing left of the vibrant person you once knew.
Round and round the cylinder spins….pull the trigger…
I don’t remember when I first knew my mom had the family disease. Some memories you bury deep. I do remember that over a 15 year period I watched my mom go from being a night nurse for a little boy in a coma to being bed ridden herself, unable to speak, feed herself, or hold her newborn grandson. I know that I was left with feelings of guilt, anger, helplessness, and intense sadness.
At the time of my mother’s passing I was 31. The family disease still didn’t have a name. None of the doctors still didn’t know anything about it. There was no test to take to see if you would get it. Still no treatment, no cure. The disease would take the lives of several more family members before it would make its way back to me and my four siblings.
Round and round the cylinder spins…pull the trigger…
Sarah's Story (BRCA2 Previvor)
I was in 2nd grade when my aunt Joy passed away. It wasn’t a pretty passing although she was a beautiful person. She was my first education on the concept of death. I remember hair loss and staples and feeling her cold, lifeless hands. I remember my mom’s tears and my aunt Barb asking me if I wanted to hold Joy’s hands longer but I didn’t want to because they were cold and I didn’t understand why. My teacher pulled me aside in class to read me a story about death. I don’t remember anything about the book other than there being fall leaves on every page and my teacher crying and I didn’t know why she was crying because she didn’t know my aunt Joy, but I understood that death makes everybody sad.
People continued to die as I continued to grow. I was a 18 when I underwent genetic testing and learned that I had an 87% lifetime risk of developing breast cancer and a 50% lifetime risk of developing ovarian cancer, as well as higher risks of skin, stomach, pancreatic and other cancers. I wondered who would hold my cold hands.
The genetic counselor told me there were options, that my life could be saved and so I began my routine screenings (physical exams, blood work, mammograms, pelvic ultrasounds and breast ultrasounds). I started to feel sick even though I didn’t have cancer. I am and have always been thankful to my mom for encouraging us to get genetic testing done because I know that it saved my life.
When I was a senior in high school my mom was diagnosed with an aggressive triple-negative breast cancer. I was rummaging through her closet after school one day right after she was diagnosed. She wasn’t home from work yet and I had a bad habit of testing out her lotions and perfumes without her permission. I found a red wig and I broke down sobbing. She was preparing herself for the hair loss that would inevitably come. I was angry because she had blonde hair, not red, so the wig was the wrong color because my mom wouldn’t look like my mom. I heard the garage door opening as I was holding the wig so I shoved it inside of her drawers, went in to my room before she could find me with the wig and then pretended to be upset about the upcoming AP tests that I didn’t give a shit about.
She went through endless rounds of chemotherapy, more surgeries than I could count and infections that caused her to knock on death’s doorstep more than once. She lost her hair and sometimes she wore the red wig but sometimes she went without any wig. I let go of my anger because I realized it was really just sadness and fear. She lost her energy and I started to see her bullshit smiles when she was in pain but wanted to protect me from sadness, just like my son can read the bullshit smiles on my face now. She fought for us and she lived to tell the stories. She still lives and she gets to see the smiles on her grandkids’ faces when she bakes them cakes shaped like bunny rabbits.
At the age of 31, I was finished having kids and I was ready to get the show on the road. I had my healthy, non-cancerous breast tissue removed (and replaced with implants) via preventative double mastectomy. I had years and numerous oncologist consultations to confirm that this was the right decision for me…
Joshua's Story (Myotubular Myopathy)
Vision, Fortitude, Resolve – those words have been at the bottom of every email that Alison Frase (Joshua’s mother) has sent for the past two decades, and they describe her character well. The day after Joshua was born, amidst every bad report the doctors gave her concerning how long her son had to live, she looked at her newborn son on a ventilator and said, “Let’s give him a chance to live.” Those words changed her life, and at that moment, she became her son’s advocate. With shoulders squared, she faced the world of MTM and all the unknowns, which surrounded an orphan disease.
Paul Frase (Joshua’s father) sat in the living room with his wife one afternoon and joked that he was ‘just the muscle’ behind the Joshua Frase Foundation, but the truth is, as the Joshua Frase Foundation wouldn’t be where it is today without Alison’s tenacity and ‘never quit’ attitude, the Joshua Frase Foundation also wouldn’t be where it is today without Paul’s muscle. Paul’s job as an NFL lineman was more than just a dream job; it was the vehicle the Frase’s would use to start their foundation. Every Sunday when Paul put on his team uniform, he was using his muscles to build a platform to raise awareness and funding for research for this deadly disorder, as his son, whose muscles failed him on a daily basis, fought for his life. Paul carried Joshua through the playground of life one activity at a time, hiking through the woods, on a tour of the White House, on a scavenger hunt, and to all night church lock-ins, all so his son could experience what ‘normal’ kids did. Carrying Joshua through life created a bond that most fathers and sons never experience. When Paul won the Ed Block Courage Award an unprecedented second time in his eleven year NFL career, he knew it was because his son showed him every day what it meant to be courageous, to stand firm in the face of adversity, and to keep getting back up time and time again when life knocks you down.
Shannah's Story (GA-1)
Emmalyn Reese Hudson graced us with her presence 8 years ago at 35 weeks gestation weighing in at 5 lbs, 7 ozs. and 18 inches long. Our beautiful baby girl was so tiny and perfect, and I couldn’t believe how blessed we were to be her parents. Her Apgar score was an 8, and she seemed otherwise developed and healthy despite being premature. She did have an elevated white count which required her to have a round of IV antibiotics and another day of observation. A few days later, we brought our seemingly healthy baby girl home. On our second night at home around 10:30 pm, we received THE devastating phone call that no parent ever wants to get. In an instant, our new baby bliss turned into sheer panic, fear, and grief. That moment, one I will never forget, is when our daughter became a brave and fearless Rare Disease warrior.
The nurse solemnly told us, “I don’t want to alarm you, but your newborn baby is very sick and needs to be brought to the hospital immediately.” She then told us to pack our bags because Emmalyn would be transferred to the Children’s Hospital two and half hours away after she was stabilized. We were given no details about what was wrong except that her Newborn Screening came back positive for a rare genetic disorder. The next couple weeks were a blur of tears mixed with overwhelming fear, uncertainty, anger, devastation, and immense heartache.
After 8 days in the Children’s Hospital, we took our baby girl home with a scary diagnosis of Glutaric Aciduria/Acidemia Type 1 (GA-1). GA-1 is a rare genetic metabolic disorder in which the body lacks the necessary enzyme needed to break down the amino acids lysine, hydroxylysine, and tryptophan which are building blocks of protein. The excessive levels of intermediate breakdown product will then accumulate and cause damage to the brain, including the basal ganglia. There is no cure for her disorder but we manage daily with specialized metabolic formula, medication, a carefully measured low protein diet, frequent blood work, strict emergency protocol management, and extra caution during cold/flu season.
Fast forward 8 years: Emmalyn is living a full, happy, and healthy life. I homeschool to keep her from being exposed to all the contagious illnesses in the school system. She has abnormal MRI’s, slight developmental delays, learning disorders, speech delays, macrocephaly, and secondary carnitine deficiency which are all common for her disorder. She is brilliant, funny, loving, compassionate, beautiful, and exceptionally brave! Looking back now, the worst phone call we ever received will also be the best call of our lives in that it was what saved Emmalyn’s life.
Without newborn screening and the quick response by her medical team, she could have lost all her motor skills or life due to metabolic acidosis, encephalopathy, and striatal necrosis. There is still much more to learn about her disorder, many people to educate and inspire, improved protocols to be established, gene therapies to be developed, and an eventual cure to be found.
Danae's Story (Homocystinuria)
My name is Danae’ Bartke and I was diagnosed with Homocystinuria in 1995 at the age of 10. We discovered the diagnoses because my younger brother had bumped his head on a table in school and then complained that he could not see. After a week or so, my mom took him into an eye doctor who referred us to the Wheaton Eye Clinic. At the Wheaton Eye Clinic they discovered that his lenses had detached from his retina and popped through his pupil. He then had immediate eye surgery to remove the lenses in both of his eyes. The doctor, at the time, told us that it could only be one of two conditions that had caused the detachment. Garrett was disqualified from one because he was not old enough, so it left us with only one possibility: Homocystinuria. The eye doctor at the Wheaton Eye Clinic then got in touch with Dr. Paul Wong and told him of the case. Immediately, Garrett was tested and it came back positive. The next step was to myself and my six siblings tested. Out of the rest of us, I was the only one who also tested back positive for Homocystinuria.
After the diagnoses Dr. Wong took us through a couple of treatments to see which ones we had responded too. The first one was just a regiment of B6. From that, we discovered we did not have the kind of Homocystinuria that was responsive to B6. He then started us on B6, B12, baby aspirin, folic acid, Hominex-2 and a low protein diet. After that we were on track; at least for a bit. I can’t say that I was a very sweet child. My brother and I gave my mother a very difficult time. We hated the food, hated our Hominex, and we did not really follow the diet like we were supposed to. Our father had died a year prior to our diagnoses, so our mom did not have the time or energy to battle us every step of the way. Eventually, I did adhere to taking the Hominex and attempted to follow the diet. I wasn’t the best patient, but I did make an attempt.
In 2009, I had a really big fork thrown in my road. As a result of not following the diet as well as I should’ve, I developed a blood clot in my wrist. Dr. Wong advised me to go immediately into the Emergency Room at Rush and he would have someone there to meet me. After a week in the hospital I was released with a new lease on life. I realized how lucky I was and that if I was going to have a healthy, productive and long life, that I was going to have to take my diet seriously.
About two weeks after being released from the hospital I received a letter from the PKU Organization of Illinois inviting me to a low protein cooking class. I had neither heard of the PKU Organization of Illinois nor did I know there were any other disorders out there that had to follow a low protein diet. I was so excited! After the cooking class, we then went to the Annual meeting where we met Malathy from Taste Connections. From her, we found out about the first national conference for Homocystinuria. We went to that in March 2011. In the course of a couple of years we went from having no community to a community that was just so helpful and kind.
In 2014 I joined the PKU Organization of Illinois board. In 2014 and 2015 I was in charge of the PKU Press. The PKU Press is PKU Organization of Illinois newsletter. It lists the events for the Spring and Fall. It also has special interest pieces, tips, recipes and much more. In 2016 I became the President of the PKU Organization of Illinois. As President, I oversaw the Board of Directors and various committees. I put myself on every committee to get a solid understanding of each function.
In 2016, I traveled to Prague for the first Methylation Defects Patient-Expert Meeting. There I was able to meet with world-renowned researchers in the Methylation Defects field, along with other patient organizations and families. It became very apparent that we needed an organization in the US for the Methylation Defects. Upon arriving back, Margie McGlynn and I began work to start up what is now HCU Network America!
Irene's Story (Breast Cancer and BRCA2)
I never thought I would…..
Looking back at everything that I have been through in the last six years makes my head spin at times. So it’s been a minute here. in 2013 at the age of 41, I was diagnosed with DCIS and IDC My former surgeon gave me some really poor advice. Luckily I didn’t take it.
He told me not to bother getting genetically tested. He told me not to have a mastectomy and he never sent me for a breast MRI. About a week after my lumpectomy, I found out I was BRCA2 positive and that’s when all the fun began. Countless doctors appointments, three opinions and I was off to the chemo chair and later a bilateral mastectomy.
None of this shit is pink or glamorous. Chemo was hell. The surgeries and the 5 years on meds were awful. I had to switch my meds three times due to side effects. When one person gets cancer, the whole family gets cancer.I have been NED for 6 years. Not a day goes by that I take it for granted. This is the reality of a cancer patient.
It’s breast cancer awareness months. Ok, so we are all pretty much aware. So let’s bring some very needed focus on genetic testing and metastatic breast cancer. The only cancer that kills is stage 4. If we can find out why people get mets, we can somehow make this disease chronic like HIV. Genetic testing is absolutely vital because it determines ones care plan and treatment.
I’ve been advocating for myself and others for the past 6 years. Sometimes it’s emotionally taxing, but it’s an extremely important cause for me. I never thought that I would be sitting here and writing about my cancer journey. If someone told me that this was going to be my life, I would have changed things. I wish I knew about BRCA so that I could have had a PBM (preventative bilateral mastectomy). So here’s my advice to everyone. Ask questions, get second opinions and if you don’t like your team of doctors get yourself a new team. If you have a family history of cancer, go and talk to a genetic counselor and get yourself tested.
Read more on Irene’s blog, mutantstrong.com
Find Irene on Instagram: @mutant_strong
These stories are written by patients. They are not intended to nor constitute medical advice and are not fact-checked by a certified genetic counselor.