For more than 20 years, Dr. Frank Powell has been surgically removing breast cancer in women. But in all that time, he has seen only two stricken with both breast and ovarian cancer even though neither of them carried a mutation in the BRCA1 gene that increases women’s risk for the diseases.
Forty-three-year-old Chye Upshaw of Newnan is one of them.
Some 22,000 women are diagnosed each year with ovarian cancer in this country. About 15 percent of them have the BRCA1 gene mutation, but it wasn’t until actress Angelina Jolie Pitt announced her decision to have a double mastectomy after testing for the gene that it became part of our public consciousness. She decided to get tested because her mother died of ovarian cancer at age 56.
The actress's announcement, widely dubbed the "Angelina effect," spawned a surge in requests for genetic testing nationwide. BRCA testing rates, according to results of a review of a large U.S. health insurer, jumped nearly 40 percent in the month after her 2013 announcement to remove her breasts and remained elevated for at least the following year. Two years later in March, doctors removed her ovaries and fallopian tubes.
Upshaw got the first in a series of cancer diagnoses threatening her life in 2012.
Nearly 22,000 women are diagnosed with ovarian cancer each year; 14,000 die.
That’s more than half and so you can see why many of these women might feel like ticking time bombs.
There was no reason to believe, really, that Upshaw had breast cancer. She was diligent about doing monthly breast self-exams. She lived an active lifestyle, ate healthy and didn’t have a strong family history of the disease. For years, she had led a breast cancer awareness program at her church.
In October 2012, she headed to Piedmont Newnan Hospital for her first mammogram. Upshaw, a mother of four children, was 40, then the recommended age for women to start having that test.
“I had no symptoms and didn’t know of any family history, so this was just a normal checkup for me,” she said.
A few weeks later, doctors told her she had cancer in her left breast.
“I was pissed. Prior to my diagnosis, I’d been working to get health information out to the community, making sure others were getting their mammogram,” Upshaw said. “I did the why me thing for a minute but managed to take it in stride and see it as an opportunity to help others going through the same thing.”
With the help of her doctors, God, and her husband, Upshaw decided the best course of action was a mastectomy, followed by reconstructive surgery.
Then just as life seemed to be returning to normal, there was more bad news. This time, doctors noticed cancer on her ovaries. This time, Upshaw decided to have a hysterectomy.
“I felt like I’d been stripped of everything that made me a woman,” she said. “My breast was gone. My ovaries. My hair had fallen out.”
None of that mattered when in December her husband and biggest supporter, Isaac, fell ill and within three months he was dead of colon cancer.
At a follow-up appointment just weeks ago, Upshaw was dealt another blow.
The cancer was in her left lymph nodes.
And so this week, she was back at Piedmont to get a mammogram and ultrasound to help doctors determine the next course of action.
When she made the decision to remove her ovaries, Jolie Pitt said she wanted to see her children grow up and meet her grandchildren.
Upshaw does, too.
Powell believes the chances are good that will happen.
“She had a fairly advanced breast cancer, and while that might decrease her chances of long-term survival, she’s done amazingly well,” Powell said.
But even he is at a loss to explain Upshaw’s double diagnosis.
“It’s pretty rare to have both cancers,” Powell said. “This is unfortunate for her.”
Even when women have the BRCA1 gene, Powell said they have a 60 percent chance of developing breast cancer at some point in their lives up to age 70 and only a 40 percent chance of developing ovarian cancer.
The bottom line is breast cancer in women is very common and deadly. If you’re at increased risk for the disease — have a family history, have the BRCA mutation, are overweight, smoke or drink alcohol — get screened now.
It could save your life.
