Patient Testimonial - "Knowledge Is Power"
With her great-grandmother being diagnosed with breast cancer at age 35, her grandmother at age 55, and her sister diagnosed in the past several years, Susan Ketcham of Storm Lake, Iowa had been diligent about her annual mammogram screenings since age 35. She admits to delaying her last mammogram by a handful of months due to an increase in COVID-19 cases in her community, but just as she was ready to check the box on another year of screening, she was caught off-guard.
“I was not ready to hear I was positive for breast cancer,” Susan said. Something was seen in her mammogram in February 2022 at 59 years old, so Susan had a biopsy which determined the tumor was malignant.
“I was taking my risk seriously and thought I was doing everything I needed to regarding prevention,” Susan adds. “Hearing the diagnosis was tough for me. I was overwhelmed and shut down for a while. I needed time to process.”
Susan says she soon learned it was good because her breast cancer was found early and hers was actually a “hopeful diagnosis.”
“My cancer could be taken care of,” says Susan. “There are much tougher diagnoses than mine.”
The first course of action was a lumpectomy performed by Dr. Jason Dierking of Buena Vista General Surgery in April. It was then that Dr. Nibash Budhathoki, one of the June E. Nylen Cancer Center medical oncologists seeing Susan during an outreach appointment at Buena Vista Regional Medical Center in Storm Lake recommended her having a radiation treatment consultation, as well as genetic testing, done.
Susan ended up traveling daily for 22 radiation treatments to lower her risk of the cancer coming back in the remaining breast tissue or nearby lymph nodes. It was during this time that she also had her genetic counseling appointment at the June E. Nylen Cancer Center. Susan met with Jessie Poskochil, a licensed and certified genetic counselor to go through family and personal history as well as additional information to identify what genetic tests should be completed.
Susan’s genetic testing results revealed she was positive for two “pathogenic changes” – the BRCA2 gene deletion and RAD51C gene deletion. BRCA stands for BReast CAncer gene and RAD51C is a rare breast and ovarian cancer susceptibility gene.
Jessie met again with Susan and her husband, Bradley, to go through what those results meant and provide a comprehensive report with recommendations that would also go to Susan’s oncologist and primary care provider.
“I wasn’t so sure about doing the genetic counseling but I decided I needed to have more information,” Susan said. “Jessie was great with me. The results of my genetic testing helped me understand my cancer and we talked about it as a family. Because of being positive for genetic cancer, statistically, we know 2 out of our 5 children are at risk. Now my kids know for sure, they can do their part to start early screenings, and can get their genetic testing done (to see if they too have the same cancer-causing genes, BRCA2 and RAD51C.)”
Susan stresses that others who have risk should definitely go through genetic counseling and testing. The knowledge as a result is key and then specific recommendations are known regarding prevention strategies and screenings.
Susan is now taking Tamoxifen, an oral drug that treats hormone receptor-positive breast cancer. She will learn at future appointments with the June E. Nylen Cancer Center how long she will continue that. She is grateful for all the top-notch medical care she has received at multiple healthcare facilities and is happy to be able to travel on the weekends with Bradley to see their 5 children, ages 26 to 36, and their 8 grandchildren.
As a pre-kindergarten teacher at Schaller-Crestland Elementary School, Susan has always believed knowledge is power. But now through first-hand experience with her diagnosis and genetic testing, she has a new perspective.
“Some things just don’t seem as important as what I stressed over before,” she says. “I think about life differently. Take it one day at a time. Give yourself grace. Slow down. Take care of yourself.”
Susan Ketcham of Storm Lake and her husband, Bradley
Susan and her husband, Bradley, and their family of 5 children, their spouses, and 8 grandchildren all together last Thanksgiving.
Know Your Risk - Get the Knowledge Genetic Testing Can Provide You
If done when cancer is already diagnosed, genetic testing helps make informed decisions on the most effective course of treatment. Genetic testing can also be done pre-diagnosis to help people understand their risk for cancer, help them make medical decisions proactively with their physician, and take steps to lower their cancer risk or detect cancer early.
Through a genetic counseling session, a certified genetic counselor will collect personal and family history and additional background information. The genetic counselor will then help decide what tests might be right.
Genetic counseling may be advised if your personal or family history includes any of the following:
2 or more close/primary family members with the same or related forms of cancer
Cancer diagnosed younger than age 50
Bilateral or multiple primary cancers - more than one cancer type in a family member
Ovarian cancer
Pancreatic cancer
Male breast cancer
Triple-negative breast cancer
Family history of a known gene mutation, including BRCA1 and MLH1
Colon or endometrial tumors with abnormal MSI/IHC
10 or more gastrointestinal polyps
Metastatic prostate cancer