29 April 2014
Waikato DHB Sisters Brave Rare Cancer Gene
Hamilton sisters Amber Argaet, 34, and Tara Ellingham, 32, have seen their fair-share of injury and illness during their14 years with Waikato District Health Board.
But Amber and Tara, who work respectively as a midwife and duty nurse manager, can tell you that no matter how many health complications you see, little can prepare you for severe first-hand experience.
Both Amber and Tara have arare gene mutation known as BRCA, which stands for BReast CAncer. They were tested positive after Tara was diagnosed with breast cancer in 2012.
“Everyone has BRCA genes. Normal BRCA genes are tumour supressing genes and help prevent cancer from occurring. But some families carry mutated BRCA genes that can be passed down from one generation to the next,” Amber said.
“Our father died from prostate cancer. His sister died of ovarian cancer. His brother died of stomach cancer. His mum died of breast cancer. It was from his side of the family that we inherited the mutated BRCA genes,” Tara said.
Women with a BRCA1 mutation carry up to an 87 per cent lifetime chance of breast cancer and 54 percent chance of ovarian cancer.
For BRCA2 gene mutations, the risks are a bit less - about 60 per cent for breast and 20 per cent for ovarian cancer.
And the sisters, both with young families, have experienced a hefty surgical journey since their BRCA diagnosis.
For Tara, who was diagnosed with cancer prior to her BRCA diagnosis, surgery was mandatory. And for Amber, who knew she also carried a high risk of cancer, surgery was a “no brainer”.
“Given that Tara had already been diagnosed with breast cancer, she initially underwent a partial mastectomy, chemotherapy for 18 months and radiotherapy for five weeks. She just recently finished treatment for breast cancer,” Amber said.
Amber could choose between high surveillance with the hope that if she did develop cancer the doctors would catch it early. Alternatively she could have prophylactic surgery to try and remove as much tissue as possible to reduce her cancer risk.
"I decided prophylactic surgery was the best option for me and after numerous tests, scans and specialist appointments, at 33 years old I underwent a bilateral salpingo-oopherectomy (ovary removal) and bilateral mastectomies," she said.
Remarkably the sisters choose to use their extreme health-hardship to raise awareness. And their message is twofold; for the general public and for women working in the health sector.
“All women ought to make sure they are self-checking for any breast abnormalities and those who are eligible need to have regular mammograms. If family history suggests the possible presence of a harmful BRCA mutation, talk to a doctor,” Tara said.
“For women working in health, it’s important to heed the advice we give to patients. None of us are exempt from illness, no matter our age or occupation. Keep setting a good example by seeking medical advice when you believe your health is in jeopardy,” she said.
Their ready advice comes from their own experience of “fantastic care” with Waikato DHB.
“I have been cared for by the most amazing healthcare professionals who have exceeded my expectations,” said Tara
“The doctors and surgeons at Waikato Hospital made what was a very daunting process as comfortable as they could; staff came in on their days off, they shared new research and advice, and would sit and answer thousands of questions.
“It’s great to know that the hospital you work for gives brilliant care. In my experience, the healthcare professionals genuinely work to give the best possible outcome for the patient.”
Amber and Tara also commend the work of BRCA support group, Gift of Knowledge, and breast cancer support group, Shocking Pink.
"We feel privileged that, unlike the women before us in our family, we will be around to see our children and perhaps even grandchildren grow up," Amber said.
Waikato DHB clinical director and breast cancer specialist Ian Campbell said, the finding of a BRCA gene mutation has huge implications for an individual – not just for themselves, but also for other family members.
“There are extremely difficult decisions to be made around risk-reducing surgery to breasts and ovaries versus surveillance. Major surgery on the one hand, with effects on self-esteem, sexuality, femininity, body image, age at menopause, and ability to breast feed.
“And surveillance on the other hand, which is firstly imperfect, but in addition, carries with it a burden of increased anxiety every year when the test date is due, compounded by not infrequent findings which require further investigation even if most of these prove not to be cancer in the end.
“There are life and health insurance issues, considerations around childbearing and sometimes differing views within one family to be dealt with.
“Amber and Tara are very brave young women, who have my greatest admiration for what they have and are doing.”
Click here for more information about BRCA
About Waikato District Health Board and Health
Waikato DHB is responsible for planning, funding and providing quality health and disability support services for the 373,220 people living in the Waikato DHB region. It has an annual turnover of $1.2 billion and employs more than 6450 people.
Health Waikato is the DHB’s main provider of hospital and health services. It has six groups across five hospital sites, three primary birthing units, two continuing care facilities and 20 community bases offering a comprehensive range of primary, secondary and tertiary health services.
A wide range of independent providers deliver other Waikato DHB-funded health services - including primary health, pharmacies and community laboratories.