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Am I next?

Randy Garrison

Hartselle Enquirer


When Shanna Coan’s genetic testing came with unfavorable results one of the first thoughts that may have gone through her mind might have been, was her fate going to be that of her grandmother, great- aunts and her mother. She was 31 years old and had three young children that she desperately wanted to love and watch grow up.

The young mother and biology teacher at Hartselle High School had a few tough decisions to make that would effect the rest of her life as well as the life of her husband and children. Coan’s genetic testing revealed positive results that she had mutations on the BRCA2 gene, which greatly increased her chances of developing breast and ovarian cancer.

Coan definitely had a family history of breast cancer. Her maternal grandmother was diagnosed at age 37 with breast cancer in 1967. She battled the disease for 14 months with cobalt treatments and succumbed to cancer in 1969 right after her 39th birthday.

Also her grandmother’s full sisters developed breast cancer in their late 40’s with one dying from the disease and the other from heart failure, thought to have been related to the treatments for cancer.

Then the disease hit even closer to home, at 50 years of age her mother Sandy Brown was diagnosed with breast cancer in 1999. To make the situation worse she had cancerous tumors in each breast, with each being a different type of cancer. Her cancer was detected during a routine mammogram and the tumors were so small they were not likely to have been detected during monthly self-examinations.

Brown had a double mastectomy and chemo treatments. She did not require radiation since she underwent the mastectomy.

Due to Brown’s family history her oncologist and genetic counselor recommended that she have genetic testing done due to her family history. Also her insurance would cover the testing due to the cancer occurrence. The genetic testing revealed she did have mutations on the BRCA2 gene.

The BRCA1 and BRCA2 genes occur on different chromosomes. Mutations on the BRCA1 affects breast cancer, increased risk of ovarian cancer, colon and pancreatic cancer. The BRCA2 mutation increases the risk for breast and ovarian cancer, and is associated with early aggressive prostate cancer, pancreatic cancer and melanoma.

The BRCA1 and BRCA2 genes are responsible for making proteins that suppress tumor growth; with mutations the repression does not occur. Also with the mutations DNA is not repaired. This can result in cells developing additional genetic alterations, which can then lead to cancer.

Since her mother’s genetic testing revealed mutations, insurance would also cover the testing for Coan and her sister Kim. Coan came back positive for BRCA2 gene mutations and here sister’s results were negative.

Her genetic counselor gave her several options. One was to do nothing; she could also begin having mammograms earlier than the typical age of 40. Also she found out that her insurance would pay for preventive surgeries due to the genetic testing results.

There is a 12 % chance any female will develop breast cancer, with either of the gene mutations there is an increased risk of 45-65% of developing breast cancer by age 70. Both Coan and her doctor felt that with her family history and the age of onset of cancer in her family members it was not a matter of if but when she would develop the disease.

Coan and her doctors decided to be proactive; she had a complete hysterectomy at age 31, followed by a bilateral mastectomy with reconstruction the next summer.

Her decision came from wanting to be around to watch her babies grow up. This motivation gave here the strength and determination to take measures to help prevent the same disease that had taken the lives of family members and had tried to take her mother’s life as well.

This was 10 years ago and she is still healthy, still teaching and loving her kids, Chase, Kennedy and Carter and living her life.

Her children will also need to be tested when they are adults as they could also suffer from the gen mutation as well. Her sons could be at a higher risk of developing prostate cancer and if her daughter has the mutation she would have the same risks as her mother.

Coan looks on her decision as one giving her another option to defeat the disease and live her life and be around to watch her children grow up.