‘I Made as Much Lemonade Out of These Lemons as I Could’ – Survivor Rachel Miller Garcia Shares Her Story

Garcia recalls the surgeon showing her drawings of her pelvic anatomy:  “They removed parts that I didn’t know very well,” she says wryly. The good news was that her cancer was almost completely contained in her left fallopian tube, and had barely begun to spread, making it stage 2b.

After the surgery Garcia began chemotherapy, a common protocol for ovarian cancer. She started to wonder whether she could have done more to prevent the disease. Garcia had known for years that she carried a BRCA1 mutation that put her at high risk of developing ovarian cancer. “But I chose screening over prophylactic surgery, knowing that monitoring wasn’t the same as prevention,” she says. “It wasn’t like I was walking around thinking I was going to get cancer. Quite the contrary; I thought I’d never get cancer.” Instead, Garcia hoped that if she ever did develop cancer, way in the future, there would be new cures to help. She beat herself up over her decision for weeks, “maybe months,” after the surgery, thinking she could have spared herself some of the ordeal.

Eventually Garcia decided instead “to make as much lemonade out of these lemons as I could. I do advocacy work for funding and policy in Washington to get more money for women’s cancers. I speak at events throughout the Bay area and sometimes on the east coast.” Now, with hindsight, Garcia says she probably should have taken the results of her genetic testing more seriously and opted for prophylactic surgery.

Genetic Testing for Ovarian Cancer Patients

All women diagnosed with ovarian cancer should have genetic testing done if they haven't already. These tests can provide valuable information for them and their family members, and also help to guide treatment for their specific cancer.

A large number of ovarian cancers, at least 10 to 15 percent that we know of, but probably more, are based on germline, or inherited, mutations. Lifestyle and chance play into a cancer diagnosis but inherited risk which is evaluated during genetic testing can play a huge role as well. Mutations of the BRCA gene, like BRCA-1 or BRCA-2, place women at a heightened risk for both ovarian and breast cancer.

If someone is a mutation carrier, they may also be at increased risk for other malignancies like pancreatic or colon cancer. That's important information not just for patients but for their family members too, who may want to get tested themselves. In the U.S., 90 percent of people who carry a BRCA gene mutation aren't aware of it until someone in their family gets cancer.

If a family member is found to be a mutation carrier but is currently cancer-free, they have several options. If a woman tests positive for a BRCA gene mutation, for instance, she may be advised to undergo surgery to remove both of her ovaries and her uterus to eliminate her risk of ovarian cancer. The typical recommendation is to get a bilateral oophorectomy and hysterectomy ideally after childbearing years, usually between ages 40 and 45.

 

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