Gina Sabella-LaRocca, 46, grew up in a "huge crazy Italian family" in San Francisco. She and her husband, Michael, live in Marin with their three teenage daughters. Sabella-LaRocca was diagnosed with breast cancer in 2009. Because of a strong family history of cancer, she also underwent genetic testing. Fortunately, the results came back negative.
When did you first become aware of your genetic risk for cancer?
We never not talked about cancer. It was a regular topic of dinner conversation when I was growing up because of the long history of cancer in my family. My paternal grandmother was diagnosed with breast cancer in her early 40s. She was the first. Then 11 of her 12 siblings were diagnosed with various types of cancer. Next my aunt was diagnosed with breast cancer in her early 60s. We also have a history of ovarian cancer, but it's harder to trace because those relatives didn't live as long. With that much cancer happening in one family, you can't help but think it's genetic.
We were always very open about it. My siblings, cousins and I would talk about what we'd do if we were diagnosed. The conversations were quite detailed. We talked about how we'd react, what kind of treatment we would choose and how we'd want to live. We all made a pact that if one of us were diagnosed, we'd fight as hard as we could to beat it.
How did you discover you had cancer?
I started getting annual mammograms at age 30 because of my family history. When I was 44, the radiologist saw something suspicious. After a series of tests and procedures, the diagnosis came back as breast cancer. That was in December 2009. Thank God I was getting screened every year, because the cancer was very fast growing and it wasn't something I could feel.
I'd been preparing myself for a cancer diagnosis all my life but the news still came as a shock. One of the first things I did was meet with genetic counselors at UCSF's Cancer Genetics and Prevention Program. They took an extensive family history, talked with me about the BRCA genes and took a blood sample.
What happened next?
In February 2010, I had my first surgery, a centennial node biopsy. Thank God the biopsy was negative. The cancer hadn't spread. That was the good news. The bad news was that it was an aggressive subtype of breast cancer, called triple negative, so I started chemotherapy a couple of weeks later. It all happened so fast it made my head spin.
After chemotherapy, I had a double mastectomy. The decision wasn't easy. It came out of several what-if discussions with my family. In the end, I didn't want to worry about the cancer coming back in my other breast. I knew I didn't want to go through all this again. In May I had a skin-sparing double mastectomy with tissue expanders. In December 2010 I had surgery to replace the expanders with implants. The following year I had another surgery to fix one breast that "fell to the side" and to reduce the size of the implants. They were way too big!
In 2012 you had your ovaries removed. What led you to that decision?
I was having trouble with excessive bleeding, bloating and just generally feeling out of sorts hormonally. Once you've had cancer, you tend to check things out early instead of letting them linger. My gynecologist took a hard look at my family history of ovarian cancer and asked me if I'd considered having my ovaries removed. The surgery was a safeguard measure, to be sure, but later that year I had them removed.
That was my seventh surgery! I remember the surgeries because they were equally hard if not harder to go through than the chemotherapy. After my last surgery, I went straight into menopause. The hot flashes are unbelievable, but I'm happy I did it.
How was your experience at UCSF?
I split my treatment between the UCSF Breast Cancer Center in Marin and the UCSF Breast Cancer Center in San Francisco. Both teams of doctors were in constant communication, which made me feel good. Dr. Cheryl Ewing, my breast cancer surgeon at UCSF, walked me through my surgical options. I appreciated that the nurses would always call to follow up after my doctor's appointments. Without fail, I'd always think of a question or two after I left the doctor's office. And then the nurse would call, just to follow up, and it's so nice to hear a kind voice and have the chance to ask those nagging questions that you can't stop thinking about. It's those little things that make a big difference.
What does the future hold?
I am worried about what the future holds for my three daughters. None of them have been tested for the breast cancer gene yet. We talk about the importance of staying healthy and being proactive. I have cousins in their late 20s and early 30s who did test positive. They plan to have prophylactic mastectomies and ovarian removal as soon as they complete their families. But my daughters are just 13, 16 and 18, so I tell them there's no use stressing about it now.
How do you feel about the choices you've made?
I feel very lucky. I know things could have been a lot worse. And I am alive and well today. Yeah!
