Cancer doesn't have to be a death sentence. Dr. Ellen Provost, director of the Epidemiology Center at the Alaska Native Tribal Health Consortium is proof.

She took a difficult route: chemotherapy, radiation and a double mastectomy. 

But she might not have had to if she'd been tested for BRCA1, a gene mutation that increase a person's risk for certain cancers, including breast cancer. 

About five years before her breast cancer diagnosis Provost suggested to her provider that she be tested for the mutation. She thought she was at high risk, but she was dismissed as a low risk. 

Five years later, in 2009, stage three breast cancer was found.

"Completely preventable," she calls it.

Maggie Miller, a certified oncology genetics counselor at Providence Alaska Medical Center, discussed Provost's case with her. 

"My role is helping to identify if there a genetic mutation so that those providers can make different suggestions to their patients," Miller said. 

Miller brings an impressive resume to her desk. From genetics to molecular biology, there's psychology and course work in counseling theory along with ethics. 

But as versed as she is, it's the examples of the human element that come through her office that really make an impact.   

"What I see everyday is people coming in because they want to take care of their loved ones." Miller says even patients who have cancer and are benefiting from gene-targeted treatments are thinking about others.

"They want to know that their sister can get tested for this and never go what she's gone through. They want to protect their granddaughters, their great-granddaughters, so there's a lot of the beauty of how much people love their family."

That's also one reason why Provost is speaking out about the importance of being tested. 

"Each woman needs to know their own risks, and I'm not just talking about getting a mammogram. I'm talking about knowing whether you're BRCA-positive, what your genetic risks are."

So what happens if a woman is identified as a carrier of BRCA1? The range of treatments is wide.

"Ideally in surgery, we would know your genetic status before removing a breast cancer lump, because you might find out you're a BRCA1 carrier and have a 65% chance of getting a second breast cancer." Miller said. "And many of those women are going to choose a bilateral mastectomy instead of lumpectomy."

Provost also notes that the gene mutation doesn't take the same predictable path; it can travel the male line too. You're just as likely to get the mutation from your mother as from your father.

While she is cancer-free, Provost deals with reminders.

"Certainly the physical changes I had to endure for the surgeries, the side effects. I feel those every day," And she's still taking medication that affects her quality of life.

But in the end, she says, she's happy to be alive. 

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