[2022-01-15] Chris Evert diagnosed with ovarian cancer
Yesterday, tennis great Chris Evert shared that she's been diagnosed with ovarian cancer. She tweeted:
I wanted to share my stage 1 ovarian cancer diagnosis and the story behind it as a way to help others. I feel very lucky that they caught it early and expect positive results from my chemo plan. Thanks to Chris McKendry for her friendship and for co-writing this very personal story with me. And thanks to all of you for respecting my need to focus on my health and treatment plan.
She provided a link to the story that her friend and fellow ESPN journalist Chris McKendry wrote: Chris Evert opens up about her stage 1C ovarian cancer diagnosis.
McKendry begins the article with the text she received from Evert on December 7, indicating that a malignant tumour had been found in one of Evert's fallopian tubes following a preventive hysterectomy. McKendry writes:
My friend Chrissie has cancer. The disease had killed her sister Jeanne. My god.
I twigged to the fact that Evert had the same rare disease as her sister and immediately wondered about a genetic link. I skipped ahead to the part of the article that shared Jeanne's story.
Jeanne Evert Dubin, Chrissie's younger sister, also a former professional tennis player, died in February 2020. She was 62. The two sisters were racing through the airport to make their flight to the WTA Finals in Singapore in October 2017 when Chrissie realized Jeanne was out of breath and couldn't keep up.
Dubin was subsequently diagnosed with late-stage ovarian cancer, meaning that it had already spread. She underwent genetic testing, which—at the time—concluded that she did not have harmful variants of the BRCA1 gene. Consequently, family members were not encouraged to pursue genetic testing.
But in the ensuing years, genetic testing evolved. After further research, healthcare professionals determined that the variant Dubin had in her BRCA1 gene was pathogenic (capable of causing disease). In October, four years after Dubin's diagnosis, Evert received a call notifying her of the change in interpretation of her sister's genetic results. She immediately sent her blood for genetic testing, which found that she, too, had a pathogenic variant in her BRCA1 gene.
On December 3, Evert underwent a preventive hysterectomy, thinking that she was getting ahead of any potential issue. However, later pathology results identified malignant cells and a tumor originating in Evert's left fallopian tube. More surgery was recommended to check whether the cancer had spread to her lymph nodes and other tissues. Evert underwent a second operation on December 13. If the cancer were found to have spread, Evert's stage 1 diagnosis would become a stage 3 diagnosis. She waited anxiously for the results:
"The longest three days of my life. Stage 1 or stage 3," she said. "If I'm clear of cancer, I'm a different statistic. I was in a daze. I just couldn't believe it. I had been working out, doing CrossFit, playing tennis. I didn't feel anything different."
On December 15, Evert's doctor called with good news. The cancer had not spread and had been removed during the hysterectomy. The article states:
Following chemotherapy, there's better than a 90% chance that her cancer never returns.
Evert no doubt benefited from her sister's prior diagnosis with ovarian cancer. Her annual exams included checks of her CA125 level (a measure of the amount of cancer antigen in her blood), ultrasounds and MRIs with contrast—all of which were negative. But the game changer was the reinterpretation of her sister's genetic testing results and her prompt notification:
That phone call was nothing short of a miracle.
McKendry concludes the article by saying:
Genetic information that her sister left behind likely saved Chrissie's life.
To her credit, Evert took immediate action: submitting her blood for genetic testing upon receiving the phone call and opting for a preventive hysterectomy as soon as she received the results that she had a pathogenic variant in her BRCA1 gene.
Many will read the ESPN article and focus on Evert's diagnosis with and treatment for ovarian cancer. When I read the piece, I'm drawn to her sister's story and the importance of genetic testing in warning others of potential risks. As the older sister, Evert could have easily developed ovarian cancer before her sister, which might have made all the difference to Dubin.
As the article lays out well, people with ovarian cancer have "no noticeable symptoms," making it almost impossible for the disease to be diagnosed at an early stage. Evert's doctor notes, "70-80% of ovarian cancer is diagnosed at Stage 3 or 4." Had Evert not taken prompt action, says her doctor, "Three months or so from now, she'd be Stage 3 or 4."
I suppose that I identify with Dubin's story because it is similar to mine. Like Dubin, my ovarian cancer was discovered in a later stage (3C), though I suspect that hers might have spread even further than mine. Like Dubin, genetic testing found a pathogenic variant in one of my BRCA genes (in my case, BRCA2, in Dubin's case, BRCA1). Like Dubin, (and I'm speculating here), I had no forewarning.
Unlike Dubin, my gene change was found during the first genetic analysis (not years later), which has given my family members the opportunity to be tested for the same pathogenic variant I have. Given that ovarian cancer has few warning signs, genetic testing can be life-saving, even if only 20-25% of ovarian cancers are linked to an inherited gene.
I also identify with Evert's story. While a "breast decision is down the road" for Evert, I have already made that decision. People with variants in their BRCA genes are not only at risk for ovarian cancer but breast cancer as well. In my case, it's just a matter of waiting my turn for a preventive bilateral mastectomy, which may be pushed back further because of COVID-related delays. In the meantime, mammograms and breast MRIs will continue.
I applaud Evert for sharing her story. As she tells her friend McKendry,
"more people need to hear stories like these!... Ovarian cancer is a very deadly disease. Any information is power."
I also echo Evert's advice:
"Be your own advocate. Know your family's history. Have total awareness of your body, follow your gut and be aware of changes. Don't try to be a crusader and think this will pass."
