Oct. 18--No one wants to get cancer. But those at risk would almost certainly want to pre-empt the disease.
That's where people like Julie Nardella, R.N., come into play.
As clinical nurse-educator at Physicians Health Alliance, the Green Ridge resident's duties include screening people to find out if their genetic makeup puts them at risk of breast, ovarian, colorectal or uterine cancer.
Mrs. Nardella joined Physicians Health Alliance two years ago to implement its hereditary cancer testing operation.
"We realized it was significant enough for us to do," she said. "We're testing about six to eight people a week, which is significant for a new program. We wanted to heighten the awareness. It's available, it's here, we can test for it.
Inherited gene?
Specifically, patients come to her to find out if their family has an inherited gene mutation that would make their chances of getting the disease significantly higher than the general population.
Initially, they fill out a questionnaire. Then, if they meet the criteria, they're tested for one of two hereditary cancer syndromes.
The first test is for hereditary breast and ovarian cancer syndrome, an inherited condition that results in an increased risk for ovarian cancer and early onset breast cancer. Most of the time, it's due to a mutation of either the BRCA1 or BRCA2 genes, both of which can be inherited from either parent.
The second test is for Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC), which increases the chances of early onset colorectal, uterine and other related cancers. The majority of cases are due to a mutation in the MLH1, MSH2 or MSH6 genes, which also can be inherited from either side of the family.
Women with the BRCA mutation have a 56 to 87 percent risk of getting breast cancer, compared to only 8 percent for the general population, Mrs. Nardella said. (Incidentally, October is National Breast Cancer Awareness Month.) For ovarian, it's 27 to 44 percent, compared to less than 1 percent for the general population.
Meanwhile, those with the Lynch syndrome mutation have up to an 82 percent chance of colorectal cancer, and up to a 71 percent chance of uterine cancer. That's compared to a 2 and 1.5 percent chance, respectively, for the general population, according to Mrs. Nardella.
"So the genetic mutation significantly increases the risk," Mrs. Nardella said. "Eight to 10 percent of the population will be affected by hereditary cancer."
Fortunately, "if we know the risk is there, we can act on it," said Mrs. Nardella, noting that those with a high risk can take several preventive measures, from regular surveillance (mammograms, colonoscopys, etc.) to medications to surgery.
"We're thrilled to see the positive response women have given us with this testing. We just want people to know it's there," Mrs. Nardella said.
"It's very rewarding," she said of her job. "If you're passionate about what you do, you don't find it difficult."
Mrs. Nardella first took an interest in nursing as a teenager doing volunteer work at a hospital outside Binghamton, N.Y. She went on to do her schooling at St. Joseph's College of Nursing and LeMoyne College in Syracuse, N.Y.
Chose focus
There, she decided to focus on women's health issues, and her career has for the most part stayed along that path, whether working in labor and delivery, gynecology or oncology.
"It's easy to see the disparities we see as women. It's easy to see there are un-met needs," she said. "As caregivers, we're so busy taking care of others that we forget to take care of ourselves."
Mrs. Nardella has plenty of other things to occupy her in addition to her job. Currently, she's pursuing her certified genetic nurse certification through the International Society of Nursing Genetics, and is working toward a doctorate through the University of Phoenix. She also volunteers as a parish nurse for the Diocese of Scranton.
"I'm pretty busy," she said. "But I don't think I'd want it any other way."
Contact the writer: jmcauliffe@timesshamrock.com
TO NOMINATE A NORTHEAST WOMAN, please submit requests via e-mail to lifestyles @timesshamrock.com or mail them to Northeast Woman Nominations, The Sunday Times, 149 Penn Ave., Scranton, PA 18503. Please include the woman's name, address and the reason the reader feels the woman is deserving. Those submitting need to include their name and a daytime phone number. Meet Julie Nardella, R.N.
At home: Resides in the Green Ridge section of Scranton with her husband, Lou, and son, Joe, a junior at the University of Scranton.
At work: Clinical nurse educator at Physicians Health Alliance.
Inspiration: Her profession, particularly in the realm of women's health.
Aspiration: Continuing her education.
Diversions: Reading, spending time with her family.
Aversion: Having to fight disparities in women's healthcare.
Quote: "Preventive care should be readily accessible for women," she said. "As caregivers, we're so busy taking care of others that we forget to take care of ourselves."
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