Vim & Vigor - Winter 2019 - UVA - 6

On Christmas morning,
when 3-year-old Aden
Kelleher unwrapped
a "doctor's coat with
sprinkles," he got just
what he wanted
from Santa.

6

W IN TER 2 0 1 9

Fully Understanding
Inherited Cancer Risk

While half of all cancers could be eliminated if everyone adopted a healthy lifestyle, there is almost nothing Kelleher
could have done to prevent hers, notes
Susan Modesitt, MD, founder of the UVA
High-Risk Breast and Ovarian Cancer
Program, one of the nation's first such
dedicated programs and the only one of
its kind in central Virginia. Right after the
birth of Kelleher's first child, she started

A Lifesaving
Screening Plan

Kelleher was in her early 30s when Dr.
Modesitt recommended an aggressive
approach to screening: regular breast
MRI (magnetic resonance imaging)
scans, which are recommended for those
at high risk for breast cancer and are
better than a mammogram at detecting
cancer, Dr. Modesitt explains.
Kelleher's MRIs were normal through
her second pregnancy. But last March,
right after she stopped breastfeeding her
youngest child, cancer showed up. "My
cancer was found by Dr. Carrie Rochman
in radiology, and in April, I had a double
mastectomy [removal of both breasts]
done by Dr. Shayna Showalter, and Dr.
Chris Campbell did my breast reconstruction," Kelleher says. "My cancer was
aggressive but caught early. This is not
typical for women under 40, who tend to
present at later stages of disease."
Dr. Modesitt hopes one day she never
again has to tell a young mother that her

PHOTOS BY JACKSON SMITH PHOTOGRAPHY

Aden has a medical doctor for a mom, so
his wish wasn't all that surprising. What
is unusual is that his medical knowledge
goes far beyond the typical preschooler.
Aden has played an active and loving
role as his mom faces a disease that has
devastated her family for generations.
"On March 18 [2019], my worst nightmare was realized with a breast cancer
diagnosis," Nicole Kelleher, MD, says.
"I am 36 and have a 1-year-old and a
3-year-old-two joyful little boys, Aden
and Connor. Like most moms of small
kids, I am primarily concerned about
my children.
"There has not been anyone in the last
three generations of my family, including
my mother, grandmother, grandfather
and aunt," Kelleher adds, "who has not

died shortly after their cancer diagnosis,
all very young, in their 30s to 50s."
While cancer is a strong family trait,
it is also a disease Kelleher is highly
familiar with through her role as a
physical medicine and rehabilitation
doctor at UVA Cancer Center and as a
competitive athlete.
Kelleher is among a team of experts
who treat people for musculoskeletal
and neurological problems. "Most of my
patients, ironically, have breast cancer,"
she says. "I know this world well, from
both a patient and physician perspective. Prior to medicine, I was a professional triathlete with several national
titles. I was a collegiate runner on a
team that has seen two other teammates
pass away early from cancer."

to be followed by Dr. Modesitt, and this is
where her story takes a miraculous turn.
Blood testing turned up no genetic
defects, but it didn't rule out the possibility that Kelleher inherited a high
risk for cancer, Dr. Modesitt notes. "We
now know that about 5 to 25 percent
of all cancers are hereditary [it varies
depending on the type of cancer]," says
Dr. Modesitt, who did her fellowship
training in gynecologic oncology at MD
Anderson Cancer Center.
"Nicole has a horrible family history
of cancer. She's absolutely high risk,"
Dr. Modesitt adds. "We think something hereditary is there, but we don't
know yet what the specific cause is for
her increased cancer risk. We can't tell
Nicole's children yet if they have inherited a cancer-risk gene or genes. But
research in this area is progressing rapidly, so in 20 years, and for her children
or grandchildren, we hope to be able to
tell them definitively what the cause is
and whether they carry such a high risk."



Vim & Vigor - Winter 2019 - UVA

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Vim & Vigor - Winter 2019 - UVA - Cover2
Vim & Vigor - Winter 2019 - UVA - Contents
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