When your lifeline is a carcinogenic mutation

When you find out you have cancer, few things can top the shock. Except maybe learning that his survival rate is two percent.

This double whammy hit Scott Nelson in 2004, when an ultrasound detected a large tumor on his pancreas. His only chance of survival was to shrink it enough to be surgically removed.

After his diagnosis in Hudson, Wis., Nelson found his way to M Health Fairview hematologist and oncologist Edward Greeno, who is now medical director of the Masonic Cancer Clinic at the U of M. Greeno was leading a clinical trial of an intensive chemotherapy regimen to shrink the tumour.

And he did. Within just a few months, Nelson’s cancer, which was due to the notorious BRCA2 cancer gene, shrank enough to be removed. He benefited from a then-unknown link between cancers caused by BRCA2 and a chemotherapy drug that was particularly effective against these tumors and was part of the clinical trial.

Her experience prompted her seven siblings, five of whom carry the BRCA2 mutation, to undergo regular genetic testing and screening. So far, eight family members carrying the mutation have had early cancers stopped in their tracks.

The payback

This year (2023), Nelson is participating in a clinical trial testing the ability of drugs called PARP inhibitors to shrink prostate cancers.

“We have very good evidence from other clinical trials that PARP inhibitors work extremely well in patients with BRCA2 mutations,” says M Health Fairview oncologist and trial leader Emmanuel Antonarakis. “If Scott hadn’t had the BRCA2 mutation, there literally wouldn’t have been another [presurgery] choice for him.

“So, paradoxically, the BRCA2 mutation, which on the one hand may have caused his prostate cancer, was also his saving grace.”

By March, Nelson’s prostate tumor had shrunk enough to be successfully removed.

Learn more about Scott Nelson’s experiences.