Advocate Health Care patient learns of two types of cancer after visiting Hereditary Cancer Clinic

When one of Julianne Fontno’s sisters was diagnosed with breast cancer, she knew she should consider her own genetic risk.

About 15 years earlier, The Fontno sisters’ father died from stomach cancer, but the family was told there likely wasn’t a genetic component, so at first Julianne was trying to assess her genetic risk but wasn’t necessarily thinking of stomach cancer.

She wasn’t expecting to have two types of cancer.

After Fontno, now 40, of Chicago, was referred last year to the Hereditary Cancer Clinic at Advocate Christ Medical Center in Oak Lawn, testing revealed she carried a gene that not only put her at an elevated risk for breast cancer but also made it likely she’d get stomach cancer, just like her dad.

In the years since his death, there were advancements in genetic testing, and more is known about the genetic link to certain cancers. Both of Julianne’s sisters also learned they had the same genetic risk.

“The story was all coming together,” Julianne said. While Julianne knew she needed to act quickly on this information, she was especially alarmed by the stomach cancer risk and started to think about proactive surgery to remove her stomach.

The gene detected gave Julianne an 80-85% chance of a stomach cancer diagnosis in her lifetime, said Dr. Marc Mesleh, Julianne’s hepatobiliary surgeon at Advocate Christ. “The risk is so high that the recommendation is to have a total gastrectomy – the removal of the entire stomach in someone’s 20s or 30s,” adding that the proactive measure is especially important as cancer in the stomach is rarely detected in early stages.

Julianne opted to have the operation, but first she went through additional breast screenings even though she had yet to turn 40, the typical age of a first mammogram, and was diagnosed with an early stage of breast cancer and had a lumpectomy before having her stomach surgery.

After her total gastrectomy, which is a minimally invasive, robotic procedure, the pathology revealed she had early stages of stomach cancer already. She was asymptomatic, so without the surgery, it could have taken months or years to detect, Dr. Mesleh said.

“I feel very lucky,” Julianne said. “I had reservations at first. I’m a foody, I love food and as a kid was known to eat everyone’s leftovers. But I knew I needed to do this because of what happened to my dad.”

Dr. Mesleh explained that while there are some new eating habits to learn, patients who have a gastrectomy can return to a normal life and enjoy food.

He said Julianne’s story highlights the impact of the genetic testing available at the Hereditary Cancer Clinic where patients can learn about their risk carried by a variety of genes. “With the power of science, patients can learn life-saving knowledge.”

Julianne said she is grateful to Dr. Mesleh and all of those involved in her care at Advocate, and said recovery has gone well. While she does watch her portions, she’s now returned to eating a variety of foods – even detailing her recipes on her food blog – especially her favorite dish, fried red snapper.

Exactly one year after her gastrectomy Julianne celebrated her recovery and good health on Oct. 19 as one of ten Advocate Health Care breast cancer patients from across Illinois as honored guests at the Chicago Bears Crucial Catch game at Soldier Field. Joined by her husband and members of the Advocate care team, Julianne helped unfurl a pink ribbon on the field at half time.

For Julianne it was a way to mark the end of a journey she didn’t expect to endure but is on the other side.