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Wednesday, November 26, 2008 11:53 AM PST

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Living with cancer

It was a summer day in 1995 when Selma resident Nazario Martinez's body went completely numb. Recently unemployed, Martinez was at a regional office filling out paperwork to get unemployment benefits for a few weeks. As the numbness in his body wore on, it got worse. "I didn't know what was going on," he says. It got so bad that when he got home, he had to crawl from his car into his house. After calling his doctor, Martinez went to get tested the next day. Tests on his upper body didn't reveal anything. The day after, Martinez felt numb again. And after yet another visit to the doctor, he was tested again. The following week, he got another call from his doctor, telling Martinez to come in for a talk.

"When he came in, I could see his face, kind of worried or something," Martinez says.

The news was not good. Martinez, who was 54-years-old at the time, was told he had cancer in his stomach. That wasn't all, either. The cancerous tumor had been ruptured.

Because of that, it needed to be removed immediately. After a lengthy explanation by his doctor of what that entailed, Martinez was told something else.

"He said, 'your stomach will be removed,'" Martinez says.
Due to this procedure, Martinez now has his esophagus connected to his large intestine.

This was Martinez's first bout with cancer. His second bout would come at the age of 58 in 1999 when he was diagnosed with colon cancer.

By the time the first cancer had stricken Martinez, he already had a brother, Frank Martinez, die from cancer of the pancreas. Another brother, John Martinez, died several years later due to gastric cancer.

At present, eight members of Nazario Martinez's immediate and extended family members have been diagnosed with cancers including colon, gastric, pancreatic and endometrial cancer.

One of these family members is one of his two daughters, 41-year-old Selma resident Noemi Martinez Garza.

A survivor of two diagnosis' of cancer, Garza was found to have endometrial cancer at the age of 32 and colon cancer at the age of 35.

But it wasn't until April -- with the urging and help of his other daughter, Selena Martinez -- that Nazario Martinez was informed of the true cause of his familial cancer problems.

Nazario Martinez found out he has a little known genetically caused ailment called Lynch Syndrome.

So far, Nazario Martinez is the only member of his family with cancer that is also confirmed to have the syndrome.

According to the U.S. National Library of Medicine, Lynch Syndrome -- also called hereditary nonpolypsis colorectal cancer -- is a genetically inherited disorder that affects the digestive tract, most notably the large intestine and rectum.

People who inherit Lynch Syndrome are not only at high risk for colon cancer but are also susceptible to other cancers forming in places like the stomach, small intestine, liver, skin, brain and gallbladder, among other places.

Women with the syndrome are also at a high risk of getting cancer in their ovaries as well as their endometrium, which is the lining of the uterus.

A variation or mutation in specific genes that help repair mistakes made during DNA replication are said to increase the risk of developing this condition.

In the case of Nazario Martinez, the possibility that his two diagnosis of cancer were linked to Lynch Syndrome first surfaced in 2002, says his daughter Selena Martinez.

At the time, his other daughter Noemi had been diagnosed with her second bout of cancer and doctors had suggested the cause might be hereditary.

However, tests on Nazario Martinez and Noemi didn't detect anything significant. Selena Martinez said this was because of the technology used at the time.

A few years later, at the end of 2006, Selena Martinez-- a fresh graduate in cellular biology from the University of California, Davis -- landed a job at the University of California, San Francisco. Currently, she works in the Department of Cellular and Molecular Pharmacology where she conducts structural biology and studies genome organization.

In 2007, Selena Martinez decided to pursue her interest in finding out the cause of her family's struggle with cancer.

Starting in July of that year, Nazario Martinez's body tissue and blood -- along with samples of his previously removed cancerous tumors -- underwent a series of genetic and molecular tests to determine if he really had Lynch Syndrome. These tests on Nazario Martinez's body tissue were conducted at labs on the campus of University of California, San Francisco.

The final results of the tests came back in April and indicated Nazario Martinez had a large deletion of the gene MSH2. This is one of the genes which help repair mistakes made during DNA replication. Because this gene was deleted, Nazario was found to have Lynch Syndrome.

"I worried about what she told me," Nazario Martinez says about the news from Selena. "I just didn't want it to show emotionally."

And although it can't be scientifically determined, the gene deletion was probably passed down to Nazario and his siblings from their mother.

"That's our likely guess," Selena says. "That they inherited the mutation from my grandmother."

In Noemi's case, while she hasn't undergone the series of tests to determine if she does have Lynch Syndrome, she believes it's likely she does.

Noemi says she plans to get tested to find out sometime soon, perhaps this winter.

But Noemi's first battle with cancer occurred in 1999, shortly after Nazario found out he had colon cancer.

At the time, Noemi and her husband, Lucas Garza, had been trying to have a child together. But that was stopped short by the news that she had cancer in the wall of her uterus.

"When they told me, it was devastating," she says.

Because of that, Noemi had to have a hysterectomy. This operation also came with unpleasant side effects, due to the imbalance of hormones caused by the hysterectomy. These symptoms include high blood pressure, high cholesterol, as well as diabetes.

A few years later, in 2002, Garza was dealt yet another blow when she found out she had cancer in her colon. Doctors at first thought she had appendicitis, but it was later realized she had a cancerous tumor above her appendix.

"It was really scary...it was scary to go through it again," she says of the experience.

The tumor was removed, along with 18 inches of her colon.

When her father, Nazario, found out he had colon cancer in 1999, he had to have 26 inches of his colon removed.

These operations have caused both of them to change their dietary habits.

Nazario can only eat small portions of food, a few times a day. He also dealt with an extreme fit of acid reflux shortly after his stomach surgery, when his esophagus was connected to his large intestine.

"It was so painful, but I tried not to show it," Nazario says.

In Noemi's case, she says she now has to restrict her diet and has to avoid things like dairy and spicy foods due to indigestion problems. This was caused not only by having part of her colon removed, but also because of the hormonal imbalance which has caused her to have ailments like diabetes.

"Little desires are life threatening," she says of foods she must avoid, like ice cream.

And though Noemi and Nazario's bodies are both currently cancer free, there is also the possibility it could show up again, since the likelihood is high due to Lynch Syndrome.

This is a realty they accept, but they both say it doesn't hold them back from living their lives to the fullest extent.

"I try not to absorb my whole thoughts that that's what my life is about," Noemi says. "I just try to continue on with what I think God has put me on the Earth for and...whatever that is, it's not to live daily with worrying about if I am going to get cancer again. But that if I do, that I'll have the strength enough to just continue on with living life and being there for my kids and enjoying their accomplishments with them."

Those children she speaks of are 17-year-old Casandra, as well as 5-year-old Mattea. Garza and her husband adopted Mattea shortly after she found out she would no longer be able to have kids.

Nazario, now 67-years-old, exhibits a similar attitude about the reality of his life.

"It's not easy to live with that dreadful disease, but you learn to live with it, because you get stronger...you learn to show that you are strong," he says. "You have faith in yourself and family, and go on living and leave that behind in your mind, not to think about it."

The fact that the syndrome was also potentially passed on to members of his immediate family has also been difficult for Nazario.

"It's hard to live with," he says.

However, Nazario says, there's nothing that can be done about the fact that this happened.

Regardless, Nazario and Noemi's experiences have made them say that preventative screenings like colonoscopies are vitally important for people to get in order to detect potential cancer.

They also both appreciate the work of Selena, who not only helped her father get genetic testing and counseling but also launched a Web site -- www.detectthemutation.org -- in order to share her family's story as well as raise awareness about Lynch Syndrome.

Because of her family's experience, Selena has also worked to raise money in order to help financially disadvantaged people get genetic testing and counseling at the University of California, San Francisco's Colorectal Cancer Prevention Program. Just this past weekend, Selena ran a half-marathon in Philadelphia in order to help raise money for this cause.

In the end, despite their hardships with cancer, both Nazario and Noemi have persevered and will continue on with their lives, thankful for all that they have.

"I think I have survived this cancer with love and being blessed," Nazario says. "And my daughter and my nephews -- even though we have had different cancers -- still, we're still here."

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