Stella arrives home in Brighton to visit her mum Evelyn after a five year absence. Anxious about the reunion, she stops off at a chicken take- away joint and is served by Noel, who dampens her fears with his wit. Stella meets her mum at an eclectic sea-front flat and learns that mum is recovering from breast cancer.
Stella feels manipulated into staying on in Brighton, but can see Evelyn is in need of support. Noel at The Chicken Shack confesses he has a brother with sickle cell anaemia and together they set about familiarising themselves with Evelyn’s medical condition.They discover that Evelyn has a family history of breast cancer of which she was unaware, Great Great Grandad Douglas died of it in 1920, his two daughters also died from cancer years later.The family history information means Evelyn is now eligible for BRCA testing to see if she is positive for BRCA 1 or 2 – genes which increase the risk of breast cancer.
Stella persuades her mum to have the BRCA test but Evelyn is cautious: she has fought most of her life from the standpoint of anarchy – what the state has got on you they can use against you – including your genes.
Also, if Evelyn turns out to be BRCA positive, this will have implications for Stella because it indicates that the cancer has a higher chance of being inherited. The test results show that Evelyn is indeed BRCA positive. Evelyn’s nurse, Brian, is optimistic, pointing out that Evelyn may benefit from new drugs called PARP inhibitors which are targeted to BRCA positive tumours.This is an example of pharmacogenetics at work.
Evelyn does not automatically have access to the PARP inhibitor because it has to undergo clinical trials in order to be shown to be safe, and to work in the way intended. Running such trials is dependent on people being willing to take part and ‘chance’ being randomly given the new drug or the best existing treatment, ie some form of chemo.