It Is What It Is

My mom was diagnosed with breast cancer about 10 years ago at age 51. She is a survivor. Her sister was diagnosed with the same cancer at 36 years-old, survived, and now has terminal ovarian cancer. Their mother died from breast and ovarian cancer at 46 years-old. Her brother died from pancreatic cancer when he was 42.

To say that my family has been touched by cancer is an understatement. I was about 14 when I had my first encounter with this disease. I recall sitting in my uncle's living room, shocked at his gaunt figure. Everyone was standing around making idle chit-chat. Eventually, all those in attendance withdrew from the living room where Uncle Boyd was in his recliner. They made their way to another room to partake of the smorgasbord of pot luck dishes all the adults had brought. The whole event seemed surreal to me. I couldn't understand why everyone was acting like nothing was happening. There was a proverbial white elephant in the room and they all seemed to ignore it. I was confused by the obvious avoidance of the subject of his pending death.

I sat down on the sofa next to his chair. I'd like to say I remember everything we said to each other, but I can't. What I do vividly recall is asking him if he was scared. I'd never met anyone who knew they were dying. I couldn't imagine what that must be like, but I figured he'd probably like to talk about it. I hope I was right. We spoke very easily and bluntly. He died a short time later.

After Uncle Boyd died and I slowly became aware of our family history of cancer, I began to develop an odd sense of resignation that I too would someday be struck with this horrible disease. I've always thought it was a matter of when, not if. Those who know me know that I am not a pessimistic person by any stretch of the imagination. My glass is always have full. I just figured that we all have to die and this would be my highly likely path.

Sometime in early adulthood I received a letter from my mom with information about the BRCA1 gene mutation. The BRCA1 gene is responsible for tumor suppression. My aunt (her sister) had had the testing done to determine exactly which mutation of the gene she carried. I tucked it safely away in a file, knowing someday I would need to act on that information and get tested. I don't recall what prompted me to pursue testing, but in 2004 I asked my doctor to perform the test, which unsurprisingly came back positive. At that time, I learned of a study at the National Institute of Health in Washington, D.C., that was following BRCA1 positive women and trying to develop additional early cancer screening techniques. As a member of the study, I participated in a variety of testing, including: CA-125 (tumor marker), mammogram, breast MRI, and breast ductal lavage (a very unpleasant test). During this time I also underwent genetic counseling. I was told I needed to consider having my ovaries out and having a bilateral prophylactic mastectomy by the time I turned 40 years old . . . I recently turned 38. This has been echoed by numerous other doctors, as well as members of my family.

So here I am, armed with the knowledge that if I do nothing, I have about a 60% risk of being struck with breast cancer, not to mention the significantly increased risk of ovarian cancer. Therefore, after serious consideration, consultation, and prayer, I have decided to have a prophylactic mastectomy. My goal is not to be a cancer survivor, but to avoid having it altogether and live a full, long life with my family. My surgery is scheduled for June 17th, 2010. Although I don't look forward to this, I am completely at peace with my decision and feel as if a weight has been lifted from me. I will chronicle my experiences throughout. Like I've told my son so many times, it is what it is. I've encouraged him to face difficult decisions head-on and to do hard things . . . and so shall I!