Monday, August 25, 2008
Hi. It's Monday and I just had, I think, the laziest weekend in the history of the world. Anna was at her dad's and I spent almost the entire weekend on the front porch reading "Pretty Is What Changes" by Jessica Queller. Very thought-provoking and very well written, this book is the story of a young woman (34) who decides to take her destiny into her own hands: because of her family history of breast-and-ovarian cancer, she takes the BRCA-1 test to determine if she has the gene-mutation that will indicate whether she is likely to develope one (or both) of those cancers at some point in her life. (I've written about this woman and this test before, after having heard her on NPR, but I finally got to read the book.)
Her test came back positive, meaning she had an 87% chance of developing breast-cancer and a 44% chance of developing ovarian cancer at some point in her life. She had, just a year prior, watched her mother suffer horribly at the end of her life. Her mother had beaten breast cancer but was diagnosed with (and ultimatly died of) ovarian cancer. Jessica certainly did not want to go through the same thing. After MUCH soul-searching and gathering many professional opinions and much information, she decided to under-go a double mastectomy. As one of her doctors told her "Breast cancer is the only preventable cancer there is." WOW.
Obviously this is very new, very cutting-edge science. Five years ago, this test was pretty much unheard of, and if you'd told your doctor that you were considering having your breasts removed as a preventative measure, he'd have laughed you right out of his office.
But now the technology is there to know. Some people want to use whatever information is available to them, others do not.
There are two distinct camps of women who are likely to test positive for the BRCA-1 gene-mutation: Those who do not want to know, or the "ignorance is bliss" camp. They would rather live their lives fully without the burden of knowing that it was most likely just a matter of time until they developed breast cancer. They prefer to let nature take it's course and deal with it if and when they are diagnosed.
Then there is the camp to which Jessica Queller belongs. She chose to take the test to find out what the odds were, and when it came back positive, she made the heart-wrenching decision to take fate into her own hands by doing the one (very drastic) thing she could do to eliminate the chance of developing breast cancer. She will, by the way, also have her ovaries removed once she turns 40; she wants to have a child first. Having removed all her breast tissue (she did undergo reconstructive surgery and has implants) she has reduced her odds of developing breast cancer in her lifetime to 1-2%. The average NON BRCA-1 positive woman has around 10% chance of developing breast cancer.
Which camp am I in? After reading this book, I am further convinced that for me, I want to know. I have my annual exam next week and I am going to arrange to take the test as soon as possible. It's amazing to me that we have the technology to find out, and furthermore, in this one instance, to be able to take control of our destiny and change it. Sign me up.
What do you think? If you knew you had a very high-risk of having the gene that caused cancer, and if you had the chance to find out if you DO have it and could then do something to prevent it, would you?