Like many, I first heard about the BRCA “Breast Cancer gene” when Angelina Jolie used the New York Times to announce her decision to have a bilateral prophylactic mastectomy after she was genetically identified as a carrier of the BRCA gene mutation. She told the world that she’d had her own breasts removed because they were ticking time bombs for breast cancer.
So maybe some of the world mourned Angie’s boobs for a minute, but this was the right choice for her. And man, did you see her in Maleficent a couple years later? Her plastic surgeon got it right!!!!
But I digress.
Angie’s announcement started a world-wide conversation about genetic testing.
How much knowledge is TOO much knowledge?
Are we playing God with all of this?
And what would you do?
But more importantly, women around the world became empowered with the knowledge that they have options! We can have genetic testing and make informed choices about our bodies to reduce our risk of getting some types of cancer.
Then it got personal. When breast cancer crashed into our lives for the second time, my mom’s physician recommended genetic testing. Mom tested positive for the BRCA mutation, and then I tested positive as well. Without hesitation, I took the radical route and chose the prophylactic mastectomy. The adventures (and misadventures) of that journey haven been chronicled in this blog.
Not everyone who tests positive for the BRCA mutations opts for the radical surgical options. A BRCA positive diagnosis can still be empowering without surgery because it allows for insurances to cover more frequent mammograms and additional cancer screenings. Early diagnosis is key to surviving breast cancer!
The lesser-known risk that comes with a BRCA mutation is an elevated chance of getting ovarian cancer. The average woman has about a 2% chance of getting ovarian cancer in her life. Someone with a BRCA mutation has something more along the lines of a 40-60% lifetime chance of getting ovarian cancer! And ovarian cancer is ugly and hard to treat. Early detection drastically increases the survival rate, but ovarian cancer is often detected late, at a point when successful treatment options are limited.
The answer? Take out the ovaries, too! That’s the procedure I will have tomorrow. I am opting for a slightly lesser invasive surgery than originally planned. We’re only removing some of the lady-plumbing, but it will get rid of the hormone-generating cancer-makers that the ovaries can be.
As a part of the procedure, I am also having some other annoying growths removed that have been wreaking havoc on my system. They have been biopsied and are benign, but will thankfully be evicted along with the ovaries.
I am not worried about the procedure. It’s outpatient, it’s laparoscopic. It will be fine. I’ll be down for just a couple weeks. I am also not worried about losing my eggs, and thus the ability to have any more biological babies. That ship has SAILED and I am very content with the children I have in my life already.
I am, however, TERRIFIED of the symptoms that will come after the surgery, the symptoms that come along with surgical menopause. Normally, a woman’s estrogen tapers off gradually. Removing the ovaries removes the estrogen COLD TURKEY!
BRCA-informed doctors have mixed opinions about oral estrogen and other hormone replacement therapies. Why put estrogen back in your system when the goal of surgery was to remove the cancer-causing organs and the hormones they produce? We're going to try and figure out what makes the most sense for me.
Without ovaries and their estrogen, it’s an instant trip to old-ladyville. Hot flashes and mood swings are nearly guaranteed, as well as other other unpleasant things like loss of libido and depression.
YAAAAAAAASSSSSS! Par-tay time!
(In case you missed it, that was me trying to pretend to be excited about all of this.)
Snark aside, I am so incredibly thankful that I can face my elevated risk of cancer empowered. I am grateful to have informed, forward-thinking doctors who support and educate me on this journey. I have so much gratitude! I know that while my family will have to take care of me now for a couple weeks, (and then deal with my mood swings for a few months after!) they WON’T have to care for me through chemo and radiation and all of the scariness that comes with breast and ovarian cancer.
Tomorrow morning, 11AM. Please send positive juju in whatever form you believe in sharing it. Low-sugar desserts and Netflix recommendations will also be greatly appreciated ;)
Do you know your risk of hereditary cancer? The community and information at FORCE, www.facingourrisk.org, has been an incredible resource! Please don’t hesitate to chat me up if you would like more information.
