My Father died November 2, 2009, after succumbing to a long battle with prostate cancer. Sadly, I was not at his side when he passed away peacefully in his sleep before dawn in Chattanooga, Tennessee, where I grew up. I had just completed my second breast cancer surgery within six weeks and was still in New York with drains attached to the left side of my body.
I adored my father. He was a certified public accountant by profession and my trusted advisor in my business life and shoulder to lean on in my personal life. Frequently the two roles collided. On one phone call we would discuss a tax issue or a business matter; on the next he would share local gossip or a chapter of the latest book he was writing about the Civil War. We’d fight over business and then share funny stories. He stood up for me when the banks turned me down for my first business loan and stood by me when my heart was crushed over a passing love affair.
We were alike in so many ways. I inherited his business sense and his work ethic, his love of fine wines and far flung travel. I inherited his sensitive skin, blue eyes and smile.
We also shared a gene mutation called BRCA2. After I was diagnosed with breast cancer I had to fill out a zillion forms about my family health history. “Breast cancer is not in my family,” I told my doctors. “I am the chosen one, unique and special.”
But my father had prostate cancer and a bout with melanoma. And his mother had pancreatic cancer as did my paternal great grand mother I later found out when I researched the family health tree. And these cancers can also share the BRAC2 gene. Also, 1 out of 40 individuals whose background comes from the Ashkenazi Jewish population has inherited one of three founder mutations in BRCA1 and BRCA2. For the record, the information I am providing comes straight from my “Clinical Genetics Service Follow Up Report” from Memorial Hospital for Cancer and Allied Diseases in New York City (“Sloan Kettering”).
My doctors suggested that I undergo genetic testing, and I did not give it a second thought. It wasn’t like I was at risk for getting cancer. I already had cancer. I just did not understand “why me?” when no one else in my immediate family had breast cancer. I assumed the cancer was the result of too much stress and being a bit overweight. But realizing that there may have been a genetic influence would explain more.
The test is simple. A nurse practitioner pricks your finger, and your blood is tested. First you fill out a more forms, and counselors sit down and talk you through everything. It is all very thorough and not intimidating.
I tested positive for the BRAC2 gene which means I had a 27% chance of having ovarian cancer by the time I hit age 70. I decided to have my ovaries and Fallopian tubes removed, a prophylactic surgery called an “oophorectomy.” The name sounds like you feel post-surgery – “Oooph!” If my cancer had only been in one breast, the risk of a recurrence in the second breast could be as high as 25-30% barring various factors. For me that was a non-issue; both my breasts had cancer and needed to go.
Some people may be afraid of undergoing genetic testing. Is not knowing the outcome better or worse? Personally, I wanted to see the big picture with my eyes wide open and do whatever I could manage the situation. If I have to choose between a fear of the unknown or a fear of knowing the truth, I prefer the latter over the former. The glass is still half full even if there is a dash of BRCA2 in it.
So, I really am my father’s daughter: a chip off the old genetic block. He died unaware that we shared “the cancer gene” – our special bond. I am glad he never knew; it would have made him sad, although it also would have brought us even closer. We shared the same spirit and courage to face anything that comes our way with an inner strength and a sense of humor.
If I were a parent I would want my daughter or son to know and understand the realities of genetic testing and help them make their own choices. I told a few relatives who I felt should know about the gene just in case they wanted to get tested themselves. I don’t think they did. Some people just do not want to know.
If my father were alive today he would tell me, “I am proud of you Melanie. You did the right thing. We will face it together.”
In many ways we did.