Saturday, October 26, 2013

Fuck cancer. Fuck genetics.

When I look at my daughter now, I get the overwhelming urge to apologize to her.
I’m sorry Mommy may have given you a very bad gene that will mean you, like her, are dogged by an enemy you can’t see. There's a 50/50 shot that you inherited a very insidious gene from me, baby girl, one that makes your lifetime risk of breast cancer 45 percent or higher, and your ovarian cancer risk almost 20 percent. That’s way higher than the average person. You could have increased odds of developing cancers such as pancreatic cancer and melanoma, too.
I feel like I owe my son an apology as well, because my mutated BRCA2 gene is harder on males than its counterpart, BRCA1. If I passed it along to him, he faces an increased risk of developing breast cancer himself, though it’s still much lower than the risk faced by females. And just like my daughter, he faces an increased risk of a host of other cancers and could pass the gene on to his children.
The creation of life is such a beautiful thing that the mutated BRCA gene seems almost sinful. How dare this thing called genetics mar beauty, such innocence, right from the very beginning!
Fuck cancer. And fuck genetics.

I worry what the future holds for Nora and Fiorello.
©Tamme Stitt Photography

Mystery solved
On October 25, I finally got the call I was expecting all along: that I was BRCA positive. Still, it takes your breath away. At long last, the family cancer curse could be explained. The disease that had killed my grandmother, her twin sister and my aunt had finally come to light. It wasn’t shitty luck or by chance that these women’s bodies turned against them. We had caught the culprit. Only we couldn’t close the case. This criminal would keep committing crimes.
My thoughts turned not only to my children, but also to that complex cyst on my right ovary that was supposedly benign. In light of the genetic test results, the breast surgeon recommended removing the ovaries, but the question was if it would be done at the same time as my already laborious DIEP flap breast reconstruction, which borrows tissue and fat from the abdomen. She asked me if I wanted to set up an appointment with my ob-gyn. “I think we need to bring a gynecological oncologist on board,” I blurted out. Though the pelvic MRI said otherwise, I was never entirely convinced the cyst was nothing. It was so…symptomatic. I was feeling pregnant (though not looking so) for a majority of each month.
 For the umpteenth time since this whole ordeal started, I was happy to have my health writing and research background. I knew the scientific literature had found that when removing a questionable cyst or performing removal of the reproductive organs, it was better to have a specialist like a gynecological oncologist do it. If the cyst was actually malignant, you need someone on your team who does this kind of surgery enough to avoid rupture. Rupture of a cancerous cyst would spread cancerous cells into the abdomen, possibly taking an early stage ovarian cancer into a much more advanced stage. Ovarian cancer survival rates are already so abysmal because of the tendency to be caught in later stages. I wasn’t taking any chances.

Me and my boobs: No love lost
©Tamme Stitt Photography

Rage against the breasts
I took a shower after that phone call from my breast surgeon. I do my best thinking there.
I was relieved that no one else was home, because, alone in that steamy shower, I unleashed years of pent-up rage. I yelled at my breasts.
Quite literally. And it went something like this:
“It wasn’t fucking enough that you decided to go all gangbusters on me and grow a little too big for my frame?” I hissed down at them. “Do you know how uncomfortable it was to be wearing a bra by the time I was in 5th grade? Do you know the hell I went through in high school, because big boobs on a scrawny chick attract negative attention? And now you’re trying to kill me? Are you FUCKING serious?”
I was being completely irrational. Maybe this was a form of slut-shaming, “boob-shaming.” It wasn’t my boobs fault that I got harassed. That would be the fault of shitheads who didn’t know the definition of or care about the emotional effects of sexual harassment. My breasts had served me well in feeding my two children as they grew from newborns to toddlers. Still, a part of me was completely pissed off at them for everything I was going through.
And the cancer! The cancer! I was literally face to face with it! Knowing that I was a health writer, the radiologist performing my biopsies satiated my desire to see all things strange and disgusting by showing me the tissue samples after he removed them from the breasts. They had looked all stringy and innocuous, but now I know. Had I known then what I was looking at, I would have punched those tissue samples right in their cancerous faces—if they had faces.

 Oddball, that's me
On Tuesday, the Hudson Valley Hospital Center's Tumor Board—essentially a meeting of oncological minds to discuss patient treatments—will present my case. I don’t think they have the time to discuss every patient, so what a dubious honor, to be considered weird enough to warrant individual scrutiny. But that’s Heather. I was always the one in the office with the computer that acted so bizarrely that even the most seasoned IT guys were left baffled. “I’ve NEVER seen that before,” was a familiar refrain. So excuse me if I don’t act surprised if it does indeed turn out that I have bilateral breast cancer AND ovarian cancer simultaneously. But the jury is still out, so I will try to remain positive till then.
   I’m hoping my gifted team of surgeons—we’re up to four so far—are able to do the DIEP procedure and the oophorectomy at the same time. I can’t fathom two separate recoveries from two separate abdominal procedures. But I’ll leave it up to the experts. Of course, I’ll still ask a million questions and probably drive them batshit crazy. But hey, that’s my right—until a restraining order says otherwise.

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