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The papers sat on my desk for a year. Every so often I’d come across them when I moved other piles of papers around. My daughters had asked me to get genetic testing for breast cancer and although I have told anyone who would listen that I would do anything for them, this task was frightening and I procrastinated.
The question that needed to be answered was: Do I have mutations in either of two breast cancer susceptibility genes—BRCA1 and BRCA2? If I had those genes, my risk of breast or ovarian cancer are significantly higher than that of a woman without such a mutation. Only 5 percent to 10 percent of breast cancers are caused by such a genetic change. The answers to the question could affect my daughters and granddaughter.
I began to answer the questions about my family’s medical history—not just my family now, but ancestors as far back as I could trace. I plumbed my memory for the many family stories my mother had told me because she was no longer around to fill in the empty spaces on the page.
After I had written what I could, I called my mother’s sister, the only one alive from that generation. At 92 she is feisty, funny and has a wonderful memory. I hope I inherited the gene for that! She answered a few questions and the pages were then as complete as they would ever be. There was so much I didn’t know but the testing would tell me enough to identify whether or not I carried BRCA1 and BRCA2.
Why did my daughters ask me to go for genetic testing? They had questions that related to their own health future. My medical history concerned them and the effect it might have on their own health futures.
I had already had two primary cancers: breast and kidney. I had also had a hysterectomy at age 48 so there was no chance for me to get ovarian cancer. But there is a list of reasons why a woman would want to be tested and I fit the description of several items on the list:
I had bi-lateral mastectomies at the age of 43.
My maternal aunt had breast cancer in her 70s.
I am of Ashkenazi (Easter European) Jewish ancestry.
I made an appointment with the genetic counseling team at our local teaching hospital. My counselor asked me many questions about my history. My maternal grandfather died of what was described as stomach cancer at the age of 43. My maternal grandmother died of what was described as pancreatic cancer at the age on 70 (or so, because nobody knew her real age!). My mother died of lung cancer. Not a pretty picture, it seemed. But none of that had anything to do with BRCA1 and BRCA2.
By the way, I was interested to learn that there are laws against discriminating against anybody who has been identified with having this gene. Insurance companies are not permitted to remove you from their rosters if you have the gene. Somehow hearing that was comforting but I’m not totally convinced.
A blood sample was taken. That was it! That was all! It was a lot simpler than I had imagined.
It will take a month for the evaluation to be done. In the meantime, I have provided the genetic counselor with pathology reports of my breast cancer and of the kidney cancer.
I’ll know the answer at the end of September. I will give the results to my daughters so that they can consider what they need to do. Of course I hope I don’t have the gene. But if I do, knowing about it is so important for the generations that will follow me—and I hope there will be many.
By the way, the best way to get information about this is to type “genetic testing for breast cancer” into Google. The information is vast.
