To screen or not to screen…that is the question

As a person with lots of cancer in my family history (unfortunately that is not such a unique bio anymore), my ears have perked up over the recent news that Jewish women are much more likely than the general population to have three common mutations in a particular gene called the BRCA1 and BRCA2 genes. These are genes that significantly increase the risk of developing breast and ovarian cancers.  According to the latest research just published by Dr. Metcalfe at Women’s College Hospital, about 1 in 45 women in the Jewish population will have a mutation, while 1 in 250 women in the general Caucasian population will have one.

What does all of this mean? Well, on the plus side it means there is a test that could potentially tell me the likelihood of developing breast or ovarian cancer.  Ovarian cancer is a silent killer with symptoms that include such common signs like bloating that it can easily be mistaken for basic things and is often undiagnosed until it’s too late.

This sounds very exciting!  A test that will help protect me potentially from life threatening illness that could take me away from my children.  Sounds peachy.   What is not so peachy and where my dilemna comes in is the ramifications of this particular test.

If I go ahead and take the test and I determine that I am a carrier for these genes, my options are now quite daunting.  Being a carrier does not ensure that I will develop any of these cancers, it just means that my chances are increased. Kelly Metcalfe, the study’s lead author and adjunct scientist at the Women’s College says that Women with a mutation in the BRCA1 or BRCA2 genes have a 20 to 40 per cent chance of developing ovarian cancer and up to an 80 per cent chance of developing breast cancer. Those odds are not appealing.

So option one is that I now get screened frequently to make sure that I am catching anything that might be sneaking up on me early.  I am very powerful now with my insider information so I cautiously live my life ensuring that I am constantly doing breast self examinations and checking my ovaries through whatever tests are available out there for checking them.  Unfortunately diagnosing and testing for Ovarian cancer is not simple nor 100% effective.  Same with breast cancer.  I just read an article a few days ago that there was a study that showed that a group of women who had in fact gone for mammograms and received results indicating that they had no signs of cancer, in fact had breast cancer.  I think those mamogram machines need some work.

Personally,  I don’t think this is an option I could live with.  Constant fear is not me.  I need to deal with the situation and move on.  I can’t live my life waiting for the hammer to drop.

Option two is a wee bit more radical.  I opt for a double mastectomy, remove my uterus and go for an ooferectomy which is just a fancy way of saying I get rid of my ovaries.  Kind of harsh.  Sounds like I’m removing all traces of my womanhood.  Puts me into menopause at the ripe old age of 37 and I will know what my mother is talking about when she complains of hotflashes.  Appealing ?  Not so much.  Something I’m willing to do to ensure that I am around to torture my children long into their lives? Yup.

The test for the genetic mutation is not currently available to women who do not have a family history of breast and/or ovarian cancer although the governement is looking into that now and hopefully there will be some changes to that soon enough. “Lucky” for me, I have a grandfather who just died of breast cancer 3 weeks ago (yes, I said grandFATHER), and an aunt who has been diagnosed with both forms of cancer, so I seem to qualify. “Lucky” seems to have a very different meaning these days in this cancer ridden era.

I think I started this article more as a debate as to how I would choose to live my life based on the test results, but I am ending it realizing that I would choose to do just that,  live my life, breasts or no breasts, the choice now seems clear.