Like Ms Jolie my mother died of cancer (technically a secondary cancer that spread from the original breast cancer). She was a few days shy of her 46th birthday when she died after 4 or 5 years of fighting the illness.
I know that because of this statistically my chances of contracting cancer are approximately double that of the rest of the population but I have never been tested for the faulty gene that Ms Jolie carries. Partly, this is because I’m neither very old nor a mother and partly its because my mother is the only member of my family to have had such an early onset cancer.
Her elder sister has fairly recently been diagnosed with breast cancer much later in life [this probably means that despite the location it was an entirely different type of cancer] and my Father’s aunt also has cancer but of a different type.
Nonetheless, I have been thinking about what a genetic risk of cancer means for me and what I might do about it. After my step-mother was also recently diagnosed with breast cancer and with my 30th birthday fast approaching my father has recently asked me to talk to my Doctor about screening. It seems a big step to consider what options the NHS might have for me with regard to earlier and more frequent tests (not normally offered to lower risk younger women) and an even bigger step to consider both genetic testing and a mastectomy. Yet, I want to be responsible and to think about the impact of my health on the people I care about – if I could prevent my loved ones watching me go through debilitating treatments and potentially dying 20 odd years before my time should I do it..?
My immediate answer must be yes. I wouldn’t wish my childhood experiences of cancer on anyone. But..
(You knew there was a but right?)
I’m not quite 30 and I don’t have children. At this stage in my life the idea of having children and possibly breast-feeding them is still more important than a statistical chance. I don’t think my breasts are the arbiter of my femininity or that I am less me without them (though I imagine it would be a shock to the system) and I don’t think that breast-feeding is a sign of true motherhood but I do think that personally I’d rather try for kids before messing with the status quo. Furthermore, I’m not ready to deal with the potential hormonal and emotional repercussions of such testing and surgery whilst kids are still a possibility. If (like Jolie) I already had children perhaps I would be more concerned with their future and how much time I could offer them but right now I am well aware that the knowledge of genetic issues combined with the physical effects of mastectomy might be enough to stop me from ever having children and I don’t want that to be the reason for our choice.
If I have a mastectomy I want it to be after we have children – and if I test positive for the gene, removal of the ovaries is also a consideration – but after kids.
Maybe that is selfish. Maybe its naive. But the fear of not being enough of a mother because I don’t have one to guide me can’t be enough of a reason to cut out a part of the mother I want to be. I would – will – actively protect my family through surgery if necessary but I can’t give up on making the family stronger because I am afraid of statistics.