Originally published in “The Seattle Times” on May 29, 2013
‘‘Women need to know there’s a woman like Angelina Jolie who can make this decision and go on with their lives. It’s totally empowering for women,” Dr. Elizabeth Swisher told The Seattle Times. She is director of the Breast and Ovarian Cancer Prevention Program at Seattle Cancer Care Alliance.
Her words really hit me. Not because I am a fan of the actress, although my opinion of her continues to rise, but because Swisher was my surgeon in 2011 when I had my ovaries and uterus removed to reduce my own risk of cancer.
Like Jolie, I have the BRCA1 gene mutation — a link to breast and ovarian cancer that is often passed on from one generation to the next.
Unlike Jolie’s relatives, neither my mother nor my grandmother had breast cancer, ovarian cancer or the BRCA1 gene mutation. I inherited it from my father.
In 2010, my dad was diagnosed with pancreatic cancer. As doctors looked into his health history, they recommended he take the test for BRCA1.
While rarely discussed, other cancers like pancreatic cancer can also be linked to the BRCA1 gene mutation. The gene is most closely associated with breast cancer and ovarian cancer — the later usually has deadly implications given the difficulties of early detection.
When my dad disclosed he was a carrier, he advised both my sister and I to take the test. I did so with much trepidation.
A few weeks after my test, I received the call — I carried the BRCA1 gene mutation.
I was distraught, angry, scared and in disbelief. I am also a mother. I had to do something in the face of the 50 percent chance of getting ovarian cancer.
Swisher was a breath of fresh air. While noting my anger at the news, she advised I should be grateful. There are so many diseases out there that we cannot detect early. Or if we can, there is not always something we can do about it. BRCA1 is different. An oophorectomy and mastectomy, respectively, can reduce the 50 percent chance of ovarian cancer and the 87 percent likelihood of breast cancer to less than 5 percent.
I knew I was done with having children, so I addressed the risk of ovarian cancer first. As an otherwise healthy woman, I was nervous to undertake such an invasive surgery.
But I also wanted to do everything I could to have a long life with my husband and children. And with advancing technologies, my surgery included less-invasive options. I acted on my knowledge, not my fears, and made a medical decision to improve my outcomes.
On Valentine’s Day, a few weeks shy of my 40th birthday, I had an oophorectomy and hysterectomy. My risk for ovarian and cervical cancers is virtually gone. The surgery also decreased my chances of breast cancer.
Every six months I monitor for breast cancer by having an MRI or a mammogram. The stress of biannual tests is likely to lead me to a prophylactic mastectomy in the future. But whatever I choose, I will be acting based on powerful medical knowledge.
My decision has been delayed by the death of my father. His loss again drives home Jolie’s motivations, which are similar to mine. She said, “I can tell my children they don’t need to fear they will lose me to breast cancer.”
With the knowledge of my genetic mutation and surgery a couple years behind me now, I’m blessed with a new perspective on the entire experience. For Jolie, me and the millions of other women these issues impact, the key thing with learning your family history and bolstering our knowledge with genetic testing is an ability to make informed decisions and ultimately go on with our lives.
Tana Senn lobbied for federal legislation to prevent insurance and employment discrimination based on genetic factors. She is a Mercer Island City Council member.
To support Dr. Elizabeth Swisher’s “Determining Genetic Risk of Ovarian Cancer,” click here.