I have an increased risk for developing breast cancer because my mother had the disease. She passed away eight years ago and since then, on most days I imagine the conversations I’d have with her about dreams and fears, writing, food, health, and love.
Sometimes I’d write about those conversations as a way to remain connected to her spirit. Today’s post is about a conversation I wish I could actually have with my mom in person.
Under a pile of bank statements, credit card offers, and various receipts lay a request form for genetic testing my OBGYN gave me half a year ago. It was an option, should I want to know if I have the breast cancer gene.
It’s just a piece of paper but I keep it stowed away under piles of paper I won’t sort through for a while. I can’t bare to think about ever having cancer, leaving my family and friends prematurely, and never seeing my children have a family of their own. Like my mother. That form is a staunch reminder of my mom’s physical absence.
The offer for genetic testing doesn’t expire as long as I either have the money or health insurance to cover its cost. My mother believed with conviction that her illness was caused by her stress and lifestyle. The stress was from being a single mother of three, an immigrant, and poor. Women with similar demographics have higher rates of breast cancer prevalence, and are more likely to die from the disease.
There are different types of breast cancer. Some are more aggressive than others, and some are passed down through the abnormal breast cancer genes, BRAC1 and BRAC2. Having these genes don’t mean breast cancer is definite, but it significantly increases your likelihood of it developing. Getting breast cancer is complicated and has a lot to do with risk factors including but not limited to, age, reproductive history, environment, lifestyle, and whether first-degree family members have/had breast cancer.
After my mom’s diagnosis, she took up yoga, ate organic food (before it was offered in grocery stores), worked part time, actively engaged in support groups, and underwent chemotherapy. We frequently talked about politics and why there was a disproportionate amount of women “like me,” as she’d say, suffering from this disease.
My mom frequently reminded me that other than herself, we have no family history of breast cancer. Therefore, I need not worry about having a similar fate. She would tell me to “just continue to eat healthy and exercise. Don’t worry so much.”
Intuitively, I know my increased risk for breast cancer is neutralized or even reduced with my lifestyle. On most days, I exercise, eat well, and try to choose organic. I’m also engaged to a wonderful and supportive partner who helps reduce my stress, and once we’re married, our union will serve as another protective factor against diseases. I go for regular check ups and floss (flossing is a protective factor against gum and heart disease, not breast cancer). But still, the genetic testing service appeals to me like a customized horoscope does to astrological believers.
Both the test and horoscope provide information about the future and would leave me with the choice to act (or not) based on what I know.
But do I want to know if I have a genetic predisposition to breast cancer? Let’s say I end up having the gene, what next? Will I be able to handle everything that needs to happen next? If I don’t have it, will knowing that help resolve hurt feelings about my mother’s death? Will I act as though I’m immune to the disease? If I choose not to get the test does avoiding it mean I’m taking an “ignorance is bliss” approach? Or does it prove my confidence in a healthy lifestyle?
My OBGYN also warned that the test results will be on my medical and insurance records. If I have a genetic predisposition, and therefore a higher risk of breast cancer, it can impact my insurance premium or restrict services offered to me. Future insurer could potential deny me coverage as well. But, the health reform, when implemented, should protect me from these types of discrimination. Thanks Obama!
My current thoughts are to do the following:
- dig up the form and put it on my fridge so I don’t conveniently forget about it and thus eliminating my need for a decision (done, by the time of publishing this post)
- find out more information about the testing such as counseling options to go with the test results, insurance implications of the results, fees and co-pays, if it’s necessary, and general pros and cons
- figure out if I’m taking my sweet time coming to a decision because I’m afraid of knowing the results (my friends and family can help me with this one)
I’ll go from there and keep you posted. At the very least, talking and learning more about the testing can only help me make an informed decision.
Yuka Polovina 