Wednesday, May 04, 2016

On breasts, babies, and the Blood.

So it’s been an interesting week.


  • I graduate May 14. All that stands between me and completing grad school is one final exam.


  • The EOGs are in just two weeks. Just a month or so stands between me and summer break (joy!) and telling my 8th grade babies goodbye (sadness!) and much, much more time for family and friends.


  • We’re almost done with adoption things (other than the obvious fundraising efforts…) and we’re just a few short meetings away from the waiting-to-be-matched stage. (EKK!)


  • We’re selling our house, and are just waiting for the right person to come along and make an offer (finally).


In other words, this, dear friends, is a very very busy, exciting time in our lives.


This week, specifically Tuesday, threw me a curveball, stopped me in my tracks, and threatened to put a rather large kink in our everything’s-crazy-but-chugging-right-along life...


I had been recommended by my ob/gyn after having my IUD put in (once we made peace with and decided to stop trying have successful pregnancy and pursue adoption fully) to have genetic counseling to see if I was a candidate for the BRCA1 and BRCA2 genetic testing… those genes that cause cancer. I had been very familiar with this testing since I took a course on breast cancer studies in college and it has always been an interest of mine. I knew I had some family history (an aunt and great grandmother with breast cancer, a grandfather with prostate), but no first degree relative - not a mother or sister- so therefore, I might be a little higher than some, but not much. I mentioned an early mammogram, and my ob/gyn again mentioned the testing so I went. I had the counseling, and it was determined I had enough family history to warrant the blood test. It would cost a couple hundred dollars (doesn’t everything?) but it seemed worth it for the peace of mind that it wasn’t an issue, and I had plenty of time for a mammogram later like most folks. I was shown tons of little pie charts and graphs, and I left the cancer center convinced of two things. 1) There was such a statistically low chance I would have it, I wouldn’t loose sleep over it (and didn’t). And 2) If I did have it, seeing all those chemotherapy patients made me completely sure that if I by some chance did have it, I would do anything not to have to go through that horror.


Tuesday, my geneticist called and said I tested positive. I have a 60-87% chance of developing cancer. My mutation is the BRCA2 gene, which has a tendency to be lower risk than BRCA1 but tends to produce the more aggressive and less responsive variety of cancer.


The typical recommended treatment (from the most conservative to the most aggressive) for someone with a risk so high is -
  1. Close surveillance (meaning mammograms and breast MRIs done every 6 months)
  2. 5 years of pre-chemotherapy (tamoxifen) - meaning taking this cancer drug to prevent cancer (but enduring some pretty icky side effects for such a time)
  3. Prophylactic mastectomy (meaning removal of both breasts, with the option of reconstructive surgery… aggressive, but shown to have the best result in radical decrease in cancer risk.)


I am hoping to breastfeed the new baby (yes, it is possible, it’s a real thing adoption people do, and it really works), so I am also in the midst of working a way to manipulate my hormones to make that happen… while trying to prevent pregnancy (and another miscarriage). Now let’s throw in an oncologist into the party and try to prevent cancer at the same time. Sheesssh. Ain’t nothing easy. I have been so excited to try the adoptive breastfeeding method, and now it looks like it will be good for both me and the baby. Breastfeeding for more than 1-2 years can significantly lower risks for breast cancer, so sign me up, especially now. It’s made me that much more determined to try to make that happen.

As of now, the game plan is still largely the same. We’re moving (eventually), adopting (soon!), and enjoying the busy day by day of work and family life. But once I am done nursing my young (however many we do eventually have by whatever means), I will need to figure out what to do with my time-bombs (how, I will henceforth be referring to my breasts…). I don’t know what the next ten years holds, but I do know I will spend them very closely monitoring my breasts and ovaries as we raise the family God has planned. And in ten years or so, I will figure out if tamoxifen alone or with a mastectomy is right for me. Breasts and fertility are so intertwined in identity, feminism, and sexuality that I can’t help but feel emotionally rocked to have both parts of my sense of self damaged. I can’t bare children and now I can’t have breasts?  And yet, how much more I feel as a Christian feminist who believes God’s plan for me is so much more than can be defined by breasts and babies! Oh, how He loves me! What lifesaving power I have in knowing this information, and what life-affirming gospel power is in knowing that the only blood connection I need to solidify my identity is Christ’s blood shed on the cross. I can’t say this news wasn’t scary. It was. But at age 28, to know who and Whose you are, to know your risks and know what lies ahead - man… I am giving Him praise!


For more info on being young and BRCA positive: http://www.ncbi.nlm.nih.gov/pubmed/22982855
http://www.facingourrisk.org/understanding-brca-and-hboc/information/hereditary-cancer/genetic-testing/basics/overview.php

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