She Faced The Brutal Choice That Angelina Jolie Once Faced
BESSIE OSTER, now39, had a BRCA1 diagnosis at 30 and was faced with the decision of whether or not to have a mastectomy. BRCA1 the gene mutation is associated with an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. At the time, her and her boyfriend Jason were dating seriously and hoped to have children, but this news sent her reproductive timeline suddenly into “overdrive”.
This is her story:
To deal with my diagnosis pre-emptively, I saw oncologists and plastic surgeons, talked to friends, joined a support group, practiced yoga, meditated and, after a year, I decided to go ahead with a preventive bilateral mastectomy. The surgery, though physically tough, was ultimately an affirming experience, one that drew me closer to my deeply supportive friends and family, as well as my future husband.
I got married a year and a half later, and started trying to have a baby almost immediately. The following six years were spent attempting to get pregnant, including undergoing many rounds of IVF. Although infertility was one of the greatest challenges of my life, it was a relief that I didn’t have to worry about breast cancer during that time. Thankfully, I have two joyful, healthy children as a result: A boy, Jesse, who just turned two, and a baby girl named Josie, who was born in January.
Life-after-baby-making is a significant milestone. Though Josie is still feeding every four hours, and sleep deprivation causes its own unique fog, I am very aware that I’ve come through an era that lasted for much of my thirties. There are also more complex reasons to contemplate what’s next: The ovarian oncologist who monitors me explained that with the BRCA1 mutation, the risk is only marginally higher than the general population until about age thirty-five to forty, at which point, it shoots up for those of us with the mutation. And as Jolie notes in her piece, early detection of ovarian cancer is tricky. It’s often quite advanced before detection, and therefore relatively fatal, compared with other types of cancer.
Medically speaking, an oophorectomy is a less complex procedure than a mastectomy. And as a friend recently pointed out, since I’m finished having children, I don’t need my ovaries anymore. Yet, when it comes to this decision that I’ve been planning for nearly a decade, I remain fearful. I’m not sure that I’m finished with the benefits of estrogen and progesterone—or quite able to wrap my head around what it means to be forced all at once into menopause, especially given the latest findings that many women may gradually move through this biological shift over a ten-plus-year span. And then there’s the whole host of issues that fall under what Jolie refers to as “feeling feminine.” What if I look and feel older? What if I don’t like it?
Don’t get me wrong. I’m all for prevention. As a teacher working in the realm of public health, I spend hours thinking and talking about disease prevention and decision-making. My prophylactic mastectomy was preventive, and I used the latest methods of genetic testing to ensure that I did not pass the mutation on to my daughter, Josie. I deeply relate to Jolie’s 2013 piece about the decision to have a mastectomy, which was proactive, empowering, and positive. But even with this information at my fingertips, I really don’t know when or how I will proceed with this next step.
It is indeed not easy to make such decisions. But as Jolie writes, “you can seek advice, learn about the options, and make choices that are right for you. Knowledge is power.” And with that, I’ve made an appointment with my ovarian oncologist to talk options and time frame. In the meantime, I’m going to go back to snuggling my beautiful baby sleeping next to me.
You never know when your life will be turned upside down from things of this nature. The best thing you can do is get yourself checked in order to be able to prevent much misfortunes.