October issue 2010
Running in the Family
Cancer is a word I have been familiar with and heard in my home nearly my entire life.
In the case of my my grandmother, I have seen the grimmest side of cancer and memories of her with the illness are flooded with images of drips, injections, doctors and hospitals. But through my mother, a breast-cancer survivor, I came to see that cancer did not mean the end of life.
A workaholic and always on the go, my mother continued her daily routine as before, but cancer, combined with its immediate treatment — chemotherapy — and long-term treatment — a regular course of medicines — took its toll on her physical health. Had it not been for the headscarf she started wearing after her chemo, I would not even have known that she had been diagnosed with cancer. But as I grew older, I began to understand the implications of this illness. She no longer had the physical stamina to go on working and taxing her body as before. Also, she became more susceptible to picking up the smallest of illnesses, and something as simple as a flu or a cough hit her far worse than it did anyone else.
It was during my mid-teen years that I really awakened to what cancer was, and what it meant for us as a family. With my grandmother and two of her sisters, my mother and my maternal aunt, all diagnosed with either ovarian or breast cancer, all indicators point towards this being a genetic disease, putting me, so to speak, next in line. Although I haven’t as yet been tested for BRCA 1 and 2 — however I do intend to do so — the fact that so many close relatives have had cancer puts me at high risk for getting it.
So what does this mean? Two things: what I must do in a medical capacity and what social concerns I have to deal with. As far as medical goes, annual screening has to begin at the age of 18. And so I did. However, I cannot get a mammogram until the age of 40. But knowing I run such a high risk of getting it before that age, having to wait till 40 is not very comforting, so you want to know what else can be done.
Ideally, as recommended by doctors, I should — and this goes for all women who are high-risk candidates — get married at an early age and complete my family by the age of 30, and get a hysterectomy immediately. But at 18 one’s response to this is: really, how can you plan these things?
In addition to that, the reason why many families do not disclose such a medical history is out of fear: Who will marry our daughter? I have been fortunate enough to be married into a family who is above such biases, but there is a lot more that needs to be thought about.
Completing a family before the age of 30 poses a likely challenge to education and career advancement. Dreams of achieving so much in little time do face a setback. Also, nobody tailors their life in a manner where one has decided that they will get married at 24 and have a kid at 25 or 26. Relationships and life in general cannot be planned in that fashion. Besides, you are not the only person whose life this affects or whose decision it is to make. Your partner features most obviously in it. What ‘must’ be done sometimes stands in direct opposition to what one ‘wants’ to do, for both you and him. In addition, getting a hysterectomy at 30 or earlier inevitably means osteoporosis and arthritis — an additional psychological factor to deal with until the illnesses manifest themselves physically.
But what being exposed to cancer has done is to numb me from fear to some extent. Of course, sometimes it arouses fear, especially when you feel unwell, but otherwise, the possibility of getting it is not something you live with every day of your life — it doesn’t weigh you down like a burden every passing moment.
However, those who are at high risk and feel it may be a disease that runs in the family should be vigilant, and get themselves tested for the BRCA 1 and 2 as well as get themselves screened regularly. I don’t know myself how I would react to testing positive in the gene test, but I do know from all the cases before me, early detection is better than late, and can lead to less pain and a better quality of life.
A version of this article originally appeared in the October 2009 issue of Newsline.