After learning that she carries a mutant cancer gene, a young mother chooses to embrace — rather than curse — her legacy.
By Lambeth Hochwald
To be Jewish is to be proud of our genes. After all, these spirals of DNA encode us for just about everything — our ability to make matzo balls, cure diseases, laugh at even the most obscure New Yorker cartoons, and giggle with Larry David. But, when I discovered that I had a gene that not only upped my cancer potential but meant having surgery that would end my fertility — and femininity as I knew it — I must admit that pride wasn't the first feeling I experienced.
But I think it should have been.
I found out three years ago that I'm among the one in 40 Ashkenazi Jews who carries the Breast Cancer (BRCA1 and BRCA2) gene mutations. I prefer to think of this discovery — that I have a predisposition to breast and ovarian cancer — as a show of strength, yet another thing that makes me a powerful Jewish woman, and not as something that will destroy me.
Not that this revelation came easily. In fact, when one of my cousins first suggested we probe whether we carry this ancient mutation, I bristled. Both my mom and my aunt (her sister) are breast cancer survivors, and my aunt is also an ovarian cancer survivor. Sure, we knew that in 1941 my grandfather's mother was "open and shut" in the operating room — her cancer had spread everywhere — but this was dismissed by the elders in the family as an isolated "sick leaf" in our otherwise blooming family tree. Times were different then, too. Cancer was the "C" word, it was a shande to even discuss such a thing — spit three times lest an evil force bring such trouble on your head.
But living in denial about our family history was no longer an option. Two years ago, these Bronx-born sisters — who had already endured chemotherapy, radiation, and the hair loss and chemofog that goes with it — were tested. Both turned out to be BRCA positive. Then my mother ordered my great-grandmother's death certificate — sure enough, she had died of ovarian cancer.
I was mad at the world, thinking of the pain my mom and aunt might have avoided if we had put the pieces of our family puzzle together and pierced the veil of secrecy sooner. Then again, to know you carry a genetic mutation that predisposes you to two types of cancer is to forever feel marked. Knowing we were BRCA positive years ago would have imposed that shadow, but it also would have allowed my mom to take immediate steps to protect her health. Because it would have reduced her risk of breast cancer significantly, she would have had her ovaries removed on the spot.
Now, when I look at photos taken at my bat mitzvah, I see my mom, who had just turned 40, looking so radiant. I wish she'd been spared the cancer.
As for me, I'm on the cusp of 40 and I'm the mother of a toddler, not a tween. Given my 50/50 odds of being a carrier of this mutation, I decided I had no choice but to submit to genetic counseling and a blood test. So I marched over to a local hospital on a gorgeous June day, just nine months after giving birth to my son, Zachary, now 3. A month later, when the counselor assigned to my case called me with my results, she asked if I was in a place "where I could talk."
That never bodes well.
The fact that I, too, was BRCA positive felt almost like an inevitability, despite my late-night prayers that I'd be negative — given, I reasoned, how much I favor my father's side of the family both in looks and body type. On this one, my cells would disagree. When it came to my breast- and ovarian- cancer risk, I was all mom.
It took me four weeks to process this information and get a game plan together. And then one rainy day, I sat with my father, who was dealing with his own pain (he was in his second of a three-year battle with brain cancer).
"See this as a blessing, not a curse," he said softly. Eureka! I had spent so much time worried about the consequences of this deleterious gene, I hadn't seen the mitzvah of it. My dad was saying that the discovery of the gene wasn't a death sentence, it was going to save my life. Hearing it from him, a retired cardiologist with whom I was so simpatico, I felt a wave of calm pass over me. We Googled the best of the best of the high-risk cancer experts in New York City.
When the day came for me to have my ovaries and fallopian tubes removed, I was as ready as I could be for the prophylactic procedure. I sat with my mom in the waiting room and we reminisced about my dad, who had passed away a month before. I was numb from mourning the loss of my father and my procreative future. But right before I walked into the O.R., I remembered a Jewish ethics class I'd taken as an undergrad. The professor was discussing the biblical imperative to guard health above all else, and I recalled that as a people, we believe in choosing life. ("Choose life in order that you will live, you and your descendants." Deuteronomy 30:15-19)
Like my great-grandmother (from whom I probably inherited BRCA), who fled the Cossacks to forge a new life in America, I am a survivor. Today, I walk my son to preschool knowing I have two tiny suture scars that, like my heart, is starting to heal. It has been a year of so much loss. Yet the tears I cried when I got my all-clear post-surgery pathology report were tears of profound joy.
I go to a cancer center twice a year for consultations, scans, and tests, and I have a new perspective. Now that I've added this BRCA status to my personal résumé, it has become clear — slowly, over the past two years — that I should be proud of who I am. My goal: To tell my story and make sure Zachary knows his legacy when the time comes. Until then, I'll keep repeating my mantra: Learn the truth of your family tree.
