BRCA Genes and Ovarian Cancer: Susan Gubar’s Memoir

Every now and again I get a nice smack upside the head and am glad for it. Today was one of those days. In the midst of errands, car radio tuned to NPR’s Talk of the Nation, I heard an interview with a brilliant woman named Susan Gubar who’s newly-minted memoir about life with ovarian cancer is now on my must-read list.

http://www.npr.org/books/titles/151761076/memoir-of-a-debulked-woman-enduring-ovarian-cancer

Not that I needed any additional information on the topic of avoiding ovarian cancer. I have a relative who lives in Susan Gubar’s ovarian cancer shoes. Ovarian cancer treatment is brutal, early detection next to impossible, and survival rates lag behind other cancers. Instead of bemoaning the fact that I will spend many of the precious days of summer recovering from prophylactic bilateral salpingo oophorectomy and breast reconstruction revision surgery, I am reminded of precisely how lucky I am to know that my BRCA1 gene mutation puts me at high risk of this killer and that I can do something about it.

Thank you, professor emeritus Susan Gubar, for making my day.

BRCA for Dummies and The Teenage Mutant Ninja Turtles

Courtesy of crazy-frankenstein.com

 

Ask anyone who is BRCA positive if they’ve had difficulty explaining their situation to others and they will scream a very loud YES in response. The learning curve surrounding the HBOC Syndrome (Hereditary Breast and Ovarian Cancer) is steep. The choices are complex and nuanced. No two individuals are alike and much depends on deeply personal choices. It ain’t easy being a mutant.

At the end of the process of screening, counseling, doing the test, receiving results and discussions with a gaggle of medical professionals, there comes a point where patients realize there are three main areas to consider in making decisions about the management of a defective BRCA gene:

Increased Screening (catch that cancer early)

Chemoprevention (fiddle with hormones that influence cancer)

Surgery (beat cancer to the punch)

A gross oversimplification of the options, yes. That is exactly what I want. An easy way to define the salient features of this biological dilemma and how to deal with it. An elevator speech that outlines BRCA in under a minute. A tutorial my dry cleaner, hairdresser or a casual acquaintance would understand.

For BRCA folks like me who have already gone toe-to-toe with cancer and lived to tell, the content of this elevator speech is not the same as someone like my sister who has never had cancer. Survivors differ from Previvors, the term given to those who have the genetic disorder but have not yet been diagnosed with cancer.

I’ve passed the first surgical hurdle in my BRCA travels – bilateral mastectomy with immediate reconstruction. More surgery lies ahead. My elevator speech will keep changing, along with my body. The elevator speech is only one of many communication tools that would benefit the BRCA community. The fact is, a genetic disorder like BRCA affects relationships at every level and patients suffer greatly as they grapple with painful, life-altering decisions and then attempt to inform, educate or persuade others who are often skeptical as well as ignorant.

Once I’m done with the elevator speech, the next chapter in BRCA for Dummies will be “How to Deal With Morons.” It will include snappy retorts to ridiculous comments like:

“Oh, you’re exaggerating. Everyone has to die from something.”

“Can you get medical marijuana for that?”

“It’s all up to the man upstairs anyway, isn’t it?”

Those teenage mutant ninja turtle dudes probably had the right idea. Do the best you can with the hand you’re dealt, fight for what’s right, and eat lots of pizza. The world can always use a few more cool mutants like those guys. Forget the BRCA for Dummies idea. Give me some Turtle Power!

BRCA and the Lingo of Breasts

Works of comedy genius, George Carlin

 

Comedian George Carlin’s classic monologue “Seven Words You Can Never Say on Television” included a rather benign slang term for breasts.

Tits.

George went on to say that he thought the word tits did not even really belong on his list because it sounded more like a good name for a snack food than something that would offend TV censors. Cheese Tits, Tater Tits. That sort of thing. When it comes to breasts there are a plethora of euphemisms, nicknames, slang, obscenities and just plain goofy words used to describe female mammary glands. For this writer, words and their meanings, origins and ever-changing shifts in usage are more than a passing fancy.

Where did some of the most common expressions for breasts come from? Tits is an easy one. It is a version of teat, a very old word and we all know what it means. But boobs? Turns out that one is less straightforward. Use of the term boob or booby dates to the sixteenth century and came into the language as a reference to a stupid person or certain large, ungainly birds who were also presumed to be dim-witted. The linguistic community seems unsure of the exact path it took to arrive at the current slang usage of boob/boobies.

While the etymology of all words mammary related may be of intellectual interest to my writer self, what intrigues me as a breast cancer survivor and a carrier of a defective BRCA1 gene, is the way the medical community has a lexicon all their own that surrounds the almighty breast. They HAVE to. In my plastic surgeon’s language, the two rather large, saggy troublemakers that once belonged to me were dispassionately described as “pendulous.” They exhibited “asymmetry.” Surgery would reduce my cancer risk and improve the “cosmesis.” In other words, my lopsided middle-aged bust line could be reworked into a smoking hot rack. Or so I hoped.

Austin Powers dubbed them jubblies and dirty pillows. High beams and honkers arrived courtesy of our car culture. The restaurant empire that is Hooters is in a category by itself. Melons and muffins for the food fans. Ubiquitous milk references. Jugs and knockers anyone? A vast array of secondary terms exists purely to describe the size of female mammary glands. What about the boys and their breasts? The male of the species is shortchanged here in every way. Man boobs are at best, an embarrassment, but not to worry, guys. Plastic surgeons are quite delighted to fix that situation and describe it with a proper term: gynecomastia.