BRCA Surgery Countdown: Party Time

As the 4th of July approaches it brings out the crazy in my Vancouver, Washington neighbors. Firecrackers that are illegal in most states are sold on every street corner here. The historic grounds of Fort Vancouver will be home to the largest firecracker show west of the Mississippi on Wednesday, but in the days before the annual patriotic blitz the Couv is booming every night. Vancouver residents simply cannot resist the desire to blow stuff up. We decided to celebrate Independence Day a bit early as well, with a dinner party. I don’t expect to host any other events this summer with surgery now 17 days away.

The original plan of an outdoor party under the stars was squelched by cool, wet weather. I thumbed my nose at the weather gods and bought some stars from the party supply store instead. Our wine theme was inspired by the sort of emergency every wine collector has at some point. A glut of really good wine in danger of heading over the hill. This time the cellar dilemma belonged to our friends John and Kathie and the wines in question were a collection of Zinfandel-based blends from Linne Calodo Winery in Paso Robles, California.

Linne Calodo wine lineup

For warm-up whites we had a lovely crisp Txakoli from our 2011 trip to Spain’s Basque region and a white Rhone-style blend from Booker, another Paso Robles winery. Boursin stuffed mushrooms, giant shrimp and a peppery Toscano cheese were the appetizers. Grilled beef tenderloin with chimichurri and roasted vegetables comprised the entree followed by nectarines and vanilla ice cream. Oh, and a plate of chocolate truffles from Moonstuck and Honest Chocolates, just because.

Stars and smiles

Right on schedule as the meal concluded, the pyrotechnics began. Nothing too elaborate. A few kabooms loud enough to scare the cats along with bright splashes of color painting the summer sky.

Count Catula and my sweet friend Heather

Soon I will have to put my wine consumption on hold in preparation for surgical adventures. My liver will go off on an alcohol-free vacation in style with the memory of this evening filled with laughter, great wine, friends old and new, and the neighborhood fireworks.

BRCA Genes and the Surgery Countdown

Three weeks to go. I feel the need to clean everything in my house. Stay busy. Have some fun. No matter how hard the logical side of my brain works, the older more primal brain sneaks in and whispers in my ear to be afraid. Very afraid. With good reason. Surgery is scary stuff.

I seek to keep myself on an even keel with regular exercise and three square meals a day from scratch with no processed foods. Well, maybe some chocolate. And I gather my good luck charms. Here is a new addition:

T-shirt from Charles Smith Wines

While Riesling may not be among my favorite varietals, I do appreciate the talents of this very colorful winemaker. The T-shirt for his Kung Fu Girl Riesling somehow reminded me that I am one tough girl. I’m ready to kick my cancer risk in the ass. Just throw in a sock monkey or two and all will be well, no matter what the animal part of my brain has to say.

Cotty and the Duck Monkey

 

BRCA1 and BRCA2 Risk Stats Simplified

I accepted long ago that my brain is wired for language, not numbers. All forms of math befuddle this word nerd. In the quest for knowledge about cancer risk, information in the form of numbers cannot be avoided. If those annoying stats were not so central to the BRCA decision-making process I’d vote to toss them out the window. In college I learned that statistics do not lie, but people do. Statistical data can be slippery and open to interpretation.

Here is a breast cancer statistic that is commonly repeated:

1 in 8 women will get breast cancer in their lifetime. What does that statement really mean? Breast cancer risk varies greatly throughout the course of one’s life according to the National Cancer Institute.

A woman’s chance of being diagnosed with breast cancer is:

from age 30 through age 39 . . . . . . 0.43 percent (often expressed as “1 in 233”)

from age 40 through age 49 . . . . . . 1.45 percent (often expressed as “1 in 69”)

from age 50 through age 59 . . . . . . 2.38 percent (often expressed as “1 in 42”)

from age 60 through age 69 . . . . . . 3.45 percent (often expressed as “1 in 29”)

Source: cancer.gov web site

Do you see 1 in 8 here anywhere? Nope. The one in eight number comes from looking at all women in the population up to age 80. This is an example of absolute risk. Let’s save relative risk for another day before I fall asleep writing this.

When it comes to absolute risk for BRCA positive people, the numbers that get tossed around can vary widely. They are often shown as a range. Keep in mind genetically inherited BRCA cancers strike differently in one family versus another. Some families will get more cancer than others and we do not know why this is so. Your family might fall at the low end of the range. Or not. This is part of why genetic counseling is a critical part of the BRCA learning curve. Those genetic counselor geeks know how to analyze numbers that are applicable to your situation.

One of the better examples of showing BRCA cancer risk as an easily understood graphic that I’ve seen comes from the new Basser Research Center for BRCA1 and BRCA2 at the University of Pennsylvania.

For this math loser, here is data I can digest and easily repeat to others. Why? Everyone understands basic percentages. In the general population, roughly 13 women out of 100 will get breast cancer at some point in their lives if they live to be 80 years old. For every 100 women who have a BRCA1 mutation like me, between 60 and 80 of them will get breast cancer if they live to age 80. Numbers like these matter when one is trying to decide whether to chop off precious body parts.

I will place these well organized numbers in my KISS (Keep It Simple Stupid) file for a book about cancer I’d like to write one day. Even if I never do fully understand the metric system or dividing fractions at least I can explain to my hairdresser why I’m having more surgery soon.