Tuesday, September 6, 2011

What About My Daughter?

When my grandson Eli was only a month old, my daughter got mastitis. It went away, but returned a few weeks later. In my narrow world, in which one-plus-one equals breast cancer, I quietly panicked. She was clear on the symptoms, which included fever and muscle aches that are not signs of cancer, so I relaxed. Now, seven months later, she continues to breastfeed and both she and Eli do it smoothly and both are fine. Adorable, in fact.

I never told my daughter of my fears, but she knows I am a world-class worrier where my children and grandchildren are concerned, so I suspect she knew that my intense concern about her mastitis was based on a broader fear.

Could she have breast cancer?

Having the disease myself is one thing. Having a child with the disease is a whole other horror, and a much bigger one. Like most parents, I would much rather be sick than have my child sick.

My worries are legitimate. The fact is, thanks to my bout with the disease, Ellen now has double the risk of getting breast cancer. I am the only person in my family with breast cancer, though, which I hope reduces her chances. And I do not have the BRCA genetic mutation, so I know I will not pass that on to her.

But hormone-negative breast cancer, the disease that found me, is more likely to strike young women like my daughter. And, while cases of breast cancer have dropped in general in recent years, instances of hormone-negative have remained steady or, in some studies, increased.

Breast cancer strikes randomly, often with no regard for risk factors or lack of them. Fewer than 10 percent of all breast cancers are connected to the BRCA mutations. And fewer than 15 percent of women who get breast cancer have a family history. I thought I was in a low-risk category, until I became a blasted statistic myself.

Statistics deal with generalizations—what happens to the “average” person in broad circumstances. Individual cases are ruled by a wide variety of variables, with the result being that people with little risk (me) get cancer, while those with increased risk (Ellen) often don’t. I have several friends whose mothers had breast cancer and who have lived in fear for years that they would get it as well, while I blithely moved along, sure I had no risk. They are fine. I got cancer.

My worries are intensified by the fact that cancer lurks in my family. I may have been the first with breast cancer, but both of my parents had other forms of cancer—my mother had pancreatic cancer and my father an early form of leukemia. My grandmother died of stomach cancer before I was even born, but the way my dad talked about it, I suspect it could actually have been cancer in one of those unmentionable “female” places.

To pile on the risks, my husband has had prostate cancer, a disease that killed his father. So,both of my kids face a risk of cancer of some sort. Still, my husband and I beat the bully and are fine. He is more than ten years past diagnosis and I am more than five years past. We like to joke that we are actually healthy people who just had a little cancer. I mean, we are both far more active than any of our friends. In the past five days, we hiked 11 miles in three different walks in the Colorado Rockies, climbing a total of about 3,000 feet. Not bad for a 65-year-old and a 73-year-old. I suspect our kids do not consider either of us as sickly.

And, even though three of my kids’ grandparents died of cancer, they all did so in their 80s, after living active, productive lives.

I am heartened by the fact that my kids’ lifestyles are, in general, healthier than mine was at their age, which reduces their risk. Both eat better. I was not a fan of vegetables until late in life, but both Ellen and Josh love their farmers’ markets and co-ops. Ellen is a vegetarian and both are excellent cooks and appreciate healthy fare such as veggie soups and salads.

Both are active—as I write this, Josh is out on a bike ride that will probably total 40 miles and include multiple steep mountain rises. Ellen not only keeps up with two kids under 25 months, but also regularly hikes around the Vermont countryside and kayaks on a nearby lake. I hope they don’t slow down the way I did in middle age. And I hope Ellen does not gain weight the way I did after menopause.

While I don't want them to live in fear, I do want them to be vigilant. Breast cancer has been mistaken for mastitis before, and early detection is important. Both my husband and I caught our diseases while they were highly treatable. Still, I would prefer my kids have nothing to detect.

Most important, I hope they take after my husband’s mother, who died quietly in her sleep at 98. Before that, she lived comfortably at home by herself and was cogent and alert and full of love for her children, grandchildren, great-grandchildren, and great-great grandchildren. Those are the genes I hope dominate my kids’ lives.

I hope, I hope, I hope.


Annie Appleseed said...

I am so sympathetic to your thoughts about family members and cancer. First I want to say that with the cancer risk in the US at 1 in two men and one in 3 women, most of us are at risk.

Mitigating that is the healthier lifestyle info you mention in relation to your kids. While not a guarantee, it may mean that if they do develop cancer, they will go through it better than others. (Actually studies already support that idea).
Secondly I appreciate the worry part because after my diagnosis at age 44 (now 19 years ago), I basically tortured my sister until she had a mammogram - at the time she had such a different risk profile from me - but I did not realize it. My mother had her first and ONLY (at age 69) that year.
I founded the Annie Appleseed Project to give people some ideas about how to deal with cancer or risk of, using natural therapies, lifestyle changes, complementary and alternative treatments. I use these methods myself.

Kim said...

Thanks for sharing your thoughts and concerns for your children. This past week has been tough as a young mom passed away from breast cancer in our area. When,oh when, will there be a cure??