MY MOTHER fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.We often speak of “Mommy’s mommy,” and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a “faulty” gene, BRCA1, which sharply increases my risk of developing breast cancerand ovarian cancer.My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.
Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.
Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.
On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.
But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.
My own process began on Feb. 2 with a procedure known as a “nipple delay,” which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.
Two weeks later I had the major surgery, where the breast tissue is removed and temporary fillers are put in place. The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life.
Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful.
I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that’s it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has.
For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.I acknowledge that there are many wonderful holistic doctors working on alternatives to surgery. My own regimen will be posted in due course on the Web site of the Pink Lotus Breast Center. I hope that this will be helpful to other women.
Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.
I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.
Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.译文 我母亲和癌症进行了近十年的抗争，在56岁时辞世。她顽强坚守，终于见到了自己的第一个外孙，她是多想能把她的外孙们都揽入怀中啊。但我的其他孩子却没有机会和她相见，感受她的慈祥和爱意。我们经常谈起“妈妈的妈妈”， 我自己也想搞清楚这种夺去她生命的病魔。 他们问过我，这种病是否也会降临在我的身上。我则总是告诉他们不要担心，但事实上，我身上带有一种“错误的”基因，BRCA1，它极大的增加了我得乳腺癌和卵巢癌的可能。 我的医生估计我有87%得乳腺癌，和50%得卵巢癌的可能，虽然每个女性得这种病的风险各不相同。 遗传基因变异只是导致乳腺癌的一部分原因。那些BRCA1基因有缺陷的人，平均来说有65%的概率得这种病。 在我了解到这就是我的实际情况后，我便决定要采用积极的办法，把这种风险降低到最低限度。我下了决心，要去做预防性双乳房切除手术。由于我得乳腺癌的概率高于得卵巢癌，于是，我便从乳房开始，这个手术也要复杂得多。 4月27号，我完成了三个月期的包括乳房切除手术在内的全部治疗。在这个阶段，我未让外界知晓此事，依然忙着自己的工作。 但是，我现在写出这件事，是因为我希望其他女性能从我的经历中受益。癌症现在还是能引起人内心恐惧的字眼，它让人深感无助。但是现在通过血液检查，就可以知道你是否容易得上乳腺癌和卵巢癌，并采取相应措施。 我自己的治疗是从2月2号开始的， 先从一个名为“乳头延迟”的手术开始， 它的作用是去除乳头后乳腺导管上的疾病，并将额外的血流量充入这一区域。这会产生一些痛感，并造成很多瘀伤，但却增加了保留乳头的机会。 两星期后，我做了主要手术，切除了乳腺组织并用一些临时性的填充物取而代之。这种手术能花八个小时。你醒来时，可以看到乳房上插着疏导管和膨胀器。仿佛置身于一个科幻电影的场景中。但在术后几天里，你就可回归正常生活。 九周后，最后的手术也完成了， 通过一个植入物再造了乳房。在过去的几年里，这种手术有了很多进步，效果非常棒。 我想通过写这篇文章，来告诉其他女性，下决心切除乳房不是件容易的事。但这是我非常欣喜做出的一个决定。我得乳腺癌的概率从87%降到了5%以下。我可以告诉我的孩子们，他们不必再担心会因为乳腺癌而失去我。 由于再也没有让他们感觉不快的事，我感到非常欣慰。他们能看到我身上的细小疤痕，但仅此而已。其他的一切还都是原来的那个妈妈，和过去别无二致。他们知道我爱他们，而且只要我能，我就会尽全力永远和他们在一起。 就我自己而言，我没觉得我的女人味有丝毫减少。我感觉自己意志如钢，作了一个勇敢的决定，它丝毫没有减少我柔情似水的女人本色。 我很幸运能有布拉德.皮特这样的生活伴侣，他是如此充满爱意，无微不至的照料我。所以，不管何人--如果他的妻子或女朋友需要经历这样的事情，都必须明白你是这个转变中非常重要的一部分。布拉德在我住院的“红莲乳房治疗中心”进行手术的过程中，须臾不离。我们设法找到能同欢同乐的片隙瞬间。我们知道这是为了我们的家庭该做的事情，这将使我们更加密切。事实也确实如此。 所有看到我这篇文章的女性，我希望帮助你们知道自己有选择的余地。我想鼓励每一位女性，特别是如果你的家族有乳腺癌和卵巢癌病史，去寻找相关信息，去向能帮助你们迈过生活上这道坎的有关专家咨询，并做出你们深思熟虑后的决定。 我了解到有很多一流的全方位的医务人员，在研究替代手术的方法。我自己的用药治疗方法将在适当时候，贴在“红莲乳房治疗中心”的网站上。我希望这能给其他女性提供帮助。根据世界卫生组织的统计，仅仅乳腺癌每年就会造成458000人死亡，主要是在低收入和中等收入的国家。保证让更多的无论贫富和背景，也无论她们生活在何方的女性，能接受基因检查和救命的预防性治疗，已经成了首要的任务。在美国，作 BRCA1和BRCA2基因检查要花3000多美元，这是很多女性望而生畏的一个障碍。 我选择将自己的故事公之于众，是因为还有很多女性不知道，自己生活在癌症的阴影之下。我的希望是，她们也能得到基因检查，而且如果她们面临着高风险，她们也能知道自己有可以排除这些风险的选择。 生活会遇到很多挑战。那些不应使我们感到恐惧的是那些我们能承担且能控制的问题。
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