Anne Leighton Massoni at Smith Farm Center for Healing and the Arts in January

I do not have cancer. My breasts are gone and so are my ovaries. But I do not have cancer. I am one of the lucky ones. Last year, I lost my second cousin Dana to ovarian cancer. She was in her late forties. Her mother - my cousin Gloria – was first diagnosed with breast cancer at thirty-six. Her second diagnosis came at fifty-four. Twice a survivor of breast cancer, she fought her last battle at sixty with ovarian cancer. My own mother died of ovarian cancer at fifty-six. All three of her sisters had breast or ovarian cancer. Only one is alive today – she is eighty-eight years old and a survivor.

Cancer is serious business in our family. Dana was the first to undergo genetic counseling. She confirmed the presence of the gene we suspected was lurking in the family tree – BRCA1. I spoke with Dana the day before she got her results. She had already been diagnosed with ovarian cancer and her treatment was underway. She wondered what she would do if the gene was present. She had no children of her own but was concerned for her younger sisters and the many cousins who would suddenly have Pandora’s box flung wide open.

There was never any question for me about what I would do. I called Dana’s genetic counselor and arranged an immediate appointment. I went through testing and counseling and learned I carried the gene as well. With the support of my husband, I decided to have a double mastectomy. I made this choice with no hesitation.

Slowly, others in the family chose testing too and the results were disheartening. Four out of five tested carried the mutant gene. In an ironic twist of fate, we learned that our cousin Betsy – Gloria’s sister – did not. Years earlier, she had undergone a prophylactic mastectomy following her sister’s death but before genetic testing was readily available. She has no regrets – her three daughters are safe.

All four of us chose surgery. Three faced two surgeries – a hysterectomy with bi-lateral oophorectomy and a double mastectomy. I required only one as my ovaries had been removed prophylactically twenty years ago by my very forward thinking gynecologist who knowing my mother’s history recommended a proactive stance.

None of this has been easy – for any of us. Breast reconstruction was without complication for three of the four. But my younger sister had numerous setbacks and multiple surgeries before ultimately choosing to have her implants removed. Surgically induced menopause is hard on women especially those in their thirties and studies indicate there may be complications later in life. It saddens me that such drastic measures were the wisest course of action available to us but at least we had options to consider and for that I am grateful. I remain hopeful that a cure will be found for breast and ovarian cancer. In the meantime, the continuing work of dedicated researchers and clinicians daily improves the quality of treatment and the chances for remission among those battling breast and ovarian cancer. There is hope.

But I must confess, nothing has prepared me for the heartache I feel for my children. Their chances of inheriting BRCA1 are fifty/fifty. I trust they will make intelligent choices to safeguard their long-term health. My only daughter will be thirty-five years old in January. She is childless. Based on statistical data it will be necessary for her to make a series of decisions in the near future that would make Solomon quake.

Nothing has prepared me for this heartache. I do not have cancer. I am one of the lucky ones. I pray she will be spared too.

Carla Massoni