Thursday, December 3, 2009

Everything Good For You Is Bad for You, Or, Everything Bad For You Is Good For You, Or, FML

Here is the thing about cancer. Many things cause it. And many things prevent it. But there is a surprising overlap in the things that both cause and prevent cancer. Alcohol? Everyone knows that that's bad for you. But, wait. Alcohol can also prevent cancer? You betcha! Becoming a mother late in life causes cancer. But, um, er, it also prevents it. Cell phones definitely cause cancer. Except when they don't. And my personal fave (because I ingest more of it than the average bear), soy causes and does not cause cancer. (In fact, here is a handy guide--called Kill or Cure?--to all the things that allegedly cause or prevent, or sometimes do both simultaneously, cancer, as reported in London's Daily Mail newspaper.)

Now mammograms, those critical diagnostic tests that I so emotionally lobbied for access to, are on the shit list. According to the New York Times, "For young women who have a high risk of breast cancer because of genetic mutations or family history, the radiation from yearly mammograms may make the risk even higher." So, wait. Let me get this straight. You're telling me that the test I would need (were I not undergoing prophylactic surgery) to save my life could actually kill me? Yep. According to the Times, "The report is particularly troubling because it suggests that the very women who are told they need mammograms most may also be the most vulnerable to harm from them." Troubling? Understatement of the year.

All of this serves to illustrate my general point: we're damned if we do, damned if we don't. As a carrier of the breast cancer gene, I have two basic options: closely monitor my breasts or cut them off. The first option presupposes the safety of the very screening techniques that would, theoretically, find any cancer at a curable stage; but what happens when all that screening actually contributes to, and possibly causes, the cancer it's supposed to find? In making my decision to have surgery, I had to weigh the heavy physical toll of altering my body against the heavy emotional toll of uncertainty and anxiety. And I found that, for me at least, I'd rather suffer brief physical pain (followed by emotional peace) than live a life in existential turmoil. Furthermore, I came to realize that the surveillance techniques available to me were not foolproof (and now, apparently, they aren't even safe) and that in order to definitely reduce my risk, I'd have to have surgery.

That surgery is now 15 days away. And the choice that brought me to this point, I'm beginning to realize, is more and more impossible. I was flipping through a book on the checkout counter of Urban Outfitters last night called Would You Rather, featuring absurd questions like "Would you rather fight Mike Tyson or talk like him?" And it's funny because we can think, "Man, it would suck to either fight or talk like Mike Tyson, so how about neither," chuckle, and then close the book. But when you are facing your own version of this--"Would you rather live you life in fear of developing breast cancer, which you have a 90% chance of getting, or cut off your breasts to lower your risk to less than 5%?"--we can't say, "Sucks to be that woman," because we are than woman. But our choice is so comically absurd, our dilemma so strange, when we make a decision, we're fucked either way. Life isn't going to be all rainbows and puppy dogs and champagne after my surgery: I'm not going to have boobs anymore. But if I were to keep my boobs, life wouldn't be rainbow-puppy dog-champagne-filled, either. It would be filled with worry and tests and worry about those tests. The point is, whatever the choice, you get things and you give things up. Either way, your life is irrevocably changed.

Given these latest findings, I'm glad I'm having surgery. But I'm dreading the study that comes out and suggests that PBMs, which we all know should prevent cancer, actually cause it. Hopefully that'll never happen. But given the precedent, it probably will. FML


  1. I figure that once upon a time I was an ocean / But now, I'm a mountain range. / Something unstoppable, set into motion / Nothing is different, but everything's changed. (Paul Simon)


  2. It's a crap-shoot, isn't it? I'm with you though (and many others!), better to battle this thing before it shows up in the first place, which so many of us feel it undoubtedly will. Also, it doesn't hurt that mastectomies have come so far, reconstruction isn't what it used to be. No, they aren't as good as the real things, but at least they won't try to kill us.

    Will be thinking of you on the 18th..

  3. Steph, it seems like a mutant's primary task in life is to figure out the lesser of the evils. I firmly believe that prophylactic surgery is basically evil but cancer is more evil still so there it is. As for trying to figure out what does and doesn't cause cancer, well, I blogged about this too -

    Good luck on the 15th. I'm thinking of you these days.



  4. Ha! It's internet short hand for fuck my life. It's tongue-in-cheek and useful for Facebook status updates about traffic, annoying coworkers, etc.

  5. Nice post on the mammogram catastrophe. Did you see this? The Advocate (among other lesbian-friendly media) has taken a stand against the ACS's new recommendations, on the grounds that they (further) limit women's access to routine care.
    Thinking about you a lot. Hang in there, kitten!

  6. I loved reading this post. Cancer is the bane of my family. My sister is on her third reconstructive surgery now. We are all terrified of what we eat and don't eat and there's just so much information out there. I give up! How are we supposed to figure out what's killing us? Should we really know? It's about to make my head explode.