I am Oneinforty. I, like many 45-year-old men, am busy with work, family, and life in general. So I keep a detailed list of things I need to do each year that I might otherwise forget: things that are easy to lose track of between meetings and travel, middle school sporting events and parent-teacher conferences.
- Change the batteries in the smoke detectors
- Change the filters in the furnace
- Rotate tires
- Have a clinical breast exam
A clinical breast exam does not appear on the to-do lists of many men. But it should…at least for one in every forty Ashkenazi Jews like me. You see, I carry the BRCA1 gene mutation. I always have, but I didn’t always know about it.
As a boy, I vaguely recall hearing that my great-grandmother had died of a “female cancer.” Details are sparse, but looking back at her symptoms and the speed of her decline, it seems certain that she died of ovarian cancer. Her son (my grandfather) also died of cancer when I was in high school. And her granddaughter (my aunt) survived breast cancer just a few years later. To me, it seemed like a series of really unfortunate events. But my wife (who works in public health and is a repository of medical factoids) asked whether my family carried the BRCA1 or BRCA2 gene mutation.
My aunt confirmed that she did have the BRCA1 gene mutation, passed down from my grandfather and his mother before him. My two first cousins were also tested. One was negative. The other was positive and made the very difficult decision to have a prophylactic bilateral mastectomy and radical hysterectomy in her late thirties. Left to my own devices, I might have sighed in relief that I am a man and forged ahead. But my wife pointed out that the BRCA gene mutations do not discriminate. And then there were my daughters to consider.
The missing piece in this puzzle you may have noticed is my father. If he was tested and found to be negative, well we’d all have dodged a bullet! But my dad did not want to know whether or not he carried the BRCA1 gene mutation. He was concerned that it would affect his outlook on life and be ever-present in the back of his mind. He has every right to make that choice. But each time I looked at my daughters, moving closer to that 18-year mark when they would need to start diligently screening for breast and ovarian cancer, I realized we needed to know.
In 2016, I tested positive for the BRCA1 gene mutation and began the first of my “adventures” in annual cancer screenings. I feel guilty when I realize that - in addition to my height and sense of humor - I may have passed this on to my girls. But as my wife likes to say: knowledge is power. With knowledge comes awareness, education, and the ability to choose. I choose to add routine annual cancer screenings to my to-do list. I choose to educate my daughters about their increased risk when the time comes. I choose to help them make good decisions based on the information that they receive. And I choose to help inform other people of Ashkenazi Jewish descent about the BRCA1 and BRCA2 gene mutations. I am Oneinforty.