Breast cancer survivor treasures the years, tries to calculate the odds

Each October, I check in. Twenty-three years as a survivor now. Despite continual seemingly sparkling news about "major breakthroughs" in breast cancer, the fact is that breast cancer remains the second leading cause of cancer deaths in women (behind lung cancer), and estimates are that over 230,000 women will be diagnosed in 2015. Over 40,000 will die from it. This is barely a budge from decades ago when I was first diagnosed, or since my cousin died in 2005, or we lost our mother in 1983.

And I'm of the opinion that women are simply being diagnosed sooner, and therefore having longer intervals between diagnosis and death, and we really have no concrete answers.

This year, on becoming aware of an incorrect negative BRCA (gene for breast cancer tendency) status test done in the early 1990s, I am now faced with yet more challenging news: I am one of the 1 in 400 to 800 women in the U.S. who do carry this genetic variation. But what to do with that information is the question. PBMO (prophylactic bilateral mastectomy and oopherectomy) is rapidly gaining traction as a way to manage the odds which range from 85 percent for breast cancer to 44 percent for the deadly ovarian cancer. With this type of "previvorship" made famous by Angelina Jolie, we are led to believe this will keep us safe -- but in fact, not necessarily.

Do I slice yet another part of my femininity away? Or roll the dice and wait?

Is conscious evolution possible? Or once the die is cast, are we predestined?

Because if the former is possible, I will be working hard to stay the straight and narrow of health and fitness and thought patterns, skirting potential vices with a very wide berth.

And if the latter is the ruling truth, there is simply no point in saving, restraining, or denying the daily pleasures and indulgences at hand. Retirement is an illusion not to be realized, nor sacrificed for -- and it's time to start lessening the material load accumulated since our year of travel. Stuff laden with memories appreciated by so very few, if not only me.

It's not like these late night thoughts haven't crossed my mind before, wondering if another shoe will drop -- quite the opposite. I mean, what normal mom sells the house and spends the proceeds taking her 10-year-old around the world for a school year?

Even with this information, we have no clear pathways. Some BRCAs never get breast cancer. Most people who do get cancer are not known carriers. The only real gain I can claim is a release of decades-long guilt and soul-searching about what I could have done differently to tip the scales to avoid all this. Or in fact, am I a modern triumph to be alive and healthy? With removal of the guilt of cause, do I also lose the power of self-healing and continued thrivership? Wouldn't it be nice to know?

Someone once said to me, "Your genes are the gun, the environment pulls the trigger."

But in this game, early detection is still the most effective way to come out the other side. Brutal treatment delays, but rarely cures, the secret timeline of this disease. I have now buried two relatives, and 11 friends.

People always want to think it's your "positive thinking" that will trick nature, or they say, "What you think about, you bring about," but I highly doubt anyone who has been through this never stews or brews in the wee hours, and I can also tell you the most positive, the most beautiful smiling Irish woman in my support group who could find the gold crumbs in the bottom of a chamber pot, died along with all the rest of them.

Perhaps her journey was a more joy-filled one, but she was unable to outwit Mother Nature.

We all continue to pray that we will solve the puzzle before it's too late.

Mary R. Katzke is executive director of Affinity Films in Anchorage.

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