At Risk for Cancer - A Personal Essay

Studies show that the fear of cancer sometimes haunts people like me—those with a history of the disease in the family. Not only do we have to cope with the loss of family members to cancer, but we worry about having to battle the disease ourselves one day.

We may be anxious enough about our risk for cancer to lose sleep over it, pop antioxidant supplements or fill our homes with the latest articles and books on cancer. My kitchen closet is filled with bottles of vitamins and supplements that I never remember to take—despite my good intentions.

My mother’s death from breast cancer in 1994 affected me like no other event in my life. Like other people whose relatives have died from cancer, I was left with a psychic scar. I felt sorrow at my mother’s death, guilt about surviving her, and fear about my future. But the experience also prompted me to turn in new directions. In my work as a freelance reporter, I began to write increasingly about cancer research and treatment, something that now inspired my passion.

In psychotherapy I talked about the anger I felt at my mother’s death, and struggled with my own anxieties. What would losing a breast mean for my own sexuality, my relationship with my husband, and my life span? My mother had lived an abbreviated life, dying when she turned 71. Did that mean I wouldn’t live beyond 71 either?

Many women have lost their mothers to breast cancer at far younger ages. For me, the loss was tragic because my mother and I had just started to become friends toward the end of her life. We had a troubled relationship through my teens and twenties, and our fights were often bitter. After she first got cancer, however, she seemed to mellow and become more approachable. It was easier for me to talk to her about the ups and downs of my career and my new marriage, and plans for the future. She often sent me corny Hallmark cards to tell me how she loved me. She was reaching out.

I think about my mother’s death and my risk for cancer as I look in the mirror and trace the quarter-sized scar on my back, left from my surgery for basal cell cancer. Though it’s rare to die from this disease, just having had it makes me more at risk for melanoma, the deadly skin cancer that kills so quickly. Since melanoma runs in my family, I question whether one day I might fall prey to this disease. It doesn’t help that I had several killer sunburns as a child and teen-ager, another risk factor.

But the truth is that people like me with a family history of cancer often overestimate their risk of developing the disease and their risk of dying from it because of their fears, says Michael Stefanek, PhD, of the American Cancer Society. “For a small number of people it’s even a question of “when will I get cancer and die from it” rather than “if I get cancer…. It’s very understandable how people can overestimate their risk, and this can lead to a type of fatalism,” he says.

My fear of cancer seems to come up for me at certain times of the year—when I get my yearly mammogram, when I go to the dermatologist once a year to have my skin checked for suspicious moles, on my mother’s birthday, and the anniversary of her death. “Do you examine your breasts every month?” the nurse practitioner asked me at my yearly gynecological exam several years ago. I laughed a little in embarrassment, and confessed that I didn’t. “That must be hard—to think about doing that,” she said with sympathy.

But I do get yearly mammograms, exercise, and try to eat those five servings of fruits and vegetables every day, I tell myself. I take comfort from the fact that mammograms can now find cancers as small as a pencil head, and most women who get cancer—more than 80%–survive for years.

From my work in interviewing cancer researchers, I know that people at high risk for cancer have widely varying psychological responses to that risk. Some avoid getting mammograms, colonoscopies or genetic tests, while others are hyper-vigilant. Some women are so worried about getting breast cancer, for instance, that they examine their breasts several times a month, a precaution that’s usually unnecessary, Stefanek says.

But the truth is that I don’t know if I can avoid cancer or conquer it, even though I make my living as a medical reporter, and am informed about the disease. There are no guarantees. Like many people at higher than average risk for cancer, I have to confront my fear. Certainly it’s not an ever-present fear, and I go about my life without terrible anxiety or constant thoughts about cancer. But sometimes the fears do rise up to trouble me.

One positive result of such questions, and my increasing involvement in research about cancer risk, was a growing willingness to face the issue of my cancer risk head on. Now I examine my breasts every month, and have a plastic card from my drugstore hanging on the shower faucet that reminds me to do it, and shows me how. I’ve begun eating more fruits and vegetables, adding a fruit snack in the afternoon instead of pie or cake. And I joined the Y, where I exercise on the stationary bikes, treadmill, and take an occasional water aerobics class.

In the mirror of the exercise room at the Y, I see my legs churning the pedals of the exercise bike. I have become plumper over the years, and I see that I am acquiring my mother’s body—not a fate I wanted for myself. For if I share my mother’s body type, might I not share her cancer?

As I learned, there were many unanswered questions. But I intended to look, and keep looking, for answers. Over the last few years, I’ve read the newest research, learned to evaluate my risk more knowingly, and even investigated genetic counseling.

I’ve learned many things in my work in writing about cancer. Above all, I know that if you worry about your cancer risk, you are not alone. And information about how to reduce your cancer risk –as well as taking action to reduce that risk — are your best weapons for defeating cancer.