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Dina Roth Port

Dina Roth Port

Posted: October 28, 2010 06:58 AM

Imagine finding out that you had a significant chance of developing breast cancer. Imagine you've watched family members suffer from the disease. And now imagine that you could take steps to make sure you wouldn't have to do the same. You could almost assure that you'd either never get breast cancer or you'd likely catch it so early that survival was nearly certain.

Seems to make perfect sense, doesn't it? No one could possibly have issues with a person taking her health and her life into her own hands, right? Think again.

People who have not had cancer but have a high risk for developing it have been dubbed "previvors." And thanks to advances in genetics and medicine, breast cancer previvors can fight the disease before it strikes. We should celebrate this whole new way of looking at breast cancer, and thousands of women and men do. But there are those out there who think this whole new previvor movement, so to speak, is an outrage.

For instance, one woman on previvors.com said, "I am a VERY aware Breast Cancer Survivor ... and I think this new "Previvors" outbreak is a disgrace. Others have said that the word "previvors" is offensive, demeaning and a slap in the face to women who have had breast cancer. They say previvors take attention away from "true" cancer survivors.

Stirring the controversy even further is the fact that some people are vehemently opposed to one option that dramatically reduces a previvor's chances of getting breast cancer: prophylactic mastectomies. These naysayers call previvors who take action "paranoid" and "hypochondriacs." They've even compared a high-risk woman removing her breasts to someone with a high-risk for cataracts removing their eyes. Some have said the surgery is self-mutilation, stupid and nonsense.

I understand why some breast cancer survivors might be angry that genetic testing and the many options previvors have today weren't available years ago, when such great strides might have helped them avoid much suffering. But how can someone who has faced breast cancer fault another woman for doing whatever she can to avoid it? How can someone judge a woman for taking steps to protect herself because she's watched her mother, her grandmother or her sister battle the disease? Who are any of us tell a woman how much value she should place on her breasts?

Take Suzanne, one of the women featured in my book, "Previvors" (www.previvors.com). Suzanne lost her mom to breast cancer when she was only four years old. She died on Suzanne's first day of kindergarten. Suzanne later found out that she, too, had a high risk for breast cancer, and she did everything in her power to make sure didn't follow in her mother's footsteps. In other words, she opted to have a prophylactic mastectomy so that her own young daughter didn't grow up without a mother like she did. Sure, if Suzanne had not had the surgery, she might have dodged the bullet. She might not have developed breast cancer. But she just wasn't willing to live with the fear and uncertainty of what fate might have had in store. It was her body. Her choice.

How a previvor confronts her risk is a very personal decision, one a person should make with the help of a genetics expert. Some choose increased surveillance or risk-reducing drugs; others opt to undergo prophylactic surgeries, a choice that is absolutely not right for everyone. Surgery does lower risk more than any other option, but it's not an ideal solution. Give previvors an equally effective, less-invasive option, and they will embrace it.

Regarding the controversy surrounding the word "previvor," which was coined by an organization called FORCE, no one is saying that facing a high risk for breast cancer is anything like facing a diagnosis. But I just don't understand this "us versus them" mentality. We need to pool our resources and do whatever we can to fight this horrific illness. We're all in this together.

What's more, previvors do have their own anxieties, confusion, suffering and sorrow. They have their own complicated decisions to contemplate. Some have a BRCA mutation, which puts their breast cancer risk up to 87 percent and their ovarian cancer risk up to 44 percent during their lifetime. Others have strong family histories and other risk factors that raise their odds considerably. Many previvors have lost multiple family members to cancer, and they view their breasts as ticking time bombs. Certainly, it's not the same as going through chemo, fighting for your life, and coping with the horrible unknown of whether or not the cancer might one day recur. But previvors do experience uncertainty and fear. It's just different a different kind of uncertainty. A different kind of fear.

Years ago, many people steered clear of another word that today gets nearly 300 million hits on Google: cancer. They wouldn't say it out loud; they'd whisper it. Or they'd abbreviate it, calling it "the big C." And millions of women battling breast cancer felt like they had to do so alone. There were no support groups. Cancer just wasn't something people talked about.

But then, in 1974, First Lady Betty Ford went public with her breast cancer diagnosis and mastectomy. Around 10 years later, October became the National Breast Cancer Awareness Month. And organizations like Susan G. Komen for the Cure brought even more awareness to the disease, complete with pink ribbons and fundraising walks. Women finally banded together, shared their stories, and created a sisterhood of breast cancer patients and survivors. They no longer felt alone.

And now high-risk women also no longer have to feel alone, thanks largely to this extra word in our vocabulary. With the term "previvors," women with increased odds of getting breast cancer finally have a name for what they are. How could anyone deny them an identity? How could anyone deny them one word that conveys so much progress and hope? The truth is, we can't. So, we might as well add it to our artillery and use it to better fight this dreadful disease.

Dina Roth Port, a freelance writer for publications such as Glamour, Parenting, and Prevention, is author of Previvors: Facing the Breast Cancer Gene and Making Life-Changing Decisions. Visit her website at www.dinarothport.com.

 
 
 
Imagine finding out that you had a significant chance of developing breast cancer. Imagine you've watched family members suffer from the disease. And now imagine that you could take steps to make su...
Imagine finding out that you had a significant chance of developing breast cancer. Imagine you've watched family members suffer from the disease. And now imagine that you could take steps to make su...
 
 
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12:00 AM on 11/07/2010
I am a 29 year old woman with a family history of breast cancer on both sides of my family, have undergone multiple lumpectomies and biopsies and have had at least 30 scans of some kind performed on my breasts since I was 23. I am scheduled in for a bilateral prophylactic mastectomy in February next year - and I feel EXCITED and happy! I found the word previvor because my mother and one sister have been remarkably critical and unsupportive of my decision - I needed to know if other people had made this kind of decision and see if they could support me where my family wasn't able or going to. Thank you for the term previvor! I don't know that I would refer to myself that way in conversation to my friends, but now when I 'google' the term, all of a sudden there are all these resources and wonderful people out there to help me get through to the surgery and the recovery afterwards - without comments like 'you're just paranoid' or 'just have kids and breast feed to reduce your risk' causing constant self doubt! I don't understand how people can get so upset about my personal decision to be free of the stress and anxiety I currently experience several weeks per year!!
Anyway - I have chosen to be a PREvivor so that I don't have to be a SURvivor.
10:06 PM on 11/02/2010
I discovered my positive BRCA1 status in 2009 when I was 58 and my 53 year old sister was diagnosed with triple negative breast cancer. She looked at me and said "do EVERYTHING you can so you NEVER have to go through this". I had a bi-lateral risk-reducing mastectomy with no reconstruction AND a complete hysterectomy and oophrectomy. She is a survivor and I am thankful to still have my sister. I did what I felt I had to do and it was MY decision. I don't care what label is used to describe me. No label required - except sister of a survivor!
nancynancy
Atheist.
12:37 PM on 11/01/2010
Because the disease runs in my family and because I was sick and tired of the never ending stress of inconclusive mammograms and biopsies, I had a bilateral prophylactic mastectomy with an immediate saline implant reconstruction 15 years ago at my own insistence at age 42. That was before studies proved the surgery lowers risk by 90%, and I faced consideral opposition from almost everyone -- doctors, friends and family. Not wanting to fight with the insurance companies, I flew down to Costa Rica and had the surgery for 20% of what it would have cost me here.

But I knew I had to do it and have never regretted my decision for one instant. Quite frankly it's my life and my body, and I don't give a rat's rear end what anyone on this board or anywhere else thinks.
08:30 PM on 10/29/2010
I danced for years with Suzanne who is featured in the book when we were in our 20's. I very distinctly remembering her say how she hoped that by the time she hit her 40's that cancer will have been cured.I think I know her well enough to say that she is a highly intelligent individual, definitely not hypochondriac. She is THE most "together" person I know and one of the people in my life who I will go to when I have a problem and she ALWAYS gives me the best advice. My point is, she doesn't need a label for herself, because trust me, she knows who she is... society felt they needed a label for HER I guess.... and if you aren't liking what society is calling her, trust me on this too- she doesn't care. She is brave, strong- the strongest as a matter of fact, and won't lose a minutes sleep over a label that you don't like.
07:20 AM on 10/29/2010
As a husband of a previvor, it is horrible that others should judge a decision to beat cancer. Call it what you want...cutting off breasts, barbaric, etc...but the bottom line is that I have my wife today. She will be there for our children. How about judging all those women with breast augmentation? They are a dime a dozen.
09:56 PM on 10/28/2010
Dina - I agree with you that the "Us vs them" thing has to stop if we are to present a united front in the fight to end this disease. However I do take issue with our seemingly constant need to try and label individual experiences within the breast cancer realm. As a person living with Stage IV metastatic breast cancer at the ripe old age of 40, I personally find these labels to be somewhat divisive and to try and simplify the experience with a catchy label just doesn't speak to everyone's story. The ugly truth about breast cancer is there is no one size fits all approach. The terms "previvor" and "survivor" are undoubtedly meaningful to those who have actually gotten through it and they do tend to be used to outwardly display one's achievement against the cancerous beast (and rightly so, if you are fortunate enough to have beaten the beast into submission). But from my perspective, the terms are another reminder of an achievement that moves a little bit further to the outer limits of possibility as each day goes by without anything that will make a difference to my outcome. For what it's worth, I did find out that I was BRCA1+ after I was initially diagnosed, despite no family history, and I wish I would have known before and had the chance to have done something about it.
10:03 AM on 10/29/2010
Anna, I am so sorry you are going through such a difficult time. And I agree that, when it comes to breast cancer, no two stories are alike. But my whole point is that, while some people might not like the terms "previvors" or even "survivors," these labels do help people. They encourage cancer organizations, medical experts, researchers, and advocates to recognize that each group has its own needs, its own psychological, emotional, and medical issues that must be addressed.

Since my book, Previvors, came out, countless women, young and old, have told me that they are thankful to have a word to describe themselves. They truly felt alone. Like I said in my blog post, how can we deny them that?

As more and more people learn what a previvor is and then realize that they actually are one, the more people will be able to have that chance to fight this disease before it strikes!!

Again, I am very sorry. I wish you health and happiness.
11:08 AM on 10/29/2010
I hear what you are saying. I was simply just pointing out my own perspective, but I mean no disrespect to my sisters who embrace these terms. Like you say we're all in this together and we all want the same thing. No more breast cancer.
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love5pets
There's an Elephant in my womb
01:51 PM on 10/29/2010
Wow, Anna, you pretty much said what I posted last night, but not nearly has delicately as you and I guess the moderators didn't like that. Let's see if they'll post this one.

I took umbrage to this article because I'm tired of all these labels being attached to this disease and then having a dialogue regarding these lablels. Wasted efforts, in my humble opinion.

In any case, what you say is spot on and from one who also has the disease, I only wish you good thoughts.

I also have no choice but to fan you. :)
06:46 PM on 10/29/2010
I agree that we shouldn't have to waste time talking about the labels "previvors" and "survivors." It's sad that people, as the ones I quoted in my article, have such hostility toward these terms. That's why I emphasized that we should accept that these words are here to stay and remain focused on finding better ways to fight this disease through prevention and treatment.
08:40 PM on 10/28/2010
I am both a breast cancer survivor and a previvor, in a sense. After learning that my breast cancer was in fact hereditary, 4 years after my diagnosis, I opted for prophylactic surgery. My doctors estimates for a recurrance of breast cancer and my lifetime ovarian cancer risk were staggeringly high. I am AWED by my previvor friends who are brave enough to choose to reduce their risks of cancer by opting for prophylactic surgery. My decision to have surgery was a no brainer because I already had survived a cancer diagnosis. I am happy they are out of the grey zone and have their very own "word". Good health to all. May you never have to hear the words, "your tumor is malignant", previvor, survivor or naysayer.
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08:06 PM on 10/28/2010
While waiting for my BRCA results I spoke with a survivor at my office about the experience and hers. She told me: "If there was a way I could have forseen this coming and stopped it, I would have cut 'em off in a minute."

Four years later and she still hasn't kicked all of the side effects from the chemo and radiation.
06:03 PM on 10/28/2010
Of course we still need to find a cure. But in the meantime, why not save some lives by focusing on ways to protect those who have a high risk? Again, this goes to the whole "us versus them" concept. It has to end!! We all need to fight this disease together!!!
03:29 PM on 10/28/2010
Everyone is entitled to their opinion about the word previvor. Like it or not, it helps identify a very real community with specific needs. In this age of genetics and getting a glimpse into our future, there will be all types of previvors. What we do with this information and gaining knowledge is what it is all about. A previvor is a person who takes action. Don't we all have a right to be proactive about our health? For those naysayers, they are entitled to their opinion. But who are they to judge what I do with my body! I am a proud previvor who no longer lives in fear of breast cancer. I am no longer defined by my fear, rather I am empowered and I want to help other women.
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mrsL
marriage & motherhood with mirth and grace
02:45 PM on 10/28/2010
All of this controversy takes the focus off the big question - what causes breast cancer? Let's figure that one out first!
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04:39 PM on 10/28/2010
There is likely multiple causes, and while you have a good point, I'd prefer to live long enough to hear what those causes are.
01:03 PM on 10/28/2010
There was a period in my life when I had so many abnormal mammograms and breast biopsies that I'd go into a blue funk just knowing I had a mammogram scheduled. I learned to schedule them in the summer when I had more emotional reserve. I'd bring someone to help support me to the biopsy appointments just because. My mammogram file is the size of someone twice my age. My kids were young, my career high pressure and my emotional reserve was low-making the impact of this experience very big for me. I've never seen the word previvor, and I'm not sure I really like it, but if it helps us to wrap our heads around the experience then it's useful.
12:32 PM on 10/28/2010
I am neither "paranoid" nor a "hypochondriac." I am an adult female that at the age of 9 watched her mother suffer for 2 years and eventually die from breast and ovarian cancer. I am a mother that does not want her children to go through what I did. I do not believe what I did was self-mutilation, stupid or nonsense and neither do my daughters. My mother was not able to meet her grandchildren - I'll be here to meet mine. Does it really matter what we call it, we are all in this together. It is a choice and it was my choice.
11:48 AM on 10/28/2010
This is an important moment for breast cancer awareness—because, more than ever, being aware of one's risk, and having the opportunity to take action, can save lives.
11:38 AM on 10/28/2010
Mtnwen, I am so sorry about your sister. My deepest condolences. I have lost people dear to me, too, to this horrible disease. And yes, they were brave and courageous until the very end.

As you pointed, people might not like the word "previvors" or even "survivors." And we are all entitled to our opinions. But the truth is, these words help women feel a sense of belonging. They encourage researchers to focus their time and financial resources on these communities. And as more people learn about the term "previvor" and realize that they are at risk, more lives will be saved.

I honestly do not understand how people can have an issue with words that helps so many people. We will always honor and remember those we lost to breast cancer, but we also need to celebrate those who are still with us. We need to celebrate life. That is why words like "previvors" and "survivors" are so important.
02:50 PM on 10/28/2010
Previvors is a word with tremendous meaning and a movement, thanks to your hard work, that will result in the saving of many lives!!!