By TAMMI JACOB Special to the Palisadian-Post Nobody is ever prepared to hear the words ‘you have cancer,’ but women should know the risks and what they can do to get early detection of the disease. I look at myself in the mirror now and don’t even know who I am looking at. I am bald. It is not me. I am sick three weeks out of the month from the chemotherapy. I have to keep telling myself that I am alive and all this will be over soon. ”I suffered from years of endometriosis (a condition in which the tissue that lines the inside of the uterus grows outside the uterus and attaches to other organs) and because of this, was told by my doctor that I should get tested for the BRCA gene, known as the genetic cancer for Eastern and Central European (Ashkenazi) Jewish ancestry. I was told that UCLA had a study and was given their number. I phoned and became part of their study in 2002. The genetic testing consisted of a questionnaire and a blood test. Two weeks after the blood test I went in for the results. I was told that I was BRCA 1 positive, which meant that I had a 50 to 85 percent chance of developing breast and ovarian cancer in my lifetime. I wasn’t shocked by the outcome of the test, for my mother was a breast cancer survivor and every other woman in her family had lost their fight against the disease. I knew my risks. I had been getting mammograms and ultrasounds every six months since I was 25 years old. ”I took the information and contemplated getting a prophylactic mastectomy to prevent the breast cancer from occurring. My insurance company had authorized the procedure and I had met with a surgeon, but I just couldn’t do it. I kept thinking that I might not get the disease. I figured if I kept up with my semi-annual mammograms and ultrasounds, anything that would come up would be diagnosed early. I took the information and did nothing with it. ”About six months after the genetic testing, my endometriosis began acting up again and I was told that the best thing for me to do was to have a complete hysterectomy. By doing so, I would not only take care of the endometriosis, but also the high risk of ovarian cancer associated with the BRCA gene mutation. I was advised that by the time ovarian cancer is diagnosed it has spread and is hard to beat, and that this would be the best option for me. Being 32 years old, this was a very hard decision for me. I was divorced and had two children, but knew that one day I would marry again and might want to have more children. I made the decision that I needed to be content with what I had and that my life was most important. I had the complete hysterectomy, ”Six months after the hysterectomy, I went in for my routine ultrasound and learned that they found two lumps on my left side and a mass against my chest wall on my right side. The doctor was taking longer than usual and so I asked her what they see when they find something. She handed me a tissue box and showed me. The tears could not stop flowing. She told me that they wanted to do a mammogram to take a better look. The mammogram confirmed the two lumps on the left side, but the mass on the right side was too deep against my chest wall to be detected by the mammogram. The doctor told me that I needed to see a surgeon right away to have a biopsy of the masses. ”By the time I got home, my primary care physician had been phoned by the radiologist and had put in the request for me to see a surgeon. Within two weeks I was having a surgical biopsy. One week later I was given the news that I had breast cancer. One month later I had a double mastectomy and began chemotherapy. All the doctors could say to me was that the hysterectomy should have prevented the breast cancer and that they didn’t know where to put me on the charts because, based upon the numbers, I should not have gotten breast cancer. Well, I did and I should be more than a statistic. ”Time has gone by so fast, it doesn’t seem real. I sit and listen to other women and their stories during my chemo sessions and realize that I am lucky. I knew that I had a family history of cancer and therefore got mammograms and ultrasounds every six months. Because the mass on my right side was so deep, a mammogram alone would not have detected it. Insurance fought me every step of the way because I am so young and they don’t think young women need mammograms. Many a time I paid out of pocket for the screenings. Women should know their risks and take every precaution. I used to think that divorce and single parenting were hardships, but they are nothing compared to the reality of cancer. ”My mother asked me to write this for the women in our community, for my aunt and cousins, to get the message out that you need to be aware and fight for quality screening. You can’t adhere to insurance protocols; they don’t care about you. You need to stay on top of your exams and know about the new screenings available to you. There are studies at UCLA that provide up-to-date information. (Editor’s Note: Palisadian Tammi Jacob, 33, who wrote this essay three months ago, has finished her chemotherapy regimen and is moving forward positively. The daughter of Lynda and Daryl Stolper, Tammi attended Palisades Elementary, Paul Revere Middle School and St. Monica’s High School. Her twins, son Kyle and daughter Remi, are kindergartners at Palisades Elementary.)
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