The one where I find out *why* I got cancer
Dodgy genes, Angelina Jolie and an exciting cover reveal
Ten years ago, I went to see a geneticist to find out if my cancer might have been caused by a mutation in BRCA1 or BRCA2, the genes that were later made famous by Angelina Jolie. Quick science lesson: we all have these genes, in fact we have two copies, inherited from each of our parents. BRCA stands for BReast CAncer, and these genes actually protect us against breast and ovarian cancer.
But sometimes genes can break. This is called a mutation. And if the thing that is protecting you breaks, you’re at greater risk of that thing. Enter: breast cancer.
When mum and I met with Professor Gareth Evans in 2012, he told us that sifting through my DNA was ‘like going through War and Peace looking for a spelling mistake’. Our genetic code is about the length of a paperback, only it looks like a series of numbers and letters (AKA gobbledygook) so it’s not as straightforward as proofreading Single Bald Female (sorry, I had to get that in somehow). A single digit out of place can result in a broken gene, which in turn can lead to illness.
Having the BRCA gene mutation would have given me a 50-85% chance of having breast cancer in my lifetime, and even though I’d already had it, there was a greater chance of having it again. I thought of my boobs as a ticking time-bomb.
Then I tested negative. It felt like good news because it meant I didn’t have to consider a preventative mastectomy to stop me from developing further cancers. At the time, I was relieved.
But I knew I had some kind of faulty gene. Breast cancer is incredibly rare in women under 40, yet I’d had it at 29. My maternal grandmother had it at 36 and died at 42. There would be other gene faults they could test for in future, but in 2012 they weren’t testing for anything else.
For the last 10 years, I have wondered why I got breast cancer. Was there something I could have done differently?
Then I was diagnosed with secondary breast cancer:
So we asked Professor Evans to take another look at my DNA, which, amazingly, he still had stored in the lab.
And that’s when I found out I carry the PALB2 gene mutation.
PALB2 is a gene that works with BRCA to protect us against breast cancer. Having a broken (or mutated) PALB2 gene gives me around a 40% chance of getting breast cancer in my lifetime, vs. about 12% in the general population. (Some sources put the PALB2 risk at up to 60%.)
I was born with a higher chance of getting breast cancer.
I’ll let that sink in.
On the day I found out, I was lying in a hospital bed at the Royal Marsden after putting my back out while vomiting from a migraine, but my mind was completely blown. I had spent the last 10 years questioning why I got breast cancer. On some small level, I’d been blaming myself, wondering what I could have done differently. And now I have the answer.
Well, I have part of the answer. Assuming I inherited the gene fault from my mum, we still don’t know why I got cancer at 29 and mum has lived to 70 without having it (she’s amazing, by the way). We met with the brilliant Dr Angela George at The Royal Marsden last month and she told us there could be several factors, like the increasing hormones in our water, the pollution in our cities and the fact that mum lives in the countryside and I’ve lived in big cities for 20 years.
She also said the fact that I’ve never had kids but my mum had them before 30 could be another contributing factor, because pregnancy can actually protect us against breast cancer. (There’s an irony in the fact that I now can’t have kids because of cancer.) And get this: she said the optimal age for me to have had my first child in terms of protecting me against breast cancer given my gene fault was 18. 18! Oh how life would have panned out differently…
I have done so much over the last 10 years to try to prevent my cancer returning. I’ve gone to bed early when others have stayed out. I’ve been the one not drinking when everyone is drinking. I’ve quit jobs that have caused me too much stress. I took curcumin, co-enzyme Q10 and vitamin D for eight years, alongside a diet high in veg and low in meat. I have rarely gone a week without running or swimming.
Now I know that none of those things would have stopped my cancer from returning. That’s not to say they didn’t help – I do think you can improve your chances of survival with a healthy diet and a lot of self care – but they weren’t going to be the sole thing to keep me healthy, because a propensity for breast cancer was in my DNA from birth.
What does this mean to me now?
It might not mean much in terms of my treatment right now. There are drugs that are showing great results with PALB2 carriers, but they’re not yet approved in the UK, and besides, we’re confident I’ll do well on my current treatment:
But knowledge is power. It allows us to make decisions based on fact and to pass this knowledge on to the next generation. Having this information may or may not make a difference to how long I live, but in terms of my peace of mind, it’s everything. I’m so glad I got the answer I was looking for.
Speaking of paperbacks (tenuous?), Single Bald Female is out in January with a brand new cover! There’s even an exclusive new chapter on the crazy rollercoaster that has been my last 10 years. It’s available to pre-order for January 19th, and of course you can still buy the hardback til then.
What do you think of the cover? As authors, we don’t get a huge say in our cover designs, but I chose the sunshiney yellow to reflect the uplifting nature of the novel. After coordinating my outfits with my hardback for the last few months, I now need to find something mustardy-yellow. Any suggestions?
Meet me at The Trouble Club
Fancy coming to hear me talk about Single Bald Female? I’m doing an event with The Trouble Club on October 20th at the beautiful women’s space The Hearth in Queen’s Park, London. It’s part of Breast Cancer Awareness Month, and I’ll be talking about everything from boobs to writing my first novel. We’ll also be joined by the Boobettes from CoppaFeel!, to talk about the importance of getting to know your normal.
My podcast is back
In other news, my podcast, Life in Food with Laura Price, returns next week! I’ll be releasing new episodes fortnightly, with brilliant guests like At the Table author Claire Powell and Black Cake writer Charmaine Wilkerson. Season two starts on October 5th – subscribe now on Apple, Spotify or Google Podcasts so you don’t miss an episode. I am very excited.
Hear me on Breast Cancer Now’s podcast
I’ve been interviewed for Breast Cancer Now’s brilliant weekly podcast. We recorded the episode the very day before I was diagnosed with secondaries, so it’s a weirdly uplifting chat that reveals nothing of what was just around the corner. For anyone who wants to know more about supporting friends and family with cancer, I can’t recommend this podcast enough. Here’s the episode:
Find me in Red magazine
I also wrote my first feature for Red about the impact of breast cancer on my friendships and how my two bezzies have powered me through it. Go get the November issue on the newstands, or read it here.
And finally, a word about Breast Cancer Awareness Month. You’ll be seeing a lot of pink in October, as businesses promise to donate a portion of their sales to charities. BCAM is a brilliant awareness-raising endeavour, but please think carefully before you buy, and question what percentage of your money is going to the cause, and to which charity. The brilliant Nicky Newman explains more in this post.
I promise I’ll soon get back to posting the sort of stuff I was posting before, but until then, keep well.
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I worked in a lingerie dept in aus many years ago , I was privileged enough to be trained for prothsesis fitting, and also help with a few fashion parades with women who had all had mastectomies, all models were breast cancer survivors , all inspirational women, I take my hat off to you , your determination and attitude are amazing, I have your book but haven’t read it yet
I agree it helps to know. I have a variant of BRCA1+ (not the familial one) that was attributed to causing my cancers. It didn’t save me from the first two at 27, but the third was detected in the BRCA1 screening program and would have been missed in routine follow-up. I had my ovaries and tubes removed too, as a precaution. I felt this was an empowering step and allowed me some control in this very random and chaotic mess. I think genetic testing is more common now in younger women contracting the disease (particularly triple negative) and this can only be a good thing. I would have had a mastectomy from the outset if I had known. It would also have been much easier as a mastectomy conducted through the scar tissue of radiotherapy is problematic. I’m glad you have your answer at last - that ‘just knowing’ feeling makes a big difference xx