Should it Stay or Should it Go? (Post 28)

I am 7 days away from phase two of my BRCA2 boob removal. This is when they take out the expanders and put in my permanent implants. The expanders have to be in a minimum of 12 weeks. My original option for the expanders implant exchange was December 20. That meant I would be recovering for Christmas. I opted to wait another 4 weeks so that BRCA2 while consuming my life, didn't also take Christmas. The long break gave me a chance to heal and to dorm an opinion about the expanders. They may look good, in fact everyone who sees me has noticed, but they don't feel real, at all. I am looking forward to the permanent implants as I have been promised they will feel more natural.

While I was healing my mom and sister were busy seeking out experts to have their own procedures completed. My mom is in a place where she is to old for reconstruction and may not have a mastectomy at all. She is less excited about not having breasts than I thought she would be. She sees them as a badge of womanhood. She told me she didn't want to live the rest of her life with out them. I told her to me they were just vehicles for cancer and I couldn't wait to get them off. My sister is more reserved about the process. I don't really know beyond that her HMO is scheduling it what her process looks like.

I am heading into my next surgery very soon. I am less focus than I was last time. This surgery will take away my ovaries, the organs that can grow cancer undetected. Ovarian cancer is a killer because there is know way to tell if you have it. By the time it is detected, it is most often too late. BRCA2 carries with it an over 60% chance of getting ovarian cancer. So my little ovaries and there Fallopian tube friends are coming out on Jan 22. My sister had her ovarian surgery just before Christmas. She opted to leave her uterus. While I respect her choice I am left puzzled by what the right thing is to do here. My own doctor was clear about me taking the uterus out. My oncologist wasn't as determined about it. When I met with the oncologist and presented him with y concerns and questions he easily changed his mind and decided to take it all out. My understanding is that leaving it there is another place cancer could grow from my mutated cells. I felt accomplished as I left his office, but now weeks later, 7 days from surgery, I am less confident it is the right thing to do. I have asked more people than I probably should have about my uterus, should it stay or should it go.

I set about, in the past few days, to look for research that would help to guide me. I found an article from 2013 that stated there was no known link between either BRCA mutation and uterine cancer. I kept digging and there it was an article that pointed out that this gene mutation is in EVERY cell of my body. There was a study done on over 1000 woman in 2016 and again in 2017. They found that of the women in the study, which were all BRCA1 or BRCA2 carriers, instances of uterine cancer were not significantly higher than that of the general population but, the type of cancer they got was rare and aggressive. The study pointed out that the cancer that develops in BRCA1 patients is called serous or serous like carcinoma. I am definitely not an oncologist nor do I think I know anything about what is the right thing to do. I am doing the research so that I can make the best decision for myself and my life trajectory. As time goes on, more studies will happen and more information will be available. In the meantime, ask the right questions of your team. Make sure you advocate for yourself. Removing the uterus is a more detailed surgery for sure and it carries with it risks but, you should have the knowledge to ask the questions to help you make that decision.