My BRCA story: What I learned facing breast cancer twice

It was my breast cancer diagnosis in 2011, when my son was not quite 1 and my daughter not quite 3, that taught me a lesson: despite everything I’d thought to be true about having total control over my life, I actually had very little.

I’d been in control of choosing my college, my major, my job, my husband and when to have our two children. What I didn’t have control of, at least not at first, were the crazy cancer cells that had decided to make their home in my right breast and armpit.

Early in my breast cancer diagnosis, I learned that I carry a BRCA2 gene variant, a mutation in one of the genes responsible for repairing damaged DNA. When that repair system doesn’t work, it increases the risk of developing certain cancers, especially breast and ovarian cancer.

I didn’t need a genetic test to know something ran in my family. My great-aunt died of breast cancer in her mid-30s, long before I was born and long before treatments like today’s existed.

My grandmother, her sister, went through breast cancer twice. I remember how sick she was from chemotherapy. Back then, the drugs were more toxic, and anti-nausea medications were limited. What she went through would level most people.

Facing my own diagnosis

The discovery of my own BRCA gene variant was terrifying, but it did two things for me:

1. It answered the question of why so many women in my family had had breast or ovarian cancer.
2. It validated the decision I’d made to have a bilateral mastectomy. With the gene variant, and because I’d developed cancer so young, I had a higher chance of recurrence, so being aggressive was important to me.

I followed every recommendation my doctors made: the double mastectomy, the chemotherapy, the white blood cell–boosting shots... I didn’t question. I just rolled up my sleeves and followed every next step that my team of doctors offered me.

Chemotherapy was tough. I was in my early 30s, chasing after my babies, trying to keep my job and my body couldn’t keep up. The nausea was constant, the fatigue bone-deep and the chemo made almost everything taste metallic.

Walking from my bed to the bathroom was like wading through wet cement. But I did it. I did it because I had help from my husband, family members and neighbors. And because I had two precious babies who needed their mommy.

Here we go again

Fast forward to 2023. My son was 13, my daughter 15. In those years, I had also cared for my mother through two of her own cancer battles linked to the same BRCA mutation we share.

Being with her during her treatments reminded me how relentless cancer can be, even after generations of women in my family have faced it. She passed away from stomach cancer not long before my own recurrence.

Losing her made facing my cancer again that much more urgent.

After discussing treatment options with my oncologist, I was ready to go through chemotherapy all over again. I’d accepted the fact that I’d lose my hair again, face unrelenting nausea (I’m sorry, but no anti-nausea drugs fully work against chemo nausea), and barrel through cancer like so many women in my family and I had done before.

But she also told me about another option, a drug called Olaparib, which had recently been approved for breast cancer patients with BRCA gene variants.

Olaparib is what’s known as a PARP inhibitor, a type of precision medicine that works by blocking the cancer cells’ ability to repair their own DNA. Since they can’t fix the damage, they die off. Meanwhile, healthy cells are largely spared.

Still, I couldn’t decide what to do. Part of me wanted to go with what I knew. Better the devil you know, right? But another part of me wanted to try something new.

I asked my oncologist if she’d be open to getting a second opinion, and thankfully, she was. She reached out to Joyce O’Shaughnessy, MD, an oncologist on the medical staff at Baylor University Medical Center, who confirmed that Olaparib could be a good fit for my case.

I decided to try it instead of chemotherapy. I’m so glad I did. While there were side effects, it was considerably less toxic for me than chemotherapy.

I also went through radiation during my recurrence. And because my cancer fed off estrogen, I decided to have my ovaries removed. Reducing estrogen helped lower the chance of my cancer returning. It wasn’t an easy decision, but it gave me one more way to take back control of my body.

In my role as a healthcare writer, I get to write often about things like precision medicine—treatments tailored to a person’s genetic makeup. And here I was, taking one myself, living proof of how far cancer treatment has come in just a decade.

Power in knowledge

If you have a family history of breast cancer, I encourage you to talk to your doctor about genetic testing. Finding out I had a BRCA mutation didn’t feel empowering at first. But once I came to terms with it, it became something I could use.

I still have to be careful and pay attention. But this feels less like a burden now, and more like having a map.

I can’t change the fact that I have this gene mutation. What I can change is what I do with that knowledge.

This story was contributed by Melanie Medina.