The scourge of housemaid's knee
May 23, 2011 1:16 PM   Subscribe

When a cancer diagnosis hits close to home, how do you avoid hypochondria yourself?

My younger sister has been diagnosed with breast cancer and is having treatment.

I've never had cancer and have no reason to think I do now, but I've scheduled a mammogram and will find a doctor to query about any other tests I need to think about.

My sister was told that the variant of cancer she has (I don't know the details – she's on another continent) tends to run strongly in families: they asked her if our mother had had it (she didn't; our paternal grandmother, however, died of it many years ago, long before modern treatments – we never met her).

My question is perhaps a tad silly: now that I know about this heightened risk, how do I avoid paranoia myself? My sister's diagnosis began with a pain in her shoulder: how do I keep any little stray ache or pain making me think I've got it?

If you had a cancer diagnosis in your family, how did you cope with this psychological rebound on yourself?
posted by zadcat to Health & Fitness (6 answers total) 1 user marked this as a favorite
Hey, I hope that your sister responds well to the treatment and that she recovers fully and quickly.

We had an ovarian cancer diagnosis in the family that came with the same warning to the rest of the women in the close circle. Each individual reacted differently, and some felt quite paranoid at every case of indigestion. What helped a lot was for each of us to talk to our doctors about it, and to get informed. Paranoia comes from lack of good and direct information. Get checked regularly, make sure your doctor knows about your risk factors, and learn to do self-tests*.

* There is an ongoing debate on the usefulness of self-tests. I happen to be pro-self-feeling-up if only to keep a good baseline of normalzadcat.
posted by copperbleu at 1:24 PM on May 23, 2011 [1 favorite]

You may want to talk to a genetic counselor about getting tested for the BRCA2 gene mutation. Briefly, certain mutations in this gene lead to a heightened risk of breast and ovarian cancer. There are many considerations for whether or not to get tested for it, and how to react if the test turns out positive or negative, so I very strongly recommend speaking with a genetic counselor before making a decision about the test either way.
posted by brainmouse at 1:28 PM on May 23, 2011 [3 favorites]

I'd take solace in the fact that paranoia is not just perfectly logical, but actually useful, within reason. With your sister's diagnosis you may already be aware of this, but early detection is highly predictive of cancer survival. Breast cancer's a different beast than when your paternal grandmother (or mine, for that matter) died of it decades ago; the latest statistics say that 88% of women diagnosed with stage I breast cancer live for 5 years or more (and not all of the 12% remaining died of cancer, either)*. Catch it at stage II, and that survival rate drops by ~10%. I know you don't want to go around thinking every twinge is a metastasis, but don't beat yourself up for being hypervigilant for a while. Your brain's heart is in the right place. So to speak.

Best of luck to you & your family.

*And those are based on cases from 10 years ago - diagnosis and treatment options have only gotten better since.
posted by deludingmyself at 2:31 PM on May 23, 2011

Hey. I was diagnosed with breast cancer when I was 24. That was enough for me to qualify for the BRCA testing brainmouse mentions. They will only test you when you meet certain risk factors. Your sister's diagnosis may qualify you. Talk to your doctor.

They test for two genes, BRCA1 and BRCA2. The test is expensive ($3300). If you've heard any of those stories about the courts deciding whether a company can patent a gene, that was about this specific test. I assume there's not a "generic" version of the test yet, so you and your insurance company have to pay for it. My insurance covered 80% of it because they cover 80% of everything.

But something like 85%+ women with the BRCA genes end up with breast cancer. But lots of people (most?) with breast cancer don't have either of the BRCA genes. I don't have them. But knowing whether I had them was important to figuring out what I was going to do about my cancer.

Depending on your genetics and your sister's age at diagnosis (younger == doctors are more worried), your doctor may recommend mammograms for you starting at a younger age or more frequently if you're already old enough to be getting them anyway. She may also want you to get MRIs (there's a special boob MRI machine, it's neat/weird).

So do the doctor stuff and find out about ways to better determine your individual risk and what ways there are to be vigilant. And then be vigilant and know that you're doing what you should. And, if you want to know about what warning signs to look for, ask the doctor about that too.

I was 24 and had cancer and didn't want to have cancer again. And I didn't want to be paranoid. And I didn't want to get mammograms all the time and be worried about getting the results each time.

So I had a bilateral mastectomy, and now I have cancer-free fake boobs. And I don't worry. And that's awesome. For me. You do whatever you want.

I have two sisters in college, and they're supposed to get MRIs and mammograms every few years. So that's what one doctor told sisters of a young cancer patient to do. Your doctor may advise you differently.

Oh, and antidepressants got me through the worst of the freaking out. So if you get to that point, there's that.

And you, or anyone else, are welcome to memail me if you want.
posted by katieinshoes at 2:40 PM on May 23, 2011 [2 favorites]

If you're worried, definitely get the genetic test done. I always assumed I had either the BRCA1 or BRCA2 gene growing up since my mother had breast cancer twice (27 and 42), her mother had it twice (40 and 60), and her mother's sister and mother both died from it. When I was diagnosed at 24 it wasn't a shock at all, and sure enough I have the BRCA2 gene. The thing with genetics is that it's not 100% certain you have the gene, which is why you should be tested if you're worried. Neither of my mom's two sisters have the gene, and both have lived well into their 40s cancer free.

Once you get tested, you'll know your options. When I talked to a genetic counsellor, we talked about the implications of knowing that I had the gene. I had a bilateral mastectomy as well, mostly because everybody thought it'd be good to get it done with then rather than wait for the other shoe to drop. Now I'm working with a onco-gyno to stay on top of the ovarian cancer threat, but that's pretty mild.
posted by kendrak at 3:11 PM on May 23, 2011

Response by poster: Wanted to thank everyone here. My sister is having treatment. I've had mammograms and now they want to talk biopsy to deal with some anomaly they've seen. I live in Canada and am not privately insured, and have no money and no family, so will not likely be offered genetic testing, but basic care is still provided if I need it.

Once again, thanks.
posted by zadcat at 12:01 PM on June 8, 2011

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