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A threat of cancer, a drastic decision

COLUMN ONE

Knowing that she is at extraordinarily high risk, a young woman weighs marriage, motherhood and life-changing surgery.

April 13, 2007|Anna Gorman | Times Staff Writer

MY dad did everything he could to look his best that morning. He shaved, brushed his hair and changed into a clean shirt.

I stepped into his room, where he lay on his bed, propped up with pillows. His face was pale and his eyelids heavy; an oxygen tube hung around his neck.

I sat down beside him and handed him my daughter, who was just 4 days old.

This was their first meeting. He looked down at her and softly touched her hair, then looked me in the eye.

"Anna," he said in a hoarse whisper, "now the race is on for you."

My father, Ira Gorman, and I were alike in so many ways. We had the same broad smile, the same freckles across our noses, the same competitive nature. We shared a love of dancing and a love of words.

We also shared a genetic mutation, BRCA1, that dramatically increases the risk of certain types of cancer.

My father had watched cancer kill his mother, aunt and sister. Now, at age 58, it was killing him too.

It was in his pancreas and had metastasized. He was home now, in the final days of 2004, with a morphine drip and hospice nurses. He had just weeks to live.

Still, he was worried for me. Ever since I found out I had the mutation in 2002, he had been pushing me to have my ovaries removed. Since getting sick, he had become more insistent.

The BRCA1 mutation, primarily found among Ashkenazi Jews, raises my risk of ovarian cancer as high as 54% and breast cancer up to 81%. The surgery would cut my chances of ovarian cancer to virtually nothing. And as long as I had the operation by the time I turned 35, it would reduce my risk of breast cancer by half. I was 30.

My father thought I was playing Russian roulette with my life. Now that I had a baby, he believed there was no reason to wait.

I felt terrified for myself as well, as though cancer were this venomous snake waiting to strike. My aunt Lois was just 34, a few years older than I, when she was diagnosed with ovarian cancer. She died at 38.

I wanted to tell my father what he wanted to hear. How could I deny him his last wish for me?

But I wasn't ready. I wanted another baby, a sibling for my daughter. Over and over, I apologized. I begged him to trust me.

Soon, I told him. Not yet, but soon.

CANCER was on my dad's side of the family, but my mom was the one following the medical research. In 1996, when genetic testing became available for the BRCA mutation, she urged my sister and me to get checked.

I kept putting it off. But my mom didn't let up, and in 2002, I decided to go ahead.

Even then, I felt oddly disconnected from what I was doing. My mind was on other things. I had just moved from Ventura to Los Angeles with my boyfriend, Coll Metcalfe, after being hired at The Times.

Two weeks after my blood was drawn, a nurse from Cedars-Sinai Medical Center called me with the results. I was in my car.

"Honey, it's positive," she said.

I don't know what I expected, but it wasn't that. I started crying and pulled over. I knew it didn't mean I had cancer, but that's how it felt. I somehow registered her saying that I could be part of a research program for high-risk women.

I immediately called Coll. We had been dating more than two years and although we hadn't talked about it much, I thought we would eventually get married. He was on the same path but not as far along. In fact, he had been reluctant to buy a couch together because of the commitment.

He was filming a documentary in Rwanda. After reaching him through his translator's cellphone, I started to speak, but tears came first.

"I'm scared," I said, rattling off the risks and describing the recommended timeline for surgery.

I was nervous about how he would react, but I gave him a deadline for putting an engagement ring on my finger -- five months later, by the time I turned 29. I knew it wasn't fair. I hated pushing him. Even I didn't feel ready to have children.

He listened and tried to comfort me, telling me everything would be OK and that we would talk more when he got home.

Weeks later, my sister took her test. The results were negative. I was relieved for her, but I couldn't help feeling envious. She didn't have to worry about sprinting toward marriage and starting a family.

That fall, I went to Cedars-Sinai for my first mammogram. After changing into a hospital gown and walking into the screening room, I suddenly became dizzy. I had trouble catching my breath. A nurse tried to calm me. I tried to calm myself. Every time I thought I was OK and stood up, I felt faint again. I rescheduled the appointment.

My birthday came and went without a marriage proposal. I felt hurt and angry.

Six weeks later, we traveled to Cambodia and Vietnam on vacation. As we stood at the ruins of Angkor Wat at sunset, all I could think was, "What is he waiting for?"

On the last day, we went out to dinner in Hanoi, both of us in our last clean clothes, exhausted from our travels. It was Valentine's Day. Coll knelt and held out a ring.

We eloped to Fiji that summer.

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