A lot of people are profoundly frustrated by the limitations of modern medicine, let down by how powerless conventional medicine can be to ‘cure’ so many of the ailments that afflict us. I agree, and yet my experience has also made me feel increasingly in awe of the skillful care I receive – in some cases from people I will never meet. These are people who know nothing about me as the quirky individual that I am and who, nevertheless, do all they can to help keep me healthy. The world is full of ‘haters’, but it’s also full of good people who use their scrupulous professionalism to care for complete strangers.
I was reminded of a particular group of strangers who take care of me ‘from a distance’ a couple of weeks ago when I sat down to read a two-page laboratory report produced following a recent operation of mine. I had had both of my apparently-healthy Fallopian tubes removed in order to reduce my risk of developing ovarian cancer – this was the lab report detailing whether the material removed really was healthy. Though I had been told by my GP the results were fine I wanted to see for myself that I really could relax – that I wasn’t one of the small number of women whose tubes look fine to the surgeon who does the op, but upon specialist examination in the lab show signs that they harbour an early cancer or a pre-cancerous condition.
Like Angelina Jolie, I am a BRCA1 mutation carrier, so I was at unusually high risk of ovarian cancer – possibly even more likely to develop it than not to. All of the women on one side of my family in the two generations above me – yes, 100% – had early cancer diagnoses, with all but one of these women dying young. More specifically, my grandmother died of ovarian cancer. This is what had pushed me toward what they call ‘risk-reducing surgery’. I knew I was living with a very high risk. But I’d been putting off the officially-recommended operation that is known to reduce risk significantly. This involves removal of ovaries and Fallopian tubes, leading to ‘surgical menopause’. I was delaying the op because abrupt and early menopause can brings its own health risks. I had already undergone two operations to reduce my breast cancer risk.
After a couple of years of reading summaries of medical studies in the evenings after work and of living with the anxiety that naturally comes with not knowing if a few days of feeling a bit unwell every once in a while might be an early sign of cancer, I decided to have an op. But a different one. This is the removal of Fallopian tubes only, which are increasingly thought to be the source of many of the most aggressive so-called ovarian cancers. More and more often, the medical literature refers to ovarian and tubal cancers. By removing my Fallopian tubes I have reduced my cancer risk significantly and avoided menopause…for now. I’ll remove my ovaries in about 5 years, when I’m closer to natural menopause. Hopefully, that will make for an ‘easier ride’.
But back to that lab report. It wasn’t lengthy, but one thing was immediately clear. The people in the lab who had received my tissue for analysis understood the significance of it and they knew that the results of their work could have a big impact on my life. They had known what to do – there on the first page was confirmation. The words: “BRCA1 protocol”. I felt like saying ‘thank you’ right there and then. Thank you for doing the right tests. I had been warned that some BRCA carriers’ tissue has slipped through the net, and not been subject to these specialist tests.
As I read on, slowly deciphering the report’s careful, technical descriptions of my tissue followed by the results of the slicing, dicing and staining techniques they had employed, I felt such appreciation for these strangers’ care. They knew they were looking for tiny but crucial signs of something having gone wrong. Did they find any? The short and simple answer is ‘Probably not’. Hurrah! I took action early enough. No mini-cancer detected. I’m safe…for now. The longer answer – spelled out in a paragraph of the report entitled ‘microscopic results’ – is that maybe there was something (or several somethings) that might be a sign that something was going to go wrong in future. But current medical knowledge of this area of female-anatomy-meets-cancer is remarkably limited and we just don’t know.
At the end of the report there’s a line stating that my case was reviewed by two other doctors. Quality control. I hope that all the people involved – and all staff in histopathology labs across the UK (and, hey, everywhere!) – know that what they do matters. They find the signs (confirm their absence) that tell complete strangers that there is something wrong, that help is needed, that something should be done. In my view, these are good people whose jobs are inherently valuable and meaningful. I thought a lot about people who work in histopathology labs in the days after I read that report, and about the kindness of strangers.
geneticgrrl 