Gina Sabella-LaRocca, 46, grew up in a "huge crazy Italian family" in San Francisco. She and her husband, Michael, live in Marin with their three teenage daughters. Sabella-LaRocca was diagnosed with breast cancer in 2009. Because of a strong family history of cancer, she also underwent genetic testing. 幸运的是，结果是阴性的.
When did you first become aware of your genetic risk for cancer?
我们从来没有 不 谈到癌症. It was a regular topic of dinner conversation when I was growing up because of the long history of cancer in my family. My paternal grandmother was diagnosed with breast cancer in her early 40s. 她是第一个. Then 11 of her 12 siblings were diagnosed with various types of cancer. Next my aunt was diagnosed with breast cancer in her early 60s. 我们还有卵巢癌的病史, but it's harder to trace because those relatives didn't live as long. With that much cancer happening in one family, you can't help but think it's genetic.
我们一直都很开放的. My siblings, cousins and I would talk about what we'd do if we were diagnosed. 谈话非常详细. We talked about how we'd react, what kind of treatment we would choose and how we'd want to live. We all made a pact that if one of us were diagnosed, we'd fight as hard as we could to beat it.
I started getting annual mammograms at age 30 because of my family history. When I was 44, the radiologist saw something suspicious. After a series of tests and procedures, the diagnosis came back as breast cancer. 那是在2009年12月. 谢天谢地，我每年都接受检查, because the cancer was very fast growing and it wasn't something I could feel.
I'd been preparing myself for a cancer diagnosis all my life but the news still came as a shock. One of the first things I did was meet with genetic counselors at UCSF's 癌症遗传学和预防项目. They took an extensive family history, talked with me about the BRCA genes and took a blood sample.
In February 2010, I had my first surgery, a centennial node biopsy. 谢天谢地，活检结果是阴性的. 癌细胞没有扩散. 这是好消息. The bad news was that it was an aggressive subtype of breast cancer, 叫三负, 所以几周后我开始了化疗. 一切发生得太快了，让我头晕目眩.
化疗后，我做了双乳切除术. 做出这个决定并不容易. It came out of several what-if discussions with my family. In the end, I didn't want to worry about the cancer coming back in my other breast. 我知道我不想再经历这一切了. In May I had a skin-sparing double mastectomy with tissue expanders. In December 2010 I had surgery to replace the expanders with implants. The following year I had a不her surgery to fix one breast that "fell to the side" and to reduce the size of the implants. 它们太大了!
我当时流血过多, bloating and just generally feeling out of sorts hormonally. Once you've had cancer, you tend to check things out early instead of letting them linger. My gynecologist took a hard look at my family history of ovarian cancer and asked me if I'd considered having my ovaries removed. The surgery was a safeguard measure, to be sure, but later that year I had them removed.
这是我的第七次手术! I remember the surgeries because they were equally hard if 不 harder to go through than the chemotherapy. After my last surgery, I went straight into menopause. The hot flashes are unbelievable, but I'm happy I did it.
I split my treatment between the UCSF 乳腺癌 Center in Marin and the UCSF 乳腺癌 Center in San Francisco. Both teams of doctors were in constant communication, which made me feel good. Dr. 谢丽尔·尤因, my breast cancer surgeon at UCSF, walked me through my surgical options. I appreciated that the nurses would always call to follow up after my doctor's appointments. Without fail, I'd always think of a question or two after I left the doctor's office. 然后护士会打电话, 为了跟进, and it's so nice to hear a kind voice and have the chance to ask those nagging questions that you can't stop thinking about. 正是这些小事造成了巨大的不同.
I am worried about what the future holds for my three daughters. None of them have been tested for the breast cancer gene yet. We talk about the importance of staying healthy and being proactive. I have cousins in their late 20s and early 30s who did test positive. They plan to have prophylactic mastectomies and ovarian removal as soon as they complete their families. But my daughters are just 13, 16 and 18, so I tell them there's no use stressing about it now.
我觉得很幸运. 我知道事情本来可能会更糟. 我今天还活得好好的. 是的!