我的医疗决定

May14,NewyorkTimes

LOSANGELES

MYMOTHERfoughtcancerforalmostadecadeanddiedat56.Sheheldoutlongenoughtomeetthefirstofhergrandchildrenandtoholdtheminherarms.Butmyotherchildrenwillneverhavethechancetoknowherandexperiencehowlovingandgraciousshewas.

我的母亲在与癌症抗争了近十年之后终于败下阵来，得年56岁。她坚持等到了第一个外孙女的出世。然而我们的孩子们将永远没有机会真正了解她，亲身感受她是怎样一个充满爱心而慷慨的人

Weoftenspeakof“Mommy’smommy,”andIfindmyselftryingtoexplaintheillnessthattookherawayfromus.Theyhaveaskedifthesamecouldhappentome.Ihavealwaystoldthemnottoworry,butthetruthisIcarrya“faulty”gene,BRCA1,whichsharplyincreasesmyriskofdevelopingbreastcancerandovariancancer.

我经常向他们提起“妈妈的妈妈”，并试图告诉他们夺去她生命的疾病是怎么回事。孩子们曾经问我，同样的事情是否会发生在我的身上。我告诉他们不要担心，实情却是我携带着跟我母亲一样的缺陷基因，BRCA1，这个基因让我罹患乳腺癌和卵巢癌的几率非常高。

MydoctorsestimatedthatIhadan87percentriskofbreastcanceranda50percentriskofovariancancer,althoughtheriskisdifferentinthecaseofeachwoman.

Onlyafractionofbreastcancersresultfromaninheritedgenemutation.ThosewithadefectinBRCA1havea65percentriskofgettingit,onaverage.

摒除个体的差异，据我的医生估算，我患乳腺癌的几率高达87%，另外还有50%的几率得卵巢癌。只有一部分的乳腺癌源于先天性的基因缺陷。然而，一旦存在这种缺陷，患癌的平均几率为65%。

OnceIknewthatthiswasmyreality,IdecidedtobeproactiveandtominimizetheriskasmuchIcould.Imadeadecisiontohaveapreventivedoublemastectomy.Istartedwiththebreasts,asmyriskofbreastcancerishigherthanmyriskofovariancancer,andthesurgeryismore