English Original
MY MOTHER fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.
We often speak of "Mommy's mommy," and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a "faulty" gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer.
My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.
Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.
On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.
But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people's hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.
My own process began on Feb. 2 with a procedure known as a "nipple delay," which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.
Two weeks later I had the major surgery, where the breast tissue is removed and temporary fillers are put in place. The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life.
Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful.
I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don't need to fear they will lose me to breast cancer.
It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that's it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.
I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has.
For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.
Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.
I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.
Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.
中文翻译
我的母亲与癌症抗争了近十年，于56岁去世。她坚持了足够长的时间，见到了她的第一个孙辈，并将他们抱在怀中。但我的其他孩子将永远没有机会认识她，感受她的慈爱与优雅。
我们经常谈论“妈妈的妈妈”，我发现自己总在试图解释夺走她生命的疾病。孩子们曾问我，同样的事会不会发生在我身上。我一直告诉他们不要担心，但事实是，我携带了一个“缺陷”基因——BRCA1，这极大地增加了我患乳腺癌和卵巢癌的风险。
我的医生估计，我患乳腺癌的风险为87%，患卵巢癌的风险为50%，尽管每位女性的风险各不相同。
一旦我认识到这是我的现实，我决定采取主动，尽可能降低风险。我决定进行预防性双侧乳房切除术。我从乳房开始，因为我患乳腺癌的风险高于卵巢癌，且手术更为复杂。
4月27日，我完成了乳房切除术涉及的为期三个月的医疗程序。在此期间，我得以保守这个秘密并继续工作。
但我现在写下这些，是希望其他女性能从我的经历中受益。癌症这个词仍然会让人心生恐惧，产生深深的无力感。但如今，通过血液检测可以查明你是否高度易感乳腺癌和卵巢癌，然后采取行动。
我自己的治疗过程始于2月2日，进行了一项名为“乳头延迟”的手术，以排除乳头后方乳腺导管中的疾病，并为该区域增加血流。这会引起一些疼痛和大量瘀伤，但增加了保留乳头的机会。
两周后，我进行了主要手术，切除了乳腺组织并放置了临时填充物。手术可能长达八小时。醒来时，你的乳房里会有引流管和组织扩张器。这确实感觉像科幻电影中的场景。但术后几天，你就可以恢复正常生活。
九周后，通过植入物进行乳房重建，完成了最后的手术。过去几年，这项技术取得了许多进步，效果可以非常理想。
我写下这些是想告诉其他女性，决定进行乳房切除术并不容易。但我非常高兴我做出了这个选择。我患乳腺癌的几率从87%降到了5%以下。我可以告诉我的孩子们，他们不必担心会因为乳腺癌而失去我。
令人安心的是，他们看不到任何让他们不适的东西。他们能看到我小小的疤痕，仅此而已。其他一切还是原来的妈妈，和以前一样。他们知道我爱他们，会尽我所能和他们在一起。就我个人而言，我丝毫没有觉得自己不像一个女人。我为自己做出了一个强有力的选择而感到充满力量，这丝毫没有减损我的女性特质。
我很幸运有一个伴侣，布拉德·皮特，他如此充满爱意和支持。所以，对于任何有妻子或女友正在经历此事的男性，要知道你是这个转变过程中非常重要的一部分。布拉德在我接受治疗的粉红莲花乳腺中心，全程陪伴了每一次手术。我们设法找到了一起欢笑的时刻。我们知道这对我们的家庭是正确的选择，并且会让我们更亲密。事实也确实如此。
对于任何读到这篇文章的女性，我希望它能帮助你了解你是有选择的。我想鼓励每一位女性，特别是如果你有乳腺癌或卵巢癌家族史，去寻求信息和医疗专家的帮助，他们可以助你度过人生的这一阶段，并做出你自己明智的选择。
根据世界卫生组织的数据，仅乳腺癌每年就导致约458,000人死亡，主要发生在中低收入国家。必须优先确保更多女性能够获得基因检测和挽救生命的预防性治疗，无论她们的经济状况、背景如何，身处何地。在美国，BRCA1和BRCA2基因检测费用超过3000美元，对许多女性来说仍然是一个障碍。
我选择不将我的故事保密，因为有许多女性并不知道自己可能生活在癌症的阴影下。我希望她们也能进行基因检测，并且如果她们风险很高，她们也能知道自己有强有力的选择。
生活充满挑战。那些不应吓倒我们的，正是我们可以承担并掌控的挑战。