Hereditary cancer 'pre-vivor' tells story of hope

COFFEE WITH WARREN, with Warren Harbeck
Cochrane Eagle, April 6, 2005

Your grandmother had breast cancer at 30, your mother died of ovarian cancer at 39, and doctors have just confirmed that you – a loving wife and mother in the prime of your life – have the same genetic likelihood for cancer that they had. Are you next in line?

This was the question facing coffee companion Monique Achtman, Calgary writer/editor and frequent visitor to our town. What she did about it is the subject of her new book, Am I Next in Line?

Monique will be at Bentleys Books in Cochrane from 1–3 p.m. April 10, for a book-signing and talk on how she conquered her fear of hereditary breast and ovarian cancer.

I've followed Monique's story for some years and have never ceased being impressed by her zest for life and her willingness to meet obstacles head-on – important factors in my endorsement of her book.

It doesn't surprise me, then, that when she became aware of the pattern of cancer-related early deaths among the women of her family, she decided to undergo BRCA gene testing and prophylactic surgery to remove much of what, in the minds of many, physically defined her as a woman.

This was not without the objections and hesitations of family and healthcare professionals, something she writes about with grace.

But with profound gratitude she pays tribute to the one person who stood by her side throughout: her husband, Myron.

Which is a major reason why I recommend this book not only to women, but to men, as well. Myron is a flesh-and-blood role model for how husbands can be sensitive to and supportive of their wives in such anxiety-filled intimate issues. A coffee-cup toast to Myron!

(It's also important for men to realize they can be carriers of the cancer-related gene mutation.)

I asked Monique recently if she was still comfortable with her decisions.

"I feel very strongly that I made the right decision for me at the time with the information that I was given," she said.

"In 1997 I had genetic counselling and gene testing that told me that I had up to an 85% risk of developing breast cancer and 65% risk of ovarian cancer before age 70. Since my mother and grandmother had both been diagnosed with these cancers before age 40, I felt that I was next in line and I was prepared to do anything to reduce my risk as much as possible.

"Choosing preventive surgery was offered with the promise that my risk would be reduced by up to 97%! Looking at my children, then ages 3 and 6 years, I did not hesitate to make the most proactive, preventive choice I could to ensure that I would be around to see them grow up and have families of their own."

Would Monique recommend others follow her example?

She certainly urges everyone to be vigilant in their healthcare, including healthy diet and lifestyle, and annual physicals and associated tests, but she doesn't recommend genetic testing and surgery for everyone.

"It's not an option for everyone. It is just one option of prevention that I was offered in 1997. Each person receives care on an individual basis and is not necessarily required to make a decision like I did.

"However, if they choose to make this decision, I can say wholeheartedly that I am very content with my life and do not live in fear. I am very pleased with the reconstructive surgery. I am happily in love with my husband and my children. And as of March 12 this year, I have outlived my mother and I am filled with hope and promise for the future and glad that I am and will continue to be a part of it!"

Am I Next in Line? is written with courage, candor and clarity, providing an important glimpse into the life of a "cancer pre-vivor," as Monique refers to herself – a survivor of a predisposition to cancer.

It "explores the very human side of hereditary cancer syndromes," wrote Dr. Rhiannon Hughes, medical director at Calgary's Cancer Genetics Research Clinic, in her Foreword. It opens doors of communication and offers "hope to families like Monique's, and for the generations to come."

For more information about this book, including links to peer support and other resources, check out

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IN MEMORY of Karol Wojtyla, Pope John Paul II, 1920–2005: He showed us how to live with joy and passion, and to die with dignity and grace.

© 2005 Warren Harbeck

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