A father’s final gift

I first learned of my dad’s cancer during my first week of what was to be a 7-week trip backpacking through South America. It was 11pm when I turned on my phone, totally exhausted after finishing a 30km hike through the mountains of Brazil that day. My phone lit up with messages, but a text from my cousin smacked me in the face, “I am so sorry about your dad.”

Panicking, I quickly skyped my parents back home in Vancouver. Speaking to dad, who had been undergoing tests for several months, I learned he had been diagnosed with prostate cancer, Stage IV, in the bones, no cure. It was devastating. Dad may have been 72, but he was in good health and should have had many good years ahead of him. The doctors gave him a 3-year prognosis. In the end, the cancer ended his life just 11 months after he was diagnosed. Through most of the cancer treatment, it was unclear why dad’s cancer was so incredibly aggressive. This was not the prostate cancer I was familiar with from my health textbooks. The one they always say, “You’ll die of something else before you die of the prostate cancer.”

This was not dad’s first run in with cancer. He’d be diagnosed with testicular cancer in his 50s, which recurred once. Because of that, dad had wondered if there might be a genetic issue and so, towards the end of his illness, he decided to join a drug study that would also provide a full gene sequence to him. His cancer progressed so rapidly that he ended up having his test fast-tracked. In spite of his unusual cancer, which did not respond very well to any of the therapies provided, his oncologist maintained that a genetic cause was unlikely. However, my mum, dad and I sat down in his office a just week before dad passed and he broke the news to us. Dad was a BRCA2 carrier.

We were confused – there was very little cancer history in our family. Certainly not the kind of history you would expect to see in a BRCA family, with scores of mothers and daughters being diagnosed with breast cancers before the age of 40. The only cancers our grandparents had seen were mild and hit in their 80s. Nothing altogether unusual. We then learned that as Ashkenazi Jews, we had a 1 in 40 risk of carrying these genes in our genome.

One of dad’s last gifts to our family was undergoing a final blood test to become the “index case” for our family. The blood was drawn in our family home just two days before he passed way.

Because of dad’s forethought and insight into his own health, I have now learned that I, too, am a BRCA2 carrier. Although the risk of inheriting the gene from a carrier is 50%, (a coin toss!) very few people in our family have inherited the gene. If dad hadn’t been tested, there is no doubt in my mind that I would have never known about the gene until it was too late. While learning of my carrier status was difficult, I am so grateful for the opportunities it affords me. I will now be able to make important choices regarding my health and will be better equipped to communicate with my doctors about needs for screening and potential preventative surgeries now and in the future. Dad’s illness and death was a huge loss for our family, I would do anything to have him back. But, because of him, I have a better chance for a future and for that I am so grateful.