Though Alice Reaves' breast cancer is in remission, her family's fears are still not settled.
The Reaves' family history with cancer is long and on both sides. Alice's sister and brother both died from cancer. Her husband, Laten, lost his mother, brother and sister to cancer.
In 2010, their daughter, Becky Woods, tested positive for the BCRA2 gene, which she inherited from her father's side of the family.
But unlike her mother, Woods was empowered with the knowledge of her predisposition.
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And her decision was easy.
Woods met with a genetic counselor in July 2010, and the then-38-year-old was told she had a sharply increased chance of developing breast and ovarian cancer.
"I'd already made up my mind that if (the tests) came back positive, I was going to have elective surgeries," Woods said.
Her sons, Drake and Reid, were 8 and 5, respectively.
"I always knew in the back of my mind that's something I could be dealing with," Woods said. "To be around for them, it was a no-brainer."
First, she had a hysterectomy, as ovarian cancer is harder to detect. The procedure was minor and non-invasive, easier than she thought it'd be.
The double mastectomy three months later was a different story. Woods couldn't lift her arms and had drain tubes sewn to each breast.
"You really feel like you've been hit by a truck," she said.
Woods had her breasts reconstructed in the same procedure.
"They'll never look the same. They'll never be perfect," she said. "But I'll be here longer to enjoy my husband and my children. (When) you're wearing clothes, no one would ever know the difference."
Two months later in March, her mother's cancer came back.
"So that just made me know I did the right thing," Woods said.
THE BRCA GENE
BRCA stands for BReast CAncer. The BRCA gene is found in all humans, but the heredity mutation of the gene, BRCA1 or BRCA2, greatly increases an individual's risk for breast and ovarian cancer, as well as melanoma and prostate and stomach cancers.
According to the National Cancer Institute, the general female population has a 12 percent chance of having breast cancer in her life. A BRCA gene mutation increases a woman's risk for breast cancer up to 85 percent. Risk of ovarian cancer in the general population is less than 2 percent, but 55 percent for those with BRCA1 and 25 percent for those with BRCA2.
People whose parents have the BRCA1/2 gene have a 50 percent chance of inheriting the mutation.
The BRCA gene mutation is rare. According to the National Cancer Institute, inherited BRCA gene mutations are only responsible for about 5 percent of breast cancers and 15 percent of ovarian cancers.
In 1990, a team of scientists from the University of California, Berkley, provided the first evidence of the BRCA gene mutation and its association with an increased risk for breast cancer. Four years later, Myriad Genetics cloned the gene and patented methods to diagnose a mutation.
This made Myriad Genetics the sole provider of BRCA gene tests. But on June 13, the U.S. Supreme Court ruled that naturally occurring DNA sequences, such as the BRCA gene, cannot be patented. The plaintiff argued the patent-restricted research made second opinions impossible to obtain and eliminated competition, thus keeping the cost of the test high.
Testing of the BRCA gene is covered by some insurance companies if certain criteria are met. Testing is less expensive once a mutation has been identified in the family, as was the case with Woods.
Her insurance did not cover the test, but two of her cousins has tested positive for the BCRA2 gene, so Woods could test for that specific gene, reducing the cost of the test to about $700 -- a full testing of the DNA costs around $5,000.
"It may not be the right thing for everybody," Woods said. "But that peace of mind is worth so much."
"In the beginning, a lot of people thought that we were overreacting, that we were getting procedures that weren't necessary because we didn't have cancer," Woods said.
But celebrities coming out as having the elective surgery has shed light on the gene and the decisions made. In May, the actress Angelina Jolie published a column in The New York Times, "My Medical Choice," about testing positive for BRCA1 and subsequently having a hysterectomy and double mastectomy.
When Woods first read the article, she thought: "I did it first and I'm a nobody."
"You have celebrities now that really make it OK," Woods said. "You're not weird or different for wanting to do this. It's about saving your life."
Jolie is known for her beauty, appearing on Maxim's Hot 100 list seven times, being named the "Most Beautiful Star" by People magazine in 2006, the "first perfect woman" by Vogue in 2002, Esquire's "Sexiest Woman Alive,' in 2004, and voted by Vanity Fair readers as the "Most Beautiful Woman in the World" in 2009.
"She can still be beautiful after that," Woods said. "There were a lot of photos of her afterward, and nobody would have known the difference."
Woods, Jolie and the thousands of other women who choose to have the preventive surgery share in their reasoning.
"She's going to live," Woods said. "Look at all the kids she's got. That's the reason she did it. And that's the reason I did, too."
Woods' genetic counselor at the Medical University of South Carolina told her about FORCE, a national nonprofit group founded on the principle that no one should face hereditary breast and ovarian cancers alone. Woods became involved with FORCE -- Facing Our Risk of Cancer Empowerment -- after having her elective surgeries.
Woods met with the two women organization FORCE in Savannah, and began attending meetings and then holding them in Beaufort as well.
The group meets quarterly, with the next meeting on Oct. 1 at the Keyserling Cancer Center in Beaufort. Attendance ranges from five to 10 women in all stages; spouses and children are often brought along.
FORCE holds a three-day national conference annually, an educational and networking conference. Health care providers are there to present and answer questions on topics such as breast cancer surveillance, breast reconstruction options, sexuality after surgery and harvesting eggs. Woods has attended three conferences to support women making the decisions she had to make.
"We get to share what we've been through and how it affected us and support them on their decisions," Woods said.
Woods watched her mother go through chemotherapy and radiation and felt the fear of losing her.
"I'm thankful I don't have to go through what my mother went through," she said. "I'm so thankful tests are out there and hope more people will consider it."
There is a 50/50 chance her brothers, Craig and Cameron, also carry the BRCA mutation, which means they can pass it along to their children, who can't be tested until they are 18 years old.
"My boys are still young, and we haven't had many conversations on it yet," Woods said. "But I'll encourage them to get tested. It empowers you to do something for yourself."
While she stills has to screen for other cancers, the two high-risk ones have been cut out. She is a "previvor," someone who survived a predisposition to or increased risk of cancer but never having had the disease.
The term "previvor" was coined in 2000 in response to a FORCE community member "needing a label," and was later ranked No. 3 in Time magazine's Top 10 Buzzwords of 2007. In 2010, Congress passed a resolution declaring the last Wednesday of September "Previvor Day."
"Because we survived something," Woods said.