Reviewed By: Alysa Cummings
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: August 8, 2008
Sometimes a particular book comes into your life at precisely the right moment. Exactly when you need it the most. Sometimes a story, a character, a message, can resonate loudly and call your name. In a nutshell, that’s what happened for me with Pretty is What Changes, a breast cancer memoir that chronicles the life of a thirty-something television scriptwriter who decides to undergo genetic testing following the death of her mother from ovarian cancer.
In the book, Jessica Queller learns that she has tested positive for the BRCA-1 mutation. As a result, as her doctors explain to her, she now has an 87% lifetime risk of breast cancer and up to a 44% lifetime risk of ovarian cancer. What are her choices? “Submit to vigilant surveillance and hope for the best, or undergo radical surgery.” The book chronicles the path to her ultimate decision to have a prophylactic bilateral mastectomy.
One week before I stumbled upon Queller’s book in the Women’s Health section of Border’s, I took a phone call at work from my gynecologist. (She called me while she was away from the office on vacation; I should’ve seen the bad news coming a mile away). My genetic testing results were back; I had tested positive for the BRCA-2 mutation. Like Queller, I had to decide on the relative merits of getting tested every few months or going under the knife to minimize my future cancer risk. Reading Queller’s story helped me think about what the next chapter of my own CancerLand journey might be.
Pretty is What Changes is a well-written page-turner, filled with memorable people and events so vividly described that they linger long after the story ends. Here’s how we first meet Queller’s mother:
My mother looked out of place in this shabby waiting room-like a swan in a chicken coop. Her dark luxurious hair evoked Jacqueline Bisset, though some people compared her to Dian Von Furstenberg, (“I’m much prettier than she is-her face is too broad,” she’d insist.) My mother was five foot four but stood taller in her signature Manolo Blahnik stilettos. My mom had been wearing Manolos back when Sarah Jessica Parker was in diapers…
In fact, the book so often reads like a script that it has to make me wonder if we will see Queller’s story on the small screen in the not too distant future. Interspersed with the excellent medical information and an accurate depiction of the cancer experience is a sprinkling of gratuitous namedropping (Calista Flockhart is a good friend, so it’s no surprise that her boyfriend, Harrison Ford, makes a cameo appearance in Chapter Seven). Queller’s social life also becomes a thread woven throughout the book; can she connect with the right man, fall in love, get married and have a baby? Her biological clock is ticking loudly and doctors recommend that she get her ovaries removed by age forty to further minimize her cancer risk.
The last part of the book follows Queller through her multiple surgeries (mastectomy and reconstruction). Like many women right before mastectomy, she takes time to say goodbye to her breasts and acknowledge the loss:
I sat on the floor of my bedroom in front of a large mirror and gazed at my naked breasts for an hour. It sounds ridiculous, but I felt sad for them. They needed to be sacrificed in exchange for my health. It seemed so strange that my own body could be a danger. That my own body could kill me. It was unfathomable.
Jessica Queller’s story grabbed me and held my attention for five hours on a hot July day. Despite our difference in age, occupation and life experience, ultimately there was a real sense of sisterhood in terms of our shared BRCA status. And that connection delivered more than a small dose of comfort.
May 6, 2010 - A new white paper -- "What is the Role of HPV Typing in the United States Now and in the Next Five Years in a Vaccinated Population?" -- provides guidance to clinicians about the administration of advanced screening technologies for cervical cancer prevention. The paper was published online April 24 in Gynecologic Oncology.