Jess Braude is expecting her first child in May 2021. (Supplied)
There’s a lot going on when a woman is first diagnosed with breast cancer.
She’s caught in the demanding “now” of what cancer means and what has to happen next.
And it all feels to be happening, for good reason, in a hurry.
Meanwhile, there are aspects of the future that she didn’t expect to be thinking about quite yet.
For a woman in her 20s and 30s about to undergo chemotherapy, there’s the matter of the future to be taken care of, the children she’d planned to have “one day”.
They need to be protected now, even though they won’t be born for some years.
This was the story of Jess Braude, newly diagnosed with breast cancer in 2017. She had just turned 30.
“After I got the diagnosis, my surgeon wanted to do a lumpectomy straight away because my tumour was relatively small,” she says.
Five months of chemotherapy was waiting.
“The aim of chemotherapy was not to shrink the tumour, it was to sort of mop up the cancer if it had spread anywhere else.”
But first there was the issue of protecting her fertility.
At this stage, Jess was receiving a monthly injection of what’s known as a GnRH analogue, a medication to protect the ovaries during chemotherapy.
But research studies show that the protective effects of this medication may not work for everyone.
“Then I had to do a round of IVF,” she says. “Doing the IVF was a back-up plan in case the injections didn’t work and the chemo destroyed my egg count and my ability to produce an egg in the future.”
Hormone injections for IVF had begun very soon after Jess had been diagnosed.
She’d had surgery. Now she’s being sent to have her eggs harvested, the eggs fertilised and then frozen. Little more than two weeks had passed.
“The point of the hormone injections is they want to stimulate you to get as many eggs as they can,” says Jess.
here was an added difficulty here, an extra reason for harvesting as many eggs as possible.
The previous year, Jess and her sister had undergone genetic testing to see if they carry mutations in the breast cancer BRCA1 or BRCA2.
Both women were found to have inherited a BRCA2 gene mutation from their father. People with BRCA1 or BRCA2 gene mutation have a higher risk of developing breast, ovarian and other cancers.
This meant that any of the embryos made from Jess’s eggs could potentially carry the mutation.
When her cancer treatment was complete, Jess began thinking about the potential dangers lurking inside her frozen embryos.
“And I found down the track that you could do this pre-implantation genetic testing,” she says.
This means a pregnancy could begin with confidence that the embryo and eventual baby weren’t carrying the BRCA2 mutation – the mutation that led to Jess developing triple negative breast cancer, a particularly aggressive non-hormone-related cancer.
“It was funny,” she says, “because obviously I knew I had a BRAC2 gene mutation before I got cancer. And my attitude then was, I wouldn’t do IVF, no way.”
She felt the genetic screening and potential rejection of a frozen embryo interfered with the natural destiny.
“Am I picking and choosing?” she asked herself. It was a philosophical objection.
“But then once I’d had the cancer I thought there was no way I could watch my child go through that,” she says.
When this interview was recorded, Jess Braude was 35 weeks pregnant and feeling that at any moment her life was about to change, in ways that were scary and sweet and overwhelmingly profound.
She has caught up with her future.