Cancer is a terrifying word. Whether it’s an easily removable mole on your forehead or a terminal diagnosis, you want to avoid it at all costs. Today’s scientific breakthroughs have finally made preventing cancer a reality in some cases, particularly in breast cancer. Geneticists have pinpointed certain genes that would make carriers as much as 84% susceptible to getting cancer. The solution seems simple. Play the odds and choose the lesser of two evils. But it’s not that easy as author Kim Horner demonstrates in her memoir, Probably Someday Cancer: Genetic Risk and Preventative Mastectomy.
Probably Someday Cancer plot summary
At age 41, Kim Horner, a journalist and mother to a one-year-old son, tests positive for a rare, genetic BRCA2 mutation which makes her highly susceptible to contracting breast cancer. It also increases her risk of ovarian and pancreatic cancer. Armed with this knowledge, she begins to seek out treatment options which range from frequent, aggressive screenings to a complete double mastectomy, hysterectomy, and bilateral salpingo-oophorectomy (ovary removal).
After looking up her statistics, meeting with several doctors, chatting with other women with the BRCA2 mutation on message boards, and attending conferences, Horner eventually decides to have the surgeries. Despite her research and preparation, the experience still comes with unexpected mental, physical, and financial struggles.
Part manual, part memoir, Probably Someday Cancer covers all of the emotional, statistical, and financial expectations with a knowledgeable yet empathetic narrator who weighs all of the pros and cons of the generational advantage that we have over our past relatives against this terrible illness.
Genetic mutations
After living through both sides of the decision-making process, Horner remains unbiased as to the individual paths a person should take to undergoing genetic testing and the actions they take upon learning the results of that test. This book isn’t propaganda promoting the “Angelina Jolie” surgery. Horner truly wrestles with every fact and scenario that she collects.
Facts, figures, and opinions are thrown in to illustrate the difficulty behind her indecision. The numbers are mind-boggling and diverse, only adding to the difficulty behind making a final decision.
Outside opinions
To supplement the statistics, Horner turns to a multitude of sources to help steer her towards a plan of action. Some are friends, family, and acquaintances who are quick to offer their uneducated, often negative opinions of having the surgery.
This was one of the most surprising aspects of her story. I would have assumed that most would be quick to encourage the surgery given the varying yet overwhelming likelihood of developing cancer. To watch someone go through cancer treatment is a scary and helpless experience for everyone involved. Any surgery that would reduce this risk to single digit percentages seems worth it.
But Horner inadvertently put me in my place by explaining the procedures, the cost, and the recovery time involved in undergoing a preventative surgery that doesn’t guarantee a cancer-free life. It’s just as easy to call it a no-brainer as it is to call it unnecessary. But every painful poke in a doctor’s office, every topless examination and photograph, and every hospital bill that arrives demonstrates the reality of this decision.
The journalist in Horner also seeks out opinions from numerous doctors. Only a few give her their definitive opinion of what she should do. The rest are vague, spurting impersonal facts in a reluctant attempt to sway her opinion.
The most helpful, though still indefinite group arrives via a website called FORCE (Facing Our Risk of Cancer Empowered). Full of supportive women also diagnosed with the BRCA2 mutation, all of whom took individual paths toward treatment. Some had surgeries. Others decided not to. Some had already been diagnosed with cancer. Others had double mastectomies, each with differing reconstructive surgeries. Each major decision came with its own set of micro-decisions, ranging from the material of their implants to their desired new cup size.
Family history
A major component in Kim Horner’s journey was the extraordinary number of relatives in her family tree who ended up with breast, ovarian, and pancreatic cancer. Once she was diagnosed with her gene mutation, Horner’s mother and sisters were also tested. Only one sister of the four women in her immediate family tested negative for the BRCA2 mutation. And as she went back through her family tree, she began to see an alarming pattern on her mother’s side of the family. Their ages were even scarier with her maternal grandmother dying at 41.
Financial strain
Surgeries are expensive, even with decent health care. This can be an understandable reason for avoiding necessary surgery let alone preventative surgery. Horner is candid about her expenses, even in the multitude of consultations whose co-pays add up.
However, she’s quick to point out that ultimately, frequent screenings for women with her mutation ultimately add up to be significantly higher out of pocket than a double mastectomy. Every time doctors feel a lump or have to MRI, biopsy, or even remove a strange grouping of cells, she’s billed. Politics aside, the Affordable Care Act has been helpful in creating necessity for these procedures, but it’s still a costly, and painful, process.
Real side effects
Horner doesn’t pretend that the decision-making process was the hardest part of her medical journey. She dives deep into the psychological effects that this diagnosis had on her, and she doesn’t surgar coat the complications or the tears shed in the weeks leading up to and following the surgery.
I like how she always makes sure to describe the waiting room décor, which is where most doctor’s appointments are spent. She also illustrates the emotional roller coaster that came with wrestling with her decision and ultimately making it. And while her complications were minimal, they were still present and are shared honestly without scaring the reader into believing that her ordeal was nightmarish. In the end, all is well. She’s now thriving in her 50’s without the burden of a genetic inevitability plaguing her.
My recommendation
This book left me with the realization that this decision, while tough, was a good problem to have. Because it left Horner with options. They were difficult, but they were more than any of the deceased members on her family tree ever got. And that goes for anyone who reads this book with a family history of breast cancer, myself included.
The idea of taking preventative measures is easy to encourage (or discourage if uninformed) but difficult to personally undergo. Deciding not to leaves you with a lifetime of doubt. Deciding to go ahead with it may put you into debt and leave you physically and emotionally bruised and battered. But every choice is a privileged and individualized choice that at least provides the information that a person needs to move forward with their life, one way or another.
I recommend Probably Someday Cancer to anyone with a family history of cancer, those who have been in Horner’s position, or even those looking to learn more about genetic testing and the opportunities it provides for difficult but life-saving decisions.
An interview with Kim Horner
About the Author and Book
Author name/pen name: Kim Horner
Author links
Book Title: Probably Someday Cancer: Genetic Risk and Preventative Mastectomy
Genre: Memoir, creative nonfiction
Book Summary
After learning that she inherited a BRCA2 genetic mutation that put her at high risk for breast and ovarian cancer, Kim Horner’s doctors urged her to consider having a double mastectomy. But how do you decide whether to have a surgery to remove your breasts to reduce your risk for a disease you don’t have and may never get? Based on extensive research, interviews, and personal experience, Horner writes about how and why she ultimately opted for a double mastectomy—the same decision actress Angelina Jolie made for a similar genetic mutation—and the surprising diagnosis that followed.
Book excerpt
I don’t have cancer. But here I am, sitting in a packed waiting room, waiting to see an oncologist. My doctor sent me here because last month, I found out that I have a harmful BRCA2 genetic mutation, an inherited genetic abnormality that puts me at a crazy high risk for breast and ovarian cancer. My lab result states that I have an “as much as an 84 percent risk of breast cancer,” though I’ve seen other information that puts my risk at closer to 50 percent.2 The test result set off a flurry of appointments. Genetic counselor. Breast surgeon. Oncologist. Gynecological oncologist. MRI. The MRI, an extra layer of screening for high-risk patients, identified a “suspicious area.” So, now I need a biopsy. Suddenly, I had a team of doctors with serious specialties who acted as if I was already sick.
Talking Shop
What do you want readers to take away from your books?
To educate themselves and be their own advocate when facing difficult medical decisions. And to know that they are not alone.
What’s the best review/compliment that you’ve received about your book?
A reader wrote me to say that the book brought her to tears because it accurately described the issues women with a very high risk of breast cancer face.
How long did it take to write your book from the day you got the idea to write it to the day you published it?
I started writing notes and thinking about the book after I had a double mastectomy in May 2016 and the book came out just under three years later.
How long have you considered yourself a writer? Did you have any formal training, or is it something you learned as you went?
I’ve considered myself a writer since I started doing a lot of writing in high school. I majored in English in college. Now, I’m working on a Master of Fine Arts in creative writing at the University of Arkansas at Monticello.
Who is on your Mt. Rushmore of great writers?
Margaret Atwood, Edith Wharton, Jane Austen, Toni Morrison
How well do you handle criticism, either while writing, editing, or reviews? Do you ever use that criticism to change your story?
Criticism can be difficult but it has helped me tremendously.
What is the most fun part about writing? The most difficult?
I love getting so lost in the story that I don’t want to leave my chair. The most difficult part is when I’m stuck and can’t figure out how to solve a problem in the piece. Suddenly I get the urge to do laundry or fix something to eat.
“What If” Scenarios
If your book ever becomes a movie and you get final say over the cast, which actors would you hire to play your characters?
Angelina Jolie for the lead role, even though I don’t look like her (unfortunately)
If you could have one person that you admire, living or dead, read your book, who would it be?
Gilda Radner
If you could be in a writer’s group with up to four famous writers, who would they be?
Margaret Atwood, Jesmyn Ward, Anne Lamott, Siddhartha Mukherjee
A wealthy reader buys 100 copies of your book and tells you to hand them out to anyone you wish. Who do you give them to?
That would be such a beautiful gift! I would give them to women facing hereditary breast and ovarian cancer.
You’re given $10,000 to spend on marketing for your book. How do you spend it?
Oooh that would be fun. I’d organize a fun event to get the word out.
Your book becomes a best seller. What do you do next?
Jump for joy!
What is one thing you would give up writing to have (or to have back)?
Can’t think of anything!
Just for Fun
Your trademark feature.
Yoga pants, T-shirt, ponytail, flip flops.
One bucket list item you’ve completed and one that’s still on your list.
I’ve been to Paris. I want to travel to other parts of Europe.
Food you’d like to win a lifetime supply of.
Dark chocolate.
Your favorite podcast.
Hidden Brain
A book that you recommend everyone reads.
Man’s Search for Meaning by Viktor Frankl
Buy it!
Buy a copy of Probably, Someday Cancer here, and help support local bookstores! This is an affiliate link, and I will earn a commission on any sales.
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Very interesting but at the same time difficult read. I’ll come back to this review for sure. Regardless of the topic heaviness your writing style is smooth and reads like a breeze. Great work again!