To commemorate National Hereditary Cancer Week (September 25 – October 1), and National Previvor Day (September 28), we're sharing the story of Jennifer Garam, who with no known history of hereditary breast or ovarian cancer, discovered that she was BRCA1-positive.
At age 43, Jennifer went to Urgent Care due to some worrisome symptoms she had been experiencing for about a week. The doctors immediately sent her for a CT scan, and then suddenly, without warning, she was diagnosed with Stage 3C ovarian cancer. After two nine-week rounds of chemotherapy, debulking surgery (a procedure in which cancerous tumors are removed from the affected areas as much as possible) and two years of an oral maintenance medication, Jennifer decided to also get a prophylactic double mastectomy to reduce her chances of developing breast cancer. (Carriers of BRCA1 have a 50-80% risk of developing the disease.) Now, cancer-free, one of her biggest challenges has been transitioning from patient to survivor. To learn more about Jennifer’s journey, including how she found the best care and what she wished she knew before her diagnosis, read our latest In Her Words below.
Name: Jennifer Garam
Location: Suburb of New York City, NY
Current Health Status: In remission
Tell us a little but about yourself.
I’m a BRCA1-positive ovarian cancer survivor and a breast cancer previvor. I went through treatment for ovarian cancer in 2018 and 2019, and had a prophylactic double mastectomy in 2021. Professionally, I’m a freelance writer and editor. Since my diagnosis, my focus in my writing has become primarily topics related to cancer. I’ve been practicing yoga for almost 25 years, and I got into taking virtual dance classes during the pandemic, so that is a relatively new hobby and I’ve added “amateur dancer” to my credentials! I am a big coffee-drinker and one of my favorite things to do is sit in a coffee shop, journaling and reading.
When were you diagnosed with cancer?
I was diagnosed with Stage 3C ovarian cancer in October 2018, one month after my 43rd birthday. There was no known history of breast or ovarian cancers in my family, but shortly after my diagnosis my doctor had me do genetic testing and I learned that I’m BRCA1-positive.
What were your first thoughts when you were diagnosed?
I was in shock at first. Everything had happened very quickly: I went to Urgent Care due to some symptoms, they sent me for a CT scan the next morning, and I got the results right away and was told to go straight to the emergency room. So, I wound up in the ER knowing that my CT scan showed multiple markers of ovarian cancer and the level of my bloodwork to detect ovarian cancer (which I later learned was a CA-125 test) was exponentially higher than normal.
Even though I hadn’t been officially diagnosed yet, I was pretty sure that I had ovarian cancer, and all the tests I had done at that point seemed to indicate that it was advanced — but I didn’t know what my stage or prognosis was, and those unknowns were terrifying. I spent the night in the ER and was admitted to the hospital the next day, and that night I thought, “Is my life over? I’m 43; is this it for me?” I had no idea if my prognosis was going to be good and I’d survive, or if I was facing down the last few months of my life.
How did your friends and family take the news?
I think everyone was shocked — I was young and healthy with no significant known history of cancer in my family, and I’d only had really noticeable, concerning symptoms for one week. Friends, family members, coworkers and former colleagues, acquaintances, and even strangers were incredibly supportive and all rallied around me.
Describe your treatment and how you arrived at that course of action.
I had nine weeks of weekly chemotherapy to shrink the tumors, followed by what’s called “debulking surgery” to remove the cancer and any organs that were affected by it. For me, that included a total hysterectomy, bilateral salpingo-oophorectomy (both ovaries and fallopian tubes removed), and having my appendix removed. Then I had nine more weeks of weekly chemo, followed by two years of taking an oral maintenance medication.
For my BRCA1-positive breast cancer risk, I did surveillance, which involved one to two physical exams annually with a breast surgeon as well as alternating breast MRIs and mammograms in conjunction with a breast ultrasound every six months for about two and a half years, and then I had a prophylactic double mastectomy last year.
I have incredible doctors and just followed their guidance and did what they suggested. This is not to say that you should never question your healthcare providers or seek different opinions if needed, but I trust and respect my doctors so much. The plans they proposed all made sense, and they always explained everything thoroughly and answered all my questions, so it was easy for me to agree with what they suggested.
Were you able to work through treatment?
Prior to my diagnosis, I was working as a freelance writer and editor, and there is a lot of stress and hustle involved in this type of work. I had to prioritize my health during that time so I didn’t work. A friend created a GoFundMe for me so I was able to take that time off and focus solely on my treatment and healing.
Where and how have you found the best care?
I completely lucked into the most amazing gynecologic oncologist and cancer care team! When I got my CT scan results from Urgent Care I was told to go to the emergency room IMMEDIATELY, so I just walked to the closest ER. The director of gynecologic oncology for that hospital examined me in the ER, and he was so wonderful I remained with him as my doctor for treatment and beyond.
For my breast care, I actually wasn’t satisfied with the first provider I went to, so over time I collected referrals from friends — and even strangers. Once I got into a conversation with the cashier at the local food co-op and got a recommendation for a breast surgeon from her! A little less than a year before my mastectomy, I switched providers and went to a breast surgical team (a breast surgeon and a plastic surgeon) that a friend went to. I am so happy I made that switch and I love this team!
Have you received any additional support or alternative therapies? If so, what kind, and have they been they beneficial?
I didn’t eat that well or cook that often before my diagnosis, and when I was diagnosed, that was a big lifestyle change I wanted to make. There is a HUGE amount of information about optimal nutrition for cancer patients and survivors online — and much of it is confusing, contradictory, and even inaccurate — so it’s really difficult to sort through and make sense of. My hospital had an oncology nutritionist so I had a few appointments with her which really helped, and this service was offered for free.
What or who have been your biggest supports? Who makes up your cancer tribe?
My mom has been my overall biggest supporter and has been with me through everything — she came to the ER when I first went there; visited me in the hospital when I was hospitalized that week; was there all day, every day when I was recovering from my ovarian cancer surgery; and has slept overnight in a chair at the foot of my hospital bed many times!
Being single, I had to rely on a lot of people during treatment, so my support network was far and wide. It included friends — both old and new, local shop owners and workers, my neighbors and the Super of my building, and many more.
What has been one of the most challenging aspects of the experience for you?
I think one of the hardest things — which no one really tells you about — is the transition from “cancer patient” to “cancer survivor.” During treatment you have all this structure and you’re in what I call “the cancer bubble” — which in some ways feels like this very safe, protected space. When treatment ended I felt adrift. And then, once I adjusted to not having cancer treatment being a part of my regular routine anymore, there were still more transitions: I knew I wanted to make changes in my life post-diagnosis, but I wasn’t sure exactly how to do that or what that would look like. And that process has taken me years — I’m still going through it!
What is one thing you wish you knew before you were diagnosed?
Even though it seems like cancer mostly affects older people, there are a LOT of young, vibrant, inspiring people out there who’ve been diagnosed with cancer! In the first support group I went to after being diagnosed, I was by far the youngest person there and many of the participants were in their 80s and 90s. I’ve since been able to seek out and find communities of cancer survivors who are about my age or younger. I’m probably one of the oldest members in the support group I go to now!
Is there a particular mantra or inspiration that helps you?
Telling myself: “I love you and you’re doing great.”
If you could offer a woman, who has been newly diagnosed, some words of wisdom for her journey, what would you tell her?
Cancer isn’t an automatic death sentence. When I first heard the words “You have cancer,” I thought I might die, and soon. It doesn’t automatically mean this.
What are you most proud of in your cancer journey?
Learning how strong and resilient I am! I didn’t know this before I was diagnosed with cancer in the way that I truly, deeply do now.
How has cancer affected your outlook on life? On illness?
It has affected everything! Being diagnosed with a life-threatening illness puts life into perspective, and it’s easier for me to see what’s important — and what’s not. There are also many things I’m unwilling to tolerate anymore, like poor treatment from men in romantic relationships, work that’s not personally meaningful, and an extremely stressful work schedule that requires me to neglect my own mental and physical health and well-being, to name a few.
How have you changed?
I’ve struggled with insecurity and people-pleasing for a long time. I’m a lot more confident now, and I value myself so much more, which makes it easier for me to advocate and stand up for myself.