What happens when breast cancer's in your family and you know there's a high chance you will suffer from it. Wendy Watson, voted Tesco's Mum of the Year, took drastic action to avoid that happening and so did her daughter. She talks to Gabrielle Fagan to mark Breast Cancer Awareness Month.
By Gabrielle Fagan.
It's evident as soon as you meet Wendy Watson and her daughter Becky Measures that they have a lot in common - a sense of humour and radiant smile, and a positive approach to life.
But that closeness is also mirrored in another way - they both have a defective gene which raises their chances of suffering breast cancer and both were trailblazers in undergoing radical surgery to prevent it claiming their lives.
In 1992 Watson became the first woman in Britain to have a pre-emptive double mastectomy, and when Measures was only 24 she opted for the same procedure.
"I'd been aware of breast cancer from a young age," explains Watson, who's detailed her experience and the challenges which led her to found the National Hereditary Breast Cancer Helpline in her new book, I'm Still Standing.
"I was only nine when I watched my mother nurse my dying grandmother who suffered from it. Eight years later when I was a teenager, my mum, a teacher, died at 45, also from breast cancer."
Despite doctors' firm assurances to the contrary - in those days the medical profession was unaware of a hereditary link to breast cancer - Watson constantly worried because of the family history that she too might develop cancer.
Her worst fears were confirmed in 1991 when she discovered that nine of the 10 women in three generations of her family had contracted breast cancer. Six had died.
"I'd had years of worry. In fact, I'd been so paranoid about my breasts that I didn't even want to check them in case I felt a lump," she says.
"I felt by the age of 37 that I literally had a death sentence hanging over me, and feared that Becky, who was only nine at the time, would, like me, lose her mum in childhood."
She had an enormous struggle to convince doctors that while she appeared perfectly healthy, a mastectomy was, for her, the only course of action which would give her peace of mind.
"Everyone apart from my husband, Chris, and close family, who totally supported me, was horrified at the thought of what I was doing. As I was apparently well, they thought it was too drastic.
"But I felt surgery would allow me to live my life free from fear. An operation and losing my breasts I could cope with, but dying of a disease I could have prevented seemed ridiculous," she says.
"When I woke up the morning after the operation I felt like the most privileged woman in the world. The elation was incredible, I had survived."
Three years later the test identifying faulty genes which cause cancer was developed.
Watson and her daughter were found to carry the then newly identified defective BRCA1 gene.
Women with a BRCA1 gene mutation have up to an 85% lifetime risk of developing breast cancer, compared with the average of 14%. It's estimated that one in 200 people in the UK carry one of the high-risk genes.
"I believe that result completely vindicated my decision and preventative mastectomy is now totally accepted as a sensible risk-reducing option," she says.
Over the last 15 years she's devoted herself to tirelessly campaigning to raise awareness of hereditary breast cancer.
One of Watson's biggest personal challenges happened in 2006 when her daughter also opted to have the same procedure, after learning that her 29-year-old cousin had developed breast cancer.
"That was a difficult time for me because even though I'd experienced it myself seeing your daughter go through any operation is difficult," says Watson.
"But she faced it so courageously and it was wonderful to know that she too had removed that very real threat to her health. She plays a key role in the charity now."
"My breasts were ticking time bombs," says Measures, a radio presenter.
"Mum left it totally up to me to make the decision but I'd seen how positive surgery could be in our situation. At the time, I was the youngest person to have that elective surgery."
She nominated her inspiring mother as Tesco Mum of the Year, a title she won this year. "I regard myself as very blessed to have been able to change my destiny," says Measures.
"Thanks to Mum's example I've been able to take control of my life. She's helped so many other women to do that and saved thousands of lives."
Watson, 56, who lives near Bakewell and previously ran a farm and then a post office, now devotes all her time to running the 24-hour National Hereditary Breast Cancer Helpline, a charity organisation which she set up in 1996.
It allows 'at-risk' women to access information on all the options available to them, as well as referrals and support.
Recently, Watson also established 30 support groups throughout the UK, including one especially for those aged under 25 for whom there is little else on offer.
She works around the clock, manning the helpline, training volunteers, seeking funding and organising fund-raising events to ensure the charity continues, as currently it only receives limited financial funding from primary care trusts.
"It's a lifeline for so many women - there are up to 200 calls a week, and I receive around 100 emails a day. We hear from desperate women who fear they are at risk or have been told they definitely are at risk and need to speak to people who understand," she says.
"The gene test is wonderful in that it allows women to consider what course they wish to take. But there's many paths available to them from screening, drug trials, having surgical intervention or, of course, doing nothing.
"There is no right or wrong thing to do - it's a matter of individual choice. So they often need help while they're going this decision-making process as they can feel very isolated because all too often people struggle to understand why people would even consider having treatment or surgery when they're not ill."
Watson's pioneering work has been recognised and hailed by medical experts around the world, and she's in discussion about setting up a similar service in Australia.
"It seems a long time since I lived under the shadow of this horrific disease, and I never imagined that my life would turn out this way," she says.
"I'm just someone who refused to accept my genetic inheritance and I will never give up helping other women to empower themselves and decide their own futures."
What is hereditary breast cancer?
Most women develop breast cancer by chance, but in a small percentage of women this can be due to a faulty gene. Three genes have been identified that give a high risk of breast cancer.
In some families, there are more breast cancers than would be expected by chance alone, particularly at young ages. This may be due to a faulty gene, especially if there are any other related cancers such as ovarian or a family member with cancer in both breasts.
If there is a family member with breast cancer still living who can give a blood sample, a genetic test may be performed to look for a faulty gene.
Am I at risk?
Advice from the National Hereditary Breast Cancer Helpline says most people who have a relative with breast cancer will not be at increased risk.
However, in families where there are two or more breast cancers occurring under the age of 50, in close family members, then this may be a reason to take a closer look at the family history.
Typically, a family affected by one of the high-risk genes will often be self-evident, with multiple breast cancers occurring.
It may be harder to recognise a trend in families of predominantly male descent. In some there are cases of male breast cancer, however most males will be unaffected by the fault although they can carry a defective gene.
Family histories are usually considered significant if there are: Two cases of breast or ovarian cancer under the age of 40 - especially a case of breast cancer in both breasts; three breast or ovarian cancers under the age of 50; and four breast or ovarian cancers occurring under age 60. (NB: The ovarian cancers can occur at any age) :: Information: I'm Still Standing, by Wendy Watson, is published by Simon & Schuster, priced £6.99. Available now. For information on the Hereditary Breast Cancer Helpline, visit www.breastcancergenetics.co.uk or call 01629 813 000