BRCA Mutations & Hereditary Cancer Risk Therapy
Support for hereditary cancer risk, genetic testing, risk-reducing surgery, and life after surgery
You don't have to have cancer for hereditary cancer risk to change your life.
Learning that you carry a BRCA1, BRCA2, or another hereditary cancer gene mutation can bring an overwhelming number of emotions, questions, and decisions. Whether you're considering genetic testing, newly learning about your risk, navigating medical decisions, or adjusting to life after preventive surgery, the emotional impact can be far-reaching, affecting how you think about your health, your future, and the decisions ahead.
For some, genetic testing follows a family member's cancer diagnosis or the loss of someone they love. Others pursue testing because of their family history, ancestry, or a desire to better understand their risk, and a positive result may come as a complete shock. For others, hereditary cancer risk has been part of their story for as long as they can remember. Maybe you grew up knowing that a parent carried a BRCA mutation, watched family members undergo cancer treatment, or lost someone to cancer at a young age. You may have spent years wondering whether you would eventually face the same risks and decisions. Still others learn about a hereditary mutation only after receiving their own cancer diagnosis, adding another layer of complexity to an already overwhelming experience.
Whatever brings you here, hereditary cancer risk can affect much more than your medical care. It can carry an emotional weight that isn't always visible to others. There is no single way to experience it, and no right way to feel. You might be grateful to have information that allows you to take preventive action while also feeling frightened, angry, resentful, or overwhelmed by the choices in front of you. Those feelings can coexist.
Considering Genetic Testing
You may have learned that you're a candidate for hereditary cancer genetic testing because of your family history, ancestry, or a known genetic mutation in your family. Perhaps someone you love has recently been diagnosed with cancer, and you're trying to process what that means for both them and you.
Deciding whether, when, and how to pursue testing can bring up fear, uncertainty, resentment, and indecision. You may feel pressure from loved ones who have strong opinions about what you should do, or find yourself struggling to follow through with testing even when you know you want the information.
Sometimes, the decision to learn about your risk is complicated by knowing that the information could change how you think about your future.
Receiving a Positive Result for a Genetic Mutation
Learning that you carry a BRCA1, BRCA2, or another hereditary cancer gene mutation can bring gratitude or relief at having important information. It can also bring fear, anger, grief, and an overwhelming number of decisions.
You may feel shocked by the news or find yourself immediately worrying about developing cancer. You may begin grieving anticipated losses related to future surgery, fertility, or changes to your body before you've even made any decisions.
Other emotions can be harder to acknowledge. You might feel angry that you have to confront decisions your peers don't have to make, guilty about potentially passing a mutation to your children, or ashamed that you're struggling when you feel you should be grateful to have information that could help protect your health.
These emotions aren't mutually exclusive. You can appreciate having this knowledge and still wish you never had to face these decisions.
Navigating Risk, Surveillance & Decisions
Living with hereditary cancer risk can be exhausting. There are specialists to consult, screenings to schedule, results to wait for, and decisions that can feel impossible to make. Even when you know the statistics about your lifetime cancer risk, those numbers can't tell you what will happen to you. Learning to live with that uncertainty can be one of the hardest parts.
High-risk surveillance can bring a recurring cycle of anxiety: anticipating an MRI or mammogram, worrying about what might be found, waiting for results, and finally feeling relief, only to know you'll be doing it all again in six months. Additional imaging or biopsies can make the process even more stressful.
Then there are the bigger decisions, including whether or when to pursue risk-reducing surgery and how it might affect your body, relationships, and future. These choices can look different depending on where you are in life. If you're single or dating, you may wonder when and how to share your genetic risk with a potential partner. If you're considering having children, you may be facing complicated questions about fertility, reproductive choices, and timing. If you're already a parent, you may worry about what your genetic status could mean for your children.
You might be navigating all of this while supporting a family member with cancer or grieving someone you've lost. And even when you're not actively dealing with a medical issue, the awareness of your risk may never be far from your mind.
Sometimes, you're simply tired of having to think about it.
Preparing for & Recovering from Surgery
Choosing to undergo risk-reducing surgery can be both empowering and emotionally difficult.
The process often involves an exhausting number of appointments and decisions: whether and when to have surgery, which procedures to pursue, whether to have breast reconstruction and what type, choosing providers, arranging time away from work, and coordinating support during recovery.
Even when surgery is a choice you've made thoughtfully and confidently, the physical and emotional experience can be more difficult than anticipated.
You may feel relief alongside grief, fear, vulnerability, frustration, or sadness. Recovery can involve pain, temporary loss of independence, unexpected complications, changes to your body, and uncertainty about the final outcome.
Undergoing major surgery to prevent a disease you don't have can be a uniquely complicated experience. The fact that surgery was preventive or elective doesn't make the experience—or the emotions that accompany it—any less significant.
Life After Risk Reduction
The emotional experience of hereditary cancer risk doesn't just go away after surgery.
You may be adjusting to a changed body, navigating breast reconstruction or additional revision procedures, coping with changes in sensation or intimacy, or managing the physical and emotional effects of surgical menopause.
There may be grief for parts of your body or aspects of your life that have changed, even if you remain confident in your decisions.
You might also feel pressure (from yourself or others) to be relieved, grateful, or ready to move on. The thing is, there is no predictable timeline for recovery.
Risk-reducing surgery can substantially lower certain cancer risks, but it doesn't eliminate every risk or necessarily resolve the anxiety that accompanied living with a genetic mutation and the decision you had to make.
It's possible to feel grateful for the opportunity to protect your health while also mourning what the process has cost you.
When prevention comes with its own losses
Considering or undergoing preventive surgery can bring a sense of relief and empowerment, but it can also involve real losses. Even when you feel confident in your decisions, you may grieve changes to your body, the choices you wish you didn't have to make, or the future you once imagined.
A risk-reducing mastectomy, with or without reconstruction, can raise complicated feelings about your body, identity, sexuality, and physical intimacy. Decisions about removing the ovaries, fallopian tubes, or sometimes the uterus can bring additional concerns about fertility, menopause, and the timing of major life decisions. Whether you're anticipating these changes or already adjusting to them, the emotional impact can be significant.
For those who have undergone surgery, recovery may bring challenges you didn't anticipate. Pain, changes in appearance or sensation, and adjusting to a body that looks or feels different can be difficult, even when you're grateful to have reduced your cancer risk. And for those still considering surgery, simply imagining these possibilities can be overwhelming.
Feeling sadness, anger, or regret about aspects of the experience doesn't necessarily mean you regret your decision or that you're making the wrong one.
You can feel confident in your choices and still wish you'd never had to make them.
You don’t have to “just feel grateful.”
For many people, connecting with others who carry hereditary cancer mutations brings an incredible sense of community. There's comfort in talking to people who understand the decisions, fears, and experiences that can be difficult to explain to someone who hasn't been through them.
At the same time, there can be pressure to embrace the role of the strong, brave, empowered “warrior.” You may love the term “previvor,” or maybe it doesn't resonate with you. You may be celebrated for taking control of your health, making difficult decisions, or undergoing preventive surgery. Or you may find that the people around you don't fully understand what you're going through, leaving you without the support you hoped for.
And maybe you do feel strong and empowered. But you might also feel scared, angry, exhausted, or resentful that you've had to face any of this in the first place. You can be grateful for the opportunity to reduce your cancer risk and still grieve what the experience has cost you.
You don't have to see this as an empowering journey for your feelings to be valid.
Therapy for BRCA & Hereditary Cancer Risk:
Therapy offers a place to talk openly about what you're experiencing, including the feelings you may not feel comfortable sharing with family, friends, or medical providers. You deserve space to make sense of what you're going through, without feeling pressured to be brave, grateful, or certain about what comes next.
We can work together to manage anxiety and uncertainty, think through difficult decisions, prepare for surgery, cope with recovery, and adjust to changes in your body, relationships, and sense of self.
My approach is warm, active, and collaborative. I use evidence-based therapies, including CBT and DBT-informed strategies, to help you develop practical ways of coping while also making space to process what you're going through.
I won't tell you what medical decisions to make or how you should feel about them. My role is to help you work through the emotional challenges so that you can make choices that reflect your own values and priorities.
