LOS ANGELES — TWO years ago I wrote about my choice to have a preventive double mastectomy. A simple blood test had revealed that I carried a mutation in the BRCA1 gene. It gave me an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. I lost my mother, grandmother and aunt to cancer.
洛杉矶——两年前，我写过一篇文章，解释自己为何选择进行预防性的双侧乳腺切除术。一次简单的血检揭示出，我是BRCA1基因突变携带者。因此，我罹患乳癌的风险估计达87%，而患卵巢癌的风险有50%。我的母亲、外祖母和姨妈均死于癌症。
I wanted other women at risk to know about the options. I promised to follow up with any information that could be useful, including about my next preventive surgery, the removal of my ovaries and fallopian tubes.
当时，我想让其他同样有患癌风险的女性了解可以作何选择。我许下了诺言，会跟进任何可能有用的讯息，包括我接下来要做的预防性手术——摘除卵巢和输卵管。
I had been planning this for some time. It is a less complex surgery than the mastectomy, but its effects are more severe. It puts a woman into forced menopause. So I was readying myself physically and emotionally, discussing options with doctors, researching alternative medicine, and mapping my hormones for estrogen or progesterone replacement. But I felt I still had months to make the date.
那时候，我计划这么做已经有一段时间了。相比切除乳腺，这个手术没那么复杂，但后果却更为严重。它会让一个女人提前绝经。所以，我一直在从生理到心理上做准备，和医生探讨各种选择，研究替代疗法，筹划我要使用的雌激素和黄体酮替代药物。不过，我原本觉得，这一天到来之前，自己还有不少时间。
Then two weeks ago I got a call from my doctor with blood-test results. “Your CA-125 is normal,” he said. I breathed a sigh of relief. That test measures the amount of the protein CA-125 in the blood, and is used to monitor ovarian cancer. I have it every year because of my family history.
然而两周前，我接到了医生的电话，告知血检结果。“你的CA-125指标正常，”他说。我舒了一口气。这个检查测的是血液中的CA-125蛋白含量，用来监控是否有卵巢癌的迹象。因为家庭的病史，我每年都做这项检查。
But that wasn’t all. He went on. “There are a number of inflammatory markers that are elevated, and taken together they could be a sign of early cancer.” I took a pause. “CA-125 has a 50 to 75 percent chance of missing ovarian cancer at early stages,” he said. He wanted me to see the surgeon immediately to check my ovaries.
不过，这并非最终结果。医生还有话要说，“好几项炎症标记物的数据有所上升，综合考虑，可能是早期癌症的迹象。”我顿了一下。“CA-125的数据有50%到75%的概率会察觉不到早期的卵巢癌，”他说，并且希望我马上去找外科医生检查卵巢。
I went through what I imagine thousands of other women have felt. I told myself to stay calm, to be strong, and that I had no reason to think I wouldn’t live to see my children grow up and to meet my grandchildren.
就像成千上万有类似经历的女性那样，我百感交集。我告诉自己要保持冷静、坚强，我也没有理由认为自己不能活下来，亲眼看着子女一天天长大，看到孙子孙女来到人世。
I called my husband in France, who was on a plane within hours. The beautiful thing about such moments in life is that there is so much clarity. You know what you live for and what matters. It is polarizing, and it is peaceful.
我给身在法国的丈夫打了电话。几个小时后，他就跳上了回家的飞机。生命中遭遇这样的时刻，美好的一面就在于，一切变得如此明了。你知道了活着的意义，知道什么才最重要。虽然极端，但却带来了平静。
That same day I went to see the surgeon, who had treated my mother. I last saw her the day my mother passed away, and she teared up when she saw me: “You look just like her.” I broke down. But we smiled at each other and agreed we were there to deal with any problem, so “let’s get on with it.”
当天，我就去拜访了外科医生。她曾治疗过我的母亲。上一次见她，是母亲去世的那天。见到我，她眼中含有泪光：“你跟她长得真像。”我崩溃了。但我们对彼此笑了笑，决定两人都准备好了要去应对任何问题，所以“我们这就开始吧。”
Nothing in the examination or ultrasound was concerning. I was relieved that if it was cancer, it was most likely in the early stages. If it was somewhere else in my body, I would know in five days. I passed those five days in a haze, attending my children’s soccer game, and working to stay calm and focused.
查体和超声波检查都没有显示出需要担心的迹象。就算是癌症，也极有可能还停留在早期，这让我松了一口气。五天之后我才能知道，是不是身体的其它部位有问题。那五天我过得昏昏沉沉，参加了孩子们的足球赛，忙着工作来保持冷静和专注。
The day of the results came. The PET/CT scan looked clear, and the tumor test was negative. I was full of happiness, although the radioactive tracer meant I couldn’t hug my children. There was still a chance of early stage cancer, but that was minor compared with a full-blown tumor. To my relief, I still had the option of removing my ovaries and fallopian tubes and I chose to do it.
出结果的那天来临了。PET/CT扫描看起来没问题，肿瘤测试的结果也呈阴性。尽管因为体内有放射性示踪剂，我不能把孩子们揽在怀中，但我满心欢喜。虽说还是存在早期癌症的可能性，但与来势凶猛的肿瘤相比，这算不上什么。让我释然的是，自己仍旧可以决定去切除卵巢和输卵管，而我的决定就是去做手术。
I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery. I have spoken to many doctors, surgeons and naturopaths. There are other options. Some women take birth control pills or rely on alternative medicines combined with frequent checks. There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally.
之所以这样抉择，并不仅仅是因为我身上携带BRCA1基因突变。我也想让其她女性明白这一点。BRCA基因突变检查结果呈阳性，并不意味着你马上要去动刀。我和很多大夫、外科医生和自然疗法专家聊过，的确有其他的选择。有些女性会吃避孕药，或者依靠替代疗法并结合频繁的检查。对付健康难题的办法不止一个。最重要的是，你要了解各种应对的办法，从中选择对你个人来说最正确的那种。
In my case, the Eastern and Western doctors I met agreed that surgery to remove my tubes and ovaries was the best option, because on top of the BRCA gene, three women in my family have died from cancer. My doctors indicated I should have preventive surgery about a decade before the earliest onset of cancer in my female relatives. My mother’s ovarian cancer was diagnosed when she was 49. I’m 39.
拿本人的例子来说，我看过的东西方医学的大夫都认为，手术摘除卵巢和输卵管是我最好的选择，因为除了BRCA基因突变，我的家人中，还有三名女性被癌症夺去了性命。医生们表示，在我的女性亲属患上癌症的最早年龄提早十年左右的那个时候，我就应该做预防性手术。我母亲确诊得了卵巢癌是在49岁，而我今年39。
Last week, I had the procedure: a laparoscopic bilateral salpingo-oophorectomy. There was a small benign tumor on one ovary, but no signs of cancer in any of the tissues.
上个星期，我做了腹腔镜下双侧输卵管卵巢切除术。一侧卵巢上有一个小的良性肿瘤，但所有组织中没有发现癌症迹象。
I have a little clear patch that contains bio-identical estrogen. A progesterone IUD was inserted in my uterus. It will help me maintain a hormonal balance, but more important it will help prevent uterine cancer. I chose to keep my uterus because cancer in that location is not part of my family history.
我的身上有一个小的透明贴片，里面含有生物同质性雌激素，子宫内则放置了一个黄体酮节育器。这将有助于维持我的激素平衡，但更重要的是有助于预防子宫癌。我选择了保留子宫，因为这个部位的癌症并不存在于我的家族病史中。
It is not possible to remove all risk, and the fact is I remain prone to cancer. I will look for natural ways to strengthen my immune system. I feel feminine, and grounded in the choices I am making for myself and my family. I know my children will never have to say, “Mom died of ovarian cancer.”
排除所有的风险是不可能的，实情是，我还是会易于罹患癌症。我会寻求自然的方式来增强自己的免疫系统。为自己和家庭，我觉得做出了一个女人的、明智的决定。我知道，孩子们以后决不用说出“妈妈死于卵巢癌”这种话了。
Regardless of the hormone replacements I’m taking, I am now in menopause. I will not be able to have any more children, and I expect some physical changes. But I feel at ease with whatever will come, not because I am strong but because this is a part of life. It is nothing to be feared.
尽管使用着激素替代药物，但我现在停经了。我不能再生育小孩，身体也将出现一些变化。然而，无论将来有何风雨，我内心坦然。这并不是因为我很坚强，而是因为这就是我生命的一部分。没有什么可怕的。
I feel deeply for women for whom this moment comes very early in life, before they have had their children. Their situation is far harder than mine. I inquired and found out that there are options for women to remove their fallopian tubes but keep their ovaries, and so retain the ability to bear children and not go into menopause. I hope they can be aware of that.
对于那些生命中早早遭遇这一难题，却还没来得及生儿育女的女性，我怀有深切的同情。她们的处境比我要艰难得多。经过咨询，我发现有切除输卵管但保留卵巢的可能性。这样就依然能怀上孩子，也不会停经。我希望她们可以了解到这一点。
It is not easy to make these decisions. But it is possible to take control and tackle head-on any health issue. You can seek advice, learn about the options and make choices that are right for you. Knowledge is power.
做出这些选择并非易事。不过，任何健康问题，我们都有可能加以掌控，正面迎击。你可以咨询建议，了解不同的应对办法，做出对你来说正确的选择。知识就是力量。