Pretty Is What Changes: Impossible Choices, the Breast Cancer Gene, and How I Defied My Destiny

I just finished one of the most amazing memoirs I've read. I read it in three days. While the writing is simple, the book is powerful. Jessica Queller, a Hollywood TV writer (Gilmore Girls, Gossip Girl), lost her mother to ovarian cancer. Her mother was pretty young, too, around 60. The first few chapters of the book talk about her mother's illness (she had breast cancer several years earlier, too) and how Jessica and her sister nursed her, put their lives on hold during her worst times, and how they eventually lost her.

After she lost her mother, Jessica got some genetic testing done to see if she carried the breast cancer gene. Turns out she did. With this gene, she had an 87 percent chance of getting breast cancer in her lifetime and a 44 percent chance of getting ovarian cancer. This mutated gene is in very few women, but it is passed down from parents to their children.

Knowing she's at high risk for cancer, and that it can happen at any age, Jessica, who was in her early 30s when she tested positive, needs to figure out what she's going to do with the information. Does she just wait and see? Does she do a preemptive strike and have her at-risk organs removed?

Jessica struggles with the information for a few years and we get to go along for the ride. She does massive research, talks to numerous doctors and meets many women who found themselves in her same position. The question of removing one's female organs is not just one of health, but of sexuality, self-esteem and the desire to have a family.

This book made me laugh and cry at several points. Her mother was afraid to die. She held on for probably a lot longer than she should've been able to. Jessica has a whole bunch of fun-loving (and very supportive) friends, including some very famous ones. It was fun to read about all of them. She went on some nightmare dates, but kept her humor through them all. Her mother and grandmother were also very unique, but lovable, characters in the book.

I don't want to tell you her ultimate decision. The book flap doesn't give it away, so I won't either. But the book is wonderful. She discusses how far we've come with genetic testing (couples can create embryos and test them for genetic mutations before deciding to keep them - this is becoming common; is this right, and who's to say?), and brings up so many ethical/moral questions.

What if it were you? Would you want to know if you had the cancer gene? Would you do what it took to prevent it, however extreme? As I'm not in the situation, I can't answer for sure. But more often than not when I weigh it in my mind: Yes & yes.

If you've ever been touched by cancer, whether you, a friend or a family member - and perhaps if because of your parent(s) you've sat and wondered if that makes you that much more susceptible and almost destined for cancer in your future - I think this book is honest, thoughtful and well worth your time. It may be hard to read at some points, but I think it's important. Pretty may change, but the beauty inside never fades.