Identical Twins With Cancer

BY Dana Manciagli

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I’m the lucky twin. That wasn’t always the case.

I was 41 years old; it was my first week in a huge new job at Microsoft’s headquarters; I was responsible for starting up a new global sales force. I remember clearly the office I was sitting in when the call came with the dreaded words, “We have your biopsy results; come into the doctor’s office now…and bring your husband.”

Following surgery and treatment, I took the genetic gene test, BRCA (pronounced brah-kuh), which came back positive. That’s not a good “positive,” by the way. So I had my ovaries out and immediately my identical twin sister, Tracy, and I were put on “surveillance” – a heightened detection process so that if cancer came back, we would catch it early.

Three years later, for Tracy, it did.  She called me: “They found cancer.” My heart sank. Not just for her journey ahead, but, selfishly, for the fear it brought back about my own mortality.

Tracy’s cancer was medically more aggressive than mine.. And since her doctors knew she had the BRCA gene, Tracy had a double mastectomy, her ovaries removed, and chemotherapy. She got the “all clear.”

My oncologist, however, read Tracy’s pathology reports and was immediately concerned. So he recommended a prophylactic – or, what I call, a “proactive” – double mastectomy since my risk was still very high. Later, that same year, I had the same breast removal procedure that Tracy had and by the same doctor. Tracy, always the “comical twin,” asked the doctors if they “…would do four for the price of two…” No takers.

Ironically, while I thought I was being proactive, the doctors found that my cancer had returned, based on analysis of the breast tissue removed. Whew, dodged another bullet!

Fast-forward seven years: It was one of those middle-of-the-night phone calls. Tracy found a golf-ball sized lump deep under her left armpit. And she knew it was cancer. Me: “Nah, Tracy, it’s just a swollen lymph node.” Ever the optimist, even though I had no idea what I was talking about… 

The next day, she learned she was right; breast cancer had spread to her lymph nodes. Tracy went immediately into surgery, radiation, then chemo, and recovery. We celebrated the end of her journey in Mexico: swimming, drinking, and dancing the nights away. We had a blast!

On July 4th, 2013, just six months later, I got another 3AM call. Tracy was in emergency, doubled over in abdominal pain. She had suffered for years with Crohn’s disease, so she thought it was a serious inflammation. The Emergency Room doctor was blunt, “We’re sorry, it’s not a Crohn’s inflammation. Your cancer has metastasized into your liver and ribs.”

May 18, 2014, just 53 years old, Tracy Frank passed peacefully at home.

I’m still the lucky twin. I got to be her “go-to-person.”  I got to help ensure she got everything she wanted. I got to talk to her about her wishes for her son, Milo, and about death and dying. I got to cry with her as we fell asleep in her huge king-size bed. Finally, I got to be her caregiver and deliver on her wishes all the way through to her beautiful Celebration of Life on the beach. 

Most importantly, nobody can take the fact that we’re twins away from me. In the beginning we were the same person, separated into two by chance. Tracy was my womb-mate, my best friend, and the most giving person I will ever know. She is always right with me. I can simply say “W.W.T.D.” – What Would Tracy Do?

Our twin gift to you is:
1. Get your mammograms like clockwork once you turn 40.
2. If you have a history of breast cancer (which we didn’t), tell your doctor and have the BRCA test for the genes contributing to hereditary breast and ovarian cancer. Information and knowledge are critical!
3. Be your own best patient advocate. Ask tons of questions, get opinions, but be careful about cruising the Internet. Every journey is different.
4. Surround yourself with family, friends, and free support systems in your community. Talk to others. You’re not alone so don’t be alone.

Tracy taught me so much and her legacy will live on forever. Whenever you find yourself complaining about the smallest thing or hesitating to be generous on a daily basis, just ask yourself “W.W.T.D.” or What Would Tracy Do.

Since Tracy is my twin sister, I am the lucky twin.



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