She starts naming the long list of family members — mom, grandma, great grandma, three great aunts — as if she's pointing to their pictures in an old photo album. But Jasmine Skinner is actually ticking off these names on her fingers. When she gets to her dad's side of the family, she quickly runs out of hands. Jasmine has more than a dozen immediate and distant family members who have been diagnosed with cancer. This would be disconcerting to anyone, but sadly for Jasmine, it is the only reality she's ever known because her journey with hereditary cancer began at her birth in July 1986.
"Mom, at age 34, had breast cancer when she was pregnant with me," recalls Jasmine, relaxing in a chair after a long day at work. "And right after I was born she had to begin chemotherapy and radiation treatment for breast cancer." The cancer went into remission for 13 years and then it struck again.
"When I was 13, Mom got breast cancer in her other breast. I remember going for treatment with her during the summertime." Jasmine was exceptionally close with her mother, Thelma, which she attributes to the large age gap between herself and her four older sisters. "I had a lot of time to hang out with Mom. Anywhere she went, I went. I didn't really know what cancer was at that age. I didn't know that Mom could die from it. I just knew she needed treatment. In my mind, it was just for her to feel better."
While she was at Cabrini College, in 2004, Jasmine's dad, Carroll Skinner, died from cancer. Her mom, meanwhile, enjoyed good health until cancer struck again in 2010. This time she had pancreatic cancer. "We didn't know where the cancer was coming from," explains Jasmine. "During her treatment, Mom was tested for BRCA. And around this time, Carlette, my third oldest sister was diagnosed with breast cancer. Carlette didn't want Mom to worry as she was going through her own cancer treatment. Since Carlette and I have grown really close since we've worked together for the past 10 years, I was the only family member she told. Of course she said I wasn't allowed to tell anyone." Carlette, age 36, also tested for BRCA. Mother and daughter, Thelma and Carlette, both tested positive for a BRCA2 mutation.
Jasmine's mom passed way in April 2011 after chemotherapy and other medications failed to help her. Jasmine had buried both of her parents by age 24. "At this point I was kind of terrified," she recalls. "Carlette suggested all of my siblings get BRCA genetic testing. I really didn't want to know, but I wanted to know. I don't like surprises and didn't want to be like everyone else who had cancer in my family had been."
Jasmine and two of her three older sisters went together for genetic testing. Carlette accompanied them for emotional support. One sister has opted not to have genetic testing. When it was time to receive her results, Jasmine chose to meet with the genetics counselor alone. "If we all found out together and my sisters didn't have it and I had it, I didn't know how I'd react. I didn't want to have family with me in case I was bitter," she says. Her two eldest siblings got their results first: each are BRCA mutation negative. "Since they tested negative I had a feeling I would have [a mutation in] BRCA2. I went into to the appointment thinking we're drawing straws," she laughs. "I'll be positive, so maybe if I was negative I would be surprised, relieved. When they told me I was positive, I thought that I would laugh, but I was very angry. I completely broke down, crying, 'You have got to be kidding me.' I thought, 'Why do I have to get it?' They started going through the statistics and I just didn't want to hear any of it. So I got up and walked out at that point."
Scared and shaken, Jasmine, who is deeply religious, immediately called her pastor and spoke to his wife. Then the pastor got on and prayed with her. "I went home and I cried. I prayed and then I cried more. I blocked Carlette from calling me. I didn't want to talk to anybody. But Carlette isn't the kind of person who won't allow you to not talk to her. As we are the closest, I only told Carlette because she had experience with it. I didn't tell my other siblings until much later. I was very bitter," she says openly, "because my oldest two sisters tested negative. I remember thinking how unfair it was - they're older, they've had their kids and are married or are in a long term relationship. They don't really need their 'female parts.' And my other sister didn't get tested at all; she was scared so I didn't want to make it worse for her."
Struggling to understand why she had "been cursed with such a sentence," Jasmine found comfort from Carlette and her faith, explaining, "Carlette was my rock as she battled it herself and had a good outcome. She is such a strong person and her faith never ceased so we prayed together and talked often. She sent me scripture to read. She's gone through the worst. I continued to go to church. I would take walks and talk to God and it helped me cope and find acceptance of my situation," she says peacefully.
With the advice of her physicians, Jasmine manages her increased cancer risk with routine screening, alternating every six months between a mammogram and breast MRI. "That way, if there is a warning sign, they can catch it as early as possible," she says and admits one of her biggest challenges is just making time for the appointments. "It's a bit difficult to have to worry about one more thing that controls my destiny. But I have no choice but to take care of it. I don't think I'll ever be as normal as women without the gene mutation. Even though I'm regularly monitored, the gene is with me at all times. It's not going anywhere," she jokes, "I wish it would!"
"I try to forget about it as much as possible, I honestly do," confesses Jasmine, "but now I'm dating. I feel like I pressure my boyfriend because I need to know what's going on with us. I can't keep something that's at risk for getting cancer forever," she exclaims referring to her breasts and ovaries. Jasmine and her boyfriend have been in a relationship since July 2012. On their first date she told him about her BRCA2 mutation and shared that both her parents died of cancer. She wanted him to know it all up front. Preventive surgical measures are not a consideration at this time she explains, "I want to be married one day. I would like to have a husband that understands me and loves me unconditionally, maybe have some children before I consider anything prophylactic." Paramount in Jasmine's mind is marrying and having children by age 35.Her boyfriend is caring and understanding of Jasmine's situation. After her mom passed, Jasmine stopped cooking. "Now my boyfriend cooks a healthier diet for me. I don't eat nearly as much fried food as I used to," she proudly declares. "I'm eating more veggies. I exercise even though I don't have any fat." Because of her boyfriend's influence, Jasmine lives a healthier life than before they began dating.
Even with the constant juggling of doctor's appointments, screenings, and the hidden pressure of marriage and childbearing, Jasmine has no regrets about her genetic testing. "It's better to know what's coming or what could be. My one sister to this day has not gotten tested and refuses to do so. She'd rather not know. She doesn't want to worry about it or go through life counting down the moments to which she'd get cancer," she says leaning forward, "But I wanted to know so I wouldn't end up like my grandma and my great aunts. They died because there wasn't testing and preventive care back then. They didn't have the opportunities to find out like we do. I tested to make sure it doesn't happen to myself."
"Though it's been explained there is a chance I won't get cancer, that's all I've ever seen in my family. People get cancer and they die. There has never been a time when a person who had cancer lived, so I thought initially it was my fate at the time," Jasmine says downhearted. Genetic testing and early screening has made Jasmine realize her fate could very well be different, adding, "Having a faith based system and great family support has helped me a lot." Jasmine advises others at risk to take precautions, have genetic testing, and be monitored as much as possible. "Yes," she says shaking her head, "it's scary but your life isn't over so don't waste time living like it is. Find a source of peace in whatever you wish and have fun. I am now at peace, and I don't worry about cancer as much as I used to. I just do what I need to do and go on with my life." With that Jasmine leans back in her chair quietly exhaling a sigh of relief.