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Pretty Is What Changes: Impossible Choices, The Breast Cancer Gene, and How I Defied My Destiny
A timely, affecting memoir from the front lines of medical When genetics can predict how we may die, how then do we decide how to live?
Eleven months after her mother succumbs to cancer, Jessica Queller has herself tested for the BRCA “breast cancer� gene mutation. The results come back positive, putting her at a terrifyingly elevated risk of developing breast cancer before the age of fifty and ovarian cancer in her lifetime. Thirty-four, unattached, and yearning for marriage and a family of her own, Queller faces an agonizing a lifetime of vigilant screenings and a commitment to fight the disease when caught, or its radical alternative—a prophylactic double mastectomy that would effectively restore life to her, even as it would challenge her most closely held beliefs about body image, identity, and sexuality.
Superbly informed and armed with surprising wit and style, Queller takes us on an odyssey from the frontiers of science to the private interiors of a woman’s life. Pretty Is What Changes is an absorbing account of how she reaches her courageous decision and its physical, emotional, and philosophical consequences. It is also an incredibly moving story of what we inherit from our parents and how we fashion it into the stuff of our own lives, of mothers and daughters and sisters, and of the sisterhood that forms when women are united in battle against a common enemy.
Without flinching, Jessica Queller answers a question we may one day face for If genes can map our fates and their dark knowledge is offered to us, will we willingly trade innocence for the information that could save our lives?
Eleven months after her mother succumbs to cancer, Jessica Queller has herself tested for the BRCA “breast cancer� gene mutation. The results come back positive, putting her at a terrifyingly elevated risk of developing breast cancer before the age of fifty and ovarian cancer in her lifetime. Thirty-four, unattached, and yearning for marriage and a family of her own, Queller faces an agonizing a lifetime of vigilant screenings and a commitment to fight the disease when caught, or its radical alternative—a prophylactic double mastectomy that would effectively restore life to her, even as it would challenge her most closely held beliefs about body image, identity, and sexuality.
Superbly informed and armed with surprising wit and style, Queller takes us on an odyssey from the frontiers of science to the private interiors of a woman’s life. Pretty Is What Changes is an absorbing account of how she reaches her courageous decision and its physical, emotional, and philosophical consequences. It is also an incredibly moving story of what we inherit from our parents and how we fashion it into the stuff of our own lives, of mothers and daughters and sisters, and of the sisterhood that forms when women are united in battle against a common enemy.
Without flinching, Jessica Queller answers a question we may one day face for If genes can map our fates and their dark knowledge is offered to us, will we willingly trade innocence for the information that could save our lives?
256 pages, Hardcover
First published April 1, 2008
19 people are currently reading
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Displaying 1 - 30 of 143 reviews
July 13, 2011
I was excited about this book for two reasons. One, it's authored by a writer from Gilmore Girls, one of the most well-written television shows ever aired. Two, it's about a 30-something New Yorker who faces her risk of breast cancer, which like me, is around 90%. I wanted the combination of BRCA information, personal anecdote, and good writing to help me sort through a few things in my own life.
I was disappointed by this book for two reasons. One, the writing was not what one would expect of someone who writes for a living. It was subpar, at best, and cliche at worst. While the story was moving, it had nearly nothing to do with the writer's ability to tell it.
Second, I couldn't get myself to like -- and thus identify -- with Jessica. This is not her fault, but her editor's. She spoke often of how many friends she has and how beautiful they find her and how many weekends she spent in the Hamptons and how many stunning Hollywood execs she dated. She writes about her friendship with Calista Flockhart in a way that only indicates that she wants you to know she is friends with Calista Flockhart. If she had made these points more subtly, it would not have overshadowed the sad, traumatic death of her mother; her brave choice to remove her breasts at 36; her incredible story of living with a gene that threatens to kill you in truly ugly ways -- and having the opportunity, thanks to advances in biomedicine and technology, to stop it.
Ultimately, the book had the opposite effect of what I had hoped-- a cathartic way to figure out what having the BRCA gene means in my own life. Instead, I put the book down wondering if I am too nonchalant about the whole thing. If, like her, I should tell everyone I know, talk to everyone who has ever had breast cancer, and get a baby in the oven as quickly as possible before taken out all of my organs.
But whatever failings I perceive the book to have are only because I had such personal, unattainable expectations for it. On its own merits, this is probably an interesting read for those who want to know more about the BRCA gene, a woman's new right to choose, and a coming of age story for those of us approaching our 30s. It also has some great stories from the Gilmore Girls set. But if you, like me, need to see yourself reflected back in the pages of this book, you're going to need a house in the Hamptons and Calista Flockhart on speed dial.
I was disappointed by this book for two reasons. One, the writing was not what one would expect of someone who writes for a living. It was subpar, at best, and cliche at worst. While the story was moving, it had nearly nothing to do with the writer's ability to tell it.
Second, I couldn't get myself to like -- and thus identify -- with Jessica. This is not her fault, but her editor's. She spoke often of how many friends she has and how beautiful they find her and how many weekends she spent in the Hamptons and how many stunning Hollywood execs she dated. She writes about her friendship with Calista Flockhart in a way that only indicates that she wants you to know she is friends with Calista Flockhart. If she had made these points more subtly, it would not have overshadowed the sad, traumatic death of her mother; her brave choice to remove her breasts at 36; her incredible story of living with a gene that threatens to kill you in truly ugly ways -- and having the opportunity, thanks to advances in biomedicine and technology, to stop it.
Ultimately, the book had the opposite effect of what I had hoped-- a cathartic way to figure out what having the BRCA gene means in my own life. Instead, I put the book down wondering if I am too nonchalant about the whole thing. If, like her, I should tell everyone I know, talk to everyone who has ever had breast cancer, and get a baby in the oven as quickly as possible before taken out all of my organs.
But whatever failings I perceive the book to have are only because I had such personal, unattainable expectations for it. On its own merits, this is probably an interesting read for those who want to know more about the BRCA gene, a woman's new right to choose, and a coming of age story for those of us approaching our 30s. It also has some great stories from the Gilmore Girls set. But if you, like me, need to see yourself reflected back in the pages of this book, you're going to need a house in the Hamptons and Calista Flockhart on speed dial.
October 8, 2021
This book took me by surprise. Looking back, I'm not sure what I was expecting, but it was a deeply moving, informative read. It is incredibly real and vulnerable, and the author strikes a perfect balance between telling her story in terms of the science as well as her personal journey with the BRCA mutation and life in general. I appreciate that she doesn't pull any punches, which made it an emotionally difficult read for me, but I found that valuable. Definitely recommend for anyone who wants to understand more about BRCA mutations, prophylactic mastectomy, or breast cancer in general.
October 24, 2017
This book is incredible. I am a breast cancer previvor 6 months ago. I’ve struggled to find a support group of brca patients here in the middle east and had to look for intentional patients in the west to give me patient to patient advice. I related to sooo many points that Jessica mentioned and highlighted at least 10 quotation that were emotional to me. Although I am a mother and I’m married but I realize that Jessica’s decision is more stressful to her. She is inspirational and strong and I am grateful for reading this book.
Today we hosted a book club meeting in Jeddah ,Saudi Arabia. The meeting was a Hereditary breast and Ovarian Cancer Awareness Day. Everyone read your book Jessica and my Obstetrician Oncologist attended and gave a presentation about BRCA. You helped me educate 15 women today. They aren’t gene carriers or survivors, but they understood every word you said and were so touched by your book.
Highly recommended for any female!
Today we hosted a book club meeting in Jeddah ,Saudi Arabia. The meeting was a Hereditary breast and Ovarian Cancer Awareness Day. Everyone read your book Jessica and my Obstetrician Oncologist attended and gave a presentation about BRCA. You helped me educate 15 women today. They aren’t gene carriers or survivors, but they understood every word you said and were so touched by your book.
Highly recommended for any female!
May 29, 2008
I think I was expecting too much from this book. I'm fascinated by the idea that someone would chop off their boobs to prevent cancer, but this book falls a little short of those expectations - which is sad because she did write for the Gilmore Girls, which was a well-written show....
The beginning chronicles her mother's fight against cancer, to set up the tension when she learns of her BRCA1 mutation. But it never gives the caliber of the information that I want.... but then again it's a fuzzy area, and Queller is one of the first wave of "previvors" that has chosen this route.... i guess in 10 years we'll know if this is a good idea or not....
The beginning chronicles her mother's fight against cancer, to set up the tension when she learns of her BRCA1 mutation. But it never gives the caliber of the information that I want.... but then again it's a fuzzy area, and Queller is one of the first wave of "previvors" that has chosen this route.... i guess in 10 years we'll know if this is a good idea or not....
May 8, 2008
I loved this book. I loved her style of writing, its kind of a no-nonsense approach. It was obvious that she lived a very privileged life and I thought she did a good job of incorporating it, but not flaunting it. As a mother and someone who saw her sister battle cancer, I know exactly what my decision would be if I tested positive for the BRCA mutation. However, I can empathize with her situation as a single woman with no children. I commend her for taking her destiny into her own hands.
April 28, 2008
Jessica Queller has composed an extremely well written book. It is filled with educational facts and inspiring personal accounts regarding a very serious issue - breast cancer. The book was not as emotional as I expected it to be which, to me, illustrated that she is such a strong woman that it carried over into her writing. This is a great book club read as it brings up many questions that will stimulate discussion. This book has opened a whole new literary world for Jessica Queller, that goes far beyond writing teen dramas.
June 5, 2008
Although the somewhat simplistic writing style left something to be desired from the critic in me, this autobiographical book about Jessica Queller's struggle with learning she has the "breast cancer gene" and deciding how to proceed is as riveting as if you were reading a novel about your own girlfriend. I especially enjoyed her dating stories, and the intensity brought from the fact that she was single, in her 30s, and wanting to have a family.
November 14, 2024
I ended this book having gained the information and perspective I was looking for when I picked it up. Her experience was well told, although I don't think I would choose to hang out with her in real life. I appreciate her openness and honesty, and I'm grateful I found her story.
June 27, 2016
I find it difficult to write an honest review for this book. I always do, when it comes to memoirs that I don't particularly care for, because who am I to judge a person for his or her thoughts or choices in life?
The first part of the book is very sad and poignant as Queller watches her mother die of ovarian cancer after beating breast cancer. Cancer is such an ugly way to die, and it's so unfair. And to lose your mother when she's only 54... I cannot even conceive. My mom is nearly 65 and I feel like we have so many more years together (knock on wood). I feel as though this part of the book was the best, written with so much feeling and love for a woman with whom she had had a difficult relationship with.
So many times did I want to shake Ms Queller by the shoulders and tell her, "Get the mastectomy already! Your breasts do not matter but your life does!" It's true that I have never had such a horrifying decision to make, but then neither have I had to watch my mother die of cancer like Queller did. For me, watching someone die of cancer, it would have been a no-brainer for me to have the elective mastectomy. But then, I've always considered my breasts as just two bags of fat on my chest. If I knew they wanted to kill me, I'd have a mastectomy so fast they wouldn't know what happened.
It was also disheartening for me to read how upset she was to lose her breasts because apparently that's what made her a woman, and without breasts, how was she going to land a man and have babies?! I even asked my husband, if I had had a mastectomy before we met, would he still find me attractive? He listed off the reasons he loved me, so many more before my physical appearance (though I do understand that sexual attraction is key). I feel as though if Queller found a man to love her for her, he would naturally find her body sexy, even if she hadn't chosen to reconstruct her breasts. It's not just about what it looks like.
Perhaps I'm viewing this from an odd set of circumstances. I have a dear friend who underwent genetic counseling because her father and many of his cousins carry the gene for stomach cancer, and they had all decided to remove their stomach to prevent cancer. My friend, once she found out she too was a carrier, underwent the surgery and now lives a full life without a stomach -- and this is a woman who lives for food! For her, it was more important to be around as long as possible for her husband and her two small children than it was to keep the stomach that would one day try to kill her. There was very little deliberation or waffling on the subject for her; her health was too important.
Also I don't particularly understand the need to have one's own genetic children. My brother isn't genetically related to me but I couldn't love him any more if we did share genes. My parents adore him and he absolutely completed our family. I don't myself understand why Queller wouldn't choose to adopt, especially because her own genetic children would have a 50/50 chance of carrying the same devastating gene (even though she's considering implanting only those embryos free of the gene, but that's an interesting topic of its own).
Had this book been more about the pros and cons of a prophylactic mastectomy from a medical standpoint, and less about her diminishing chances in the dating world, I probably would have enjoyed this book more. I do admire her for finally removing her breasts and going through all that pain and misery; it was definitely the correct decision. I hope she enjoys many healthy, cancer-free years ahead of her.
The first part of the book is very sad and poignant as Queller watches her mother die of ovarian cancer after beating breast cancer. Cancer is such an ugly way to die, and it's so unfair. And to lose your mother when she's only 54... I cannot even conceive. My mom is nearly 65 and I feel like we have so many more years together (knock on wood). I feel as though this part of the book was the best, written with so much feeling and love for a woman with whom she had had a difficult relationship with.
So many times did I want to shake Ms Queller by the shoulders and tell her, "Get the mastectomy already! Your breasts do not matter but your life does!" It's true that I have never had such a horrifying decision to make, but then neither have I had to watch my mother die of cancer like Queller did. For me, watching someone die of cancer, it would have been a no-brainer for me to have the elective mastectomy. But then, I've always considered my breasts as just two bags of fat on my chest. If I knew they wanted to kill me, I'd have a mastectomy so fast they wouldn't know what happened.
It was also disheartening for me to read how upset she was to lose her breasts because apparently that's what made her a woman, and without breasts, how was she going to land a man and have babies?! I even asked my husband, if I had had a mastectomy before we met, would he still find me attractive? He listed off the reasons he loved me, so many more before my physical appearance (though I do understand that sexual attraction is key). I feel as though if Queller found a man to love her for her, he would naturally find her body sexy, even if she hadn't chosen to reconstruct her breasts. It's not just about what it looks like.
Perhaps I'm viewing this from an odd set of circumstances. I have a dear friend who underwent genetic counseling because her father and many of his cousins carry the gene for stomach cancer, and they had all decided to remove their stomach to prevent cancer. My friend, once she found out she too was a carrier, underwent the surgery and now lives a full life without a stomach -- and this is a woman who lives for food! For her, it was more important to be around as long as possible for her husband and her two small children than it was to keep the stomach that would one day try to kill her. There was very little deliberation or waffling on the subject for her; her health was too important.
Also I don't particularly understand the need to have one's own genetic children. My brother isn't genetically related to me but I couldn't love him any more if we did share genes. My parents adore him and he absolutely completed our family. I don't myself understand why Queller wouldn't choose to adopt, especially because her own genetic children would have a 50/50 chance of carrying the same devastating gene (even though she's considering implanting only those embryos free of the gene, but that's an interesting topic of its own).
Had this book been more about the pros and cons of a prophylactic mastectomy from a medical standpoint, and less about her diminishing chances in the dating world, I probably would have enjoyed this book more. I do admire her for finally removing her breasts and going through all that pain and misery; it was definitely the correct decision. I hope she enjoys many healthy, cancer-free years ahead of her.
October 31, 2008
I am a 32 year old and a 1 year Breast Cancer Survivor so this book hit close to home for me. I had to take this book chapter by chapter and in stages to read. It took me awhile to read all of this because it was very emotional for me. My Mom passed away from Ovarian Cancer , at the age of 54, just like the author's mother did & I could relate with the stories she shared about her mother. It was pretty eerie reading through the book and remembering my mother going through the same stages as her mother. I never thought somebody else would ever be able to relate to what I had gone through. Personally having the BRCA1 gene really touched upon my feelings - mainly the decisions that I have had to make over the last year. Jessica Queller is a wonderful author and really brings to the forefront the issues that are involved with this gene mutation. Early detection and proactive steps are the most important lessons in having the BRCA1 and in this book. Bravo Jessica Queller! You are a hero and a brave soul to reach out to other people who walk a similar path as you! Thank you for sharing your story. It gives me hope and courage.
April 3, 2020
This book is a really poignant look into the change that happens in a person with something as all-encompassing as a genetic mutation that increases your risk of cancer. As a genetic counselor, I'm so glad to have read this book because I think it gives not only insight into what a patient may go through, but also reminds us of the humanity that exists all around us. It's not a literary masterpiece, so if you are expecting that I think you will be disappointed. I recommend going into this book with an open mind and treating it like a conversation with a friend - then it becomes wonderful. It is written in a very easy, digestible manner even though the content is heavy. I really recommend this book to anyone who wants to learn and understand more about the experience of women who go through similar diagnoses.
February 25, 2009
The subject matter of this book made for a difficult read, but I was really curious about the author's journey. After watching her mother die of cancer, the author took a test to find out that she was positive for a mutated gene that caused an increase in her chance of getting breast cancer. She had to make a difficult decision as to have preventative surgery to lower her risk. It was definitely one of those books where I wanted to cry at certain points, just to let off some of the pressure--I can only imagine what the actual situation was like! This is probably an important book for women to read, but enter into it knowing what you'll be reading about.
June 3, 2008
Really great idea for a book, but I wish I could rewrite whole chapters for the author and ship them back to her in a box marked, "JUST A SUGGESTION."
May 22, 2019
2019 PopSugar Reading Challenge - A book with a zodiac sign or astrology term in the title (Cancer).
After watching her mother win her battle with breast cancer, only to die from ovarian cancer, Jessica, a Hollywood screenwriter, chose to get tested for the BRCA gene mutation. When tests showed a positive result for the BRCA-1 gene mutation, which significantly increased her chances of breast and ovarian cancer, she felt her life spin out of control. As a woman in her thirties, who still dreamed of love and children, she was forced to make a difficult decision - continue what would become a lifetime of vigilant screenings in hopes of finding the cancer early if she was diagnosed with breast or ovarian cancer, or decide to significantly reduce her risks by having a double mastectomy and oophorectomy. Choosing to have the preventative surgeries was a double-edged sword though - she would no longer have the threat of cancer hanging over her head, but it would destroy her hopes of having children and breastfeeding. It would also challenge her feelings about sexuality and the way she felt about her body, something ingrained into her by her Hollywood friends and her fashion conscious mother. And, if she choose to have a child, how far would she go with genetic testing to guarantee a child who would not carry this gene? With all of these questions, Jessica spends months researching her options, and talking with women who have already made their decision, or are themselves in the process of making this life altering decision. A very thought provoking story. What would you do if you were told that your genes put you at high risk for a deadly disease?
After watching her mother win her battle with breast cancer, only to die from ovarian cancer, Jessica, a Hollywood screenwriter, chose to get tested for the BRCA gene mutation. When tests showed a positive result for the BRCA-1 gene mutation, which significantly increased her chances of breast and ovarian cancer, she felt her life spin out of control. As a woman in her thirties, who still dreamed of love and children, she was forced to make a difficult decision - continue what would become a lifetime of vigilant screenings in hopes of finding the cancer early if she was diagnosed with breast or ovarian cancer, or decide to significantly reduce her risks by having a double mastectomy and oophorectomy. Choosing to have the preventative surgeries was a double-edged sword though - she would no longer have the threat of cancer hanging over her head, but it would destroy her hopes of having children and breastfeeding. It would also challenge her feelings about sexuality and the way she felt about her body, something ingrained into her by her Hollywood friends and her fashion conscious mother. And, if she choose to have a child, how far would she go with genetic testing to guarantee a child who would not carry this gene? With all of these questions, Jessica spends months researching her options, and talking with women who have already made their decision, or are themselves in the process of making this life altering decision. A very thought provoking story. What would you do if you were told that your genes put you at high risk for a deadly disease?
March 22, 2018
What would YOU do if your mother recently died from ovarian cancer (and previously had breast cancer) and you found out that, because of a gene you carried, there was an alarmingly elevated risk of developing breast cancer before the age of fifty; that there was an up to 87 percent chance you too would develop breast cancer and an up to 44 percent chance of developing ovarian cancer? Would you forge ahead and live your best life, even with this dark, high risk shadow over your head? Or would you take a preemptive, science-based approach by surgically removing the body parts most at risk for becoming riddled with disease?
Gilmore Girls writer Jessica Queller shares how–single, 34, with no kids–she faced this gut-wrenching dilemma, while her 'biological clock' is clanging. Analyzing her options from the heart and from the head, Queller interviews doctors and researches the latest in medicine, while also getting guidance and support from other women faced with the same choice, in order make the decision that's best for her. Queller also gives an incredibly moving tribute to family that supports you until the bitter end, to the complex and complicated beauty of the mother-daughter bond, and to the nurturing strength of sisterhood.
Gilmore Girls writer Jessica Queller shares how–single, 34, with no kids–she faced this gut-wrenching dilemma, while her 'biological clock' is clanging. Analyzing her options from the heart and from the head, Queller interviews doctors and researches the latest in medicine, while also getting guidance and support from other women faced with the same choice, in order make the decision that's best for her. Queller also gives an incredibly moving tribute to family that supports you until the bitter end, to the complex and complicated beauty of the mother-daughter bond, and to the nurturing strength of sisterhood.
December 6, 2022
I valued this book for the emotional perspective of an individual with a BRCA1 mutation it provides. I had difficulty relating to the author throughout her journey, but that was one of the things I liked best about this book. I know I will encounter many patients who have perspectives more similar to those of Jessica Queller, and it was valuable to have this window into that perspective. As Jessica Queller and her family are very wealthy and white, the financial difficulties and racial disparities that many patients experience were not highlighted in this story, but some of the emotional hardship (and especially the experience many "previvors" have of watching a family member go through breast/ovarian cancer) were valuable.
October 28, 2018
I had to read this book for a genetic counseling class I am taking and would recommend it to pretty much anyone. Jessica Queller is strong in her writing and vulnerability as she takes on hard personal subjects of femininity, body image, genetic testing and the emotions that come with that. The central thought I read from this book was the community she formed throughout the process. I look forward to reading her Op-Ed piece in the New York Times and following her story further.
July 2, 2017
Jessica is an excellent writer and it's a compelling read. She is faced with terrible choices regarding her seemingly healthy body. The book does drag a bit, but I'd definitely recommend it for any woman faced with this disease.
April 20, 2018
A sobering look at a contentious mother-daughter relationship and the difficult choices that face women identified as carrying BRCA gene mutation. This memoir was written ten years ago, but the story continues to underscores the importance of getting counseling prior to undergoing genetic testing.
October 11, 2018
Must read for anyone who has breasts!
Painfully moving and real. So worth it. The power of endurance this woman and those mentioned within is inspiring. There is much critical info as well
Painfully moving and real. So worth it. The power of endurance this woman and those mentioned within is inspiring. There is much critical info as well
December 25, 2020
A surprisingly personal and intimate memoir. I was expecting this book to be scientific and focused on breast cancer, but was pleasantly surprised at how the author chose to elaborate on many aspects of her personal life. Queller’s focus on relationships reminds the reader that breast cancer and the BRCA gene influences, but does not define, a person. She also goes into depth exploring concepts of privacy and self-worth.
January 11, 2021
A memoir. Well written and informative with an extremely challenging decision.
November 13, 2021
I really enjoyed this book. It was very informative and a good story. Interesting and entertaining. I would recommend it to anyone dealing with breast cancer or who has the gene.
November 19, 2021
I had a hard time putting this memoir down.
February 27, 2024
This book was extremely inspiring while at the same time being witty and full of humour and stories of love and womanhood. Bravo!
May 31, 2009
This book touched me very deeply and I was overwhelmed by how open Jessica Queller was with her very personal experience. I'm still kind of reeling from it.
Jessica Queller was a 35 year old writer for the hit TV show Gilmore Girls when she was struck a mighty blow -- she tested positive for the BRCA-1 gene mutation, which meant she had an 87% chance of getting breast cancer and a 44% chance of getting ovarian cancer by age 50. She faced the very personal decision -- prevent the cancer by having a prophylactic bilateral mastectomy and oompherectomy or undergo aggressive surveillance for cancer every 6 months for the rest of her life.
Jessica and her sister Danielle, along with their father Fred, helped their mother fight breast cancer and then helplessly watched as their mother Stephanie, died from ovarian cancer. Jessica was prompted by a doctor cousin to go ahead and get tested for the gene mutation that would indicate the possibility of breast cancer. When she tested positive for BRCA-1 she was overwhelmed. Jessica began a lengthy research adventure to learn her options as well as gain strength from friends and family as she determined what to do with this new information.
At the time Jessica found out she was positive, she was single and had no children. The idea of removing her breasts and ovaries was very concerning for her -- what man would want a woman who had no breasts and no ovaries? Jessica began meeting other women who had either tested positive or were in the middle of fighting their own breast cancer. She made her decision, have the prophylactic bilateral mastectomy and eventually have the oompherectomy (but first have a child or 2 -- even on her own -- before removing the ovaries). Jessica then wrote an Op-Ed piece that appeared in the New York Times about her mother's battles with cancer as well as her own pre-vivor battle and all the information she was able to find. She was met with an overwhelming response from women who wished her luck and felt great sympathy for her but were also amazed by the decision she had made. The decision to have the mastectomy turns out to be a good one when the doctor tells her she did have pre-cancer cells in her breast tissues. At the time she wrote the book (2008), she was still single at age 37 but was looking forward to having a child before removing the ovaries.
Jessica's courage flows throughout the book. Her fears over a future without breasts and ovaries are very honest and upfront. She does not take on the issue of cancer and surgery lightly and she did a lot of research on her own as well as had many discussions with a lot of doctors before she made her decision. She also found a lot of support from her friends and family, as well as strangers she met over the course of her journey. To me, she is courageous and brave. I don't know if I would have the strength or the courage to forge that road. She found strength on the website FORCE and she grew into a whole new person. As a single woman, I sympathized with her dating dramas and her fears of what a man would think of her post-surgery; cancer has deeply affected my own family. I found myself crying throughout most of this book, some of those tears were out of sadness (the scene where Jessica and Danielle find out their mother has died was heartbreaking) and some tears of joy (the birth of Jessica's nephew).
This is a book I would recommend to anyone, it doesn't matter if your life has been touched by cancer or not, read this book. She is fresh and upfront and honest and I found that to be so wonderful. I rarely read memoirs, but this is one that I think I could read repeatedly and learn something new from it every time.
Jessica Queller was a 35 year old writer for the hit TV show Gilmore Girls when she was struck a mighty blow -- she tested positive for the BRCA-1 gene mutation, which meant she had an 87% chance of getting breast cancer and a 44% chance of getting ovarian cancer by age 50. She faced the very personal decision -- prevent the cancer by having a prophylactic bilateral mastectomy and oompherectomy or undergo aggressive surveillance for cancer every 6 months for the rest of her life.
Jessica and her sister Danielle, along with their father Fred, helped their mother fight breast cancer and then helplessly watched as their mother Stephanie, died from ovarian cancer. Jessica was prompted by a doctor cousin to go ahead and get tested for the gene mutation that would indicate the possibility of breast cancer. When she tested positive for BRCA-1 she was overwhelmed. Jessica began a lengthy research adventure to learn her options as well as gain strength from friends and family as she determined what to do with this new information.
At the time Jessica found out she was positive, she was single and had no children. The idea of removing her breasts and ovaries was very concerning for her -- what man would want a woman who had no breasts and no ovaries? Jessica began meeting other women who had either tested positive or were in the middle of fighting their own breast cancer. She made her decision, have the prophylactic bilateral mastectomy and eventually have the oompherectomy (but first have a child or 2 -- even on her own -- before removing the ovaries). Jessica then wrote an Op-Ed piece that appeared in the New York Times about her mother's battles with cancer as well as her own pre-vivor battle and all the information she was able to find. She was met with an overwhelming response from women who wished her luck and felt great sympathy for her but were also amazed by the decision she had made. The decision to have the mastectomy turns out to be a good one when the doctor tells her she did have pre-cancer cells in her breast tissues. At the time she wrote the book (2008), she was still single at age 37 but was looking forward to having a child before removing the ovaries.
Jessica's courage flows throughout the book. Her fears over a future without breasts and ovaries are very honest and upfront. She does not take on the issue of cancer and surgery lightly and she did a lot of research on her own as well as had many discussions with a lot of doctors before she made her decision. She also found a lot of support from her friends and family, as well as strangers she met over the course of her journey. To me, she is courageous and brave. I don't know if I would have the strength or the courage to forge that road. She found strength on the website FORCE and she grew into a whole new person. As a single woman, I sympathized with her dating dramas and her fears of what a man would think of her post-surgery; cancer has deeply affected my own family. I found myself crying throughout most of this book, some of those tears were out of sadness (the scene where Jessica and Danielle find out their mother has died was heartbreaking) and some tears of joy (the birth of Jessica's nephew).
This is a book I would recommend to anyone, it doesn't matter if your life has been touched by cancer or not, read this book. She is fresh and upfront and honest and I found that to be so wonderful. I rarely read memoirs, but this is one that I think I could read repeatedly and learn something new from it every time.
This entire review has been hidden because of spoilers.
February 2, 2015
This review has been crossposted from my blog at . Please head there for more in-depth reviews by me, which appear on a timely schedule.
Jessica has just received the news that she has a breast cancer gene that gives her an 80%+ chance of getting cancer. It's given to her in the baldest way possible, yet it will change her life radically.
I've got a vested interest in reading this novel. It's part fiction, part fact, and it hits close to home. I have a family history of reproductive cancers, and I've often considered whether I'll need a mastectomy.
Somehow I feel like her case was sort of divinely touched. She didn't have any huge problems with her reconstruction or anything else. It makes it a bit different that this is in the USA. I'd almost guarantee that Australian women, and women in other countries don't have access to the same resources.
I found it interesting that a writer would find then to write something like this. I certainly wish I had time! Writing is her thing and she uses it to promote awareness for this cancer, which is great.
I picked up this novel off of the super reduced stack at uni. The partner bought it for me, figuring I'd start it and not necessarily finish it. Or maybe he thought it was a present for my mother. Anyway I settled down to read it, and he couldn't believe I was taking the time to do it. Sometimes I like an easy to read fiction book! His argument was that the writer was some sort of person he'd read about or something. I don't follow movies or anything so I had no idea. I'm evaluating the movie purely on what I read.
Jessica spins the tale convincingly. I felt the changes in the protagonist and at times it was painful to read. I didn't necessarily empathise - I'd chop off my breasts in an instant if I knew I would reduce my chances of cancer. But then I'm not partner shopping either.
The title of the book was really well applicable to the contents. It's not that she feels ugly afterwards, she's got fantastic new breasts! But it's rooted in what her mother thought of her, so it's deeper than the reader would think.
Would I recommend this novel for breast cancer survivors? Maybe. Not in Australia though perhaps. I would recommend it for those women thinking about being tested for BRCA mutations or preventative surgery. Any more insight you can have is good insight.
Jessica has just received the news that she has a breast cancer gene that gives her an 80%+ chance of getting cancer. It's given to her in the baldest way possible, yet it will change her life radically.
I've got a vested interest in reading this novel. It's part fiction, part fact, and it hits close to home. I have a family history of reproductive cancers, and I've often considered whether I'll need a mastectomy.
Somehow I feel like her case was sort of divinely touched. She didn't have any huge problems with her reconstruction or anything else. It makes it a bit different that this is in the USA. I'd almost guarantee that Australian women, and women in other countries don't have access to the same resources.
I found it interesting that a writer would find then to write something like this. I certainly wish I had time! Writing is her thing and she uses it to promote awareness for this cancer, which is great.
I picked up this novel off of the super reduced stack at uni. The partner bought it for me, figuring I'd start it and not necessarily finish it. Or maybe he thought it was a present for my mother. Anyway I settled down to read it, and he couldn't believe I was taking the time to do it. Sometimes I like an easy to read fiction book! His argument was that the writer was some sort of person he'd read about or something. I don't follow movies or anything so I had no idea. I'm evaluating the movie purely on what I read.
Jessica spins the tale convincingly. I felt the changes in the protagonist and at times it was painful to read. I didn't necessarily empathise - I'd chop off my breasts in an instant if I knew I would reduce my chances of cancer. But then I'm not partner shopping either.
The title of the book was really well applicable to the contents. It's not that she feels ugly afterwards, she's got fantastic new breasts! But it's rooted in what her mother thought of her, so it's deeper than the reader would think.
Would I recommend this novel for breast cancer survivors? Maybe. Not in Australia though perhaps. I would recommend it for those women thinking about being tested for BRCA mutations or preventative surgery. Any more insight you can have is good insight.
June 9, 2008
I thought I would like this book better. It was written by a woman in her mid 30s, who discovered that she had the breast cancer gene. The book chronicles her life as she learns to accept the diagnosis and what it means, and through her decision to have prophylactic mastecomy and reconstruction. Because of my personal connection to the topic, I thought I would be really moved by the book (I heard about it on NPR a few weeks ago and couldn't wait to read it). But the author really bothered me. I couldn't relate to her at all - she is a wealthy woman from New York with a priveleged upbringing who had a great job in the entertainment industry that paid lots of money. The thought of getting the surgery never seemed to go to a very deep level (she talked a lot about her mother's ideal of feminine beauty). It all seemed shallow. A lot of her internal dialogue about whether or not to get the surgery focused on whether or not she could find a man who would want to be with her. I realize that this is a real concern, and maybe because I am with someone now I don't fully understand it. But in the grand scheme of things, that would be closer to the bottom of my list. It also bothered me that in her decision making, she never had to think about how to pay for the surgeries or how to support herself while she was recovering. It's great that she didn't have to worry about it, but that's not reality for the majority of people facing this decision, or any other major medical decision for that matter. Health insurance maximums or co-payments, and not being able to afford the time off of work without pay, make these decisions almost impossible to make for too many people.
BUT.... I do have a personal connection to this topic, which is what saved this book. It is just one more thing that I've read in my own decision making process, and I'm sure that when I get to the other side and have made a decision, that I will feel comfortable with that decision partly because of what I've read.
BUT.... I do have a personal connection to this topic, which is what saved this book. It is just one more thing that I've read in my own decision making process, and I'm sure that when I get to the other side and have made a decision, that I will feel comfortable with that decision partly because of what I've read.
April 28, 2009
Couldn't put the book down. Well-written and quickly paced.
It captures the uncertainty of dealing with breast cancer risk, BRCA testing, and the process of making decisions after a positive test in an honest way. The author didn't flinch from telling a three-dimensional story: the testing affected her romantic relationships, familial relationships and friendships. I appreciated how many different breast cancer and ovarian cancer stories are woven in (from women Jessica knows or meets during her journey). This gave the book some heft and context. I also like how the author touched issues related to surgical options for women with BRCA mutations, and not just about body image. Women in their 30s who test positive for BRCA have to make big decisions about breastfeeding and whether/when to have children.
This is not an exhaustive treatment of the issue of BRCA testing, nor is the author's personal privileged East Coast background (and current Hollywood life) going to resonate with all readers. Most working poor and middle-class women with breast cancer risk or BRCA mutations have their situation seriously complicated by finances and health insurance.
Ultimately, though, there are just two books with personal stories about BRCA genetic mutation testing (this and Blood Matters), and I recommend reading both. It's important to have a plurality of views and experiences around an issue where the patient drives so much of the decision-making process.
It captures the uncertainty of dealing with breast cancer risk, BRCA testing, and the process of making decisions after a positive test in an honest way. The author didn't flinch from telling a three-dimensional story: the testing affected her romantic relationships, familial relationships and friendships. I appreciated how many different breast cancer and ovarian cancer stories are woven in (from women Jessica knows or meets during her journey). This gave the book some heft and context. I also like how the author touched issues related to surgical options for women with BRCA mutations, and not just about body image. Women in their 30s who test positive for BRCA have to make big decisions about breastfeeding and whether/when to have children.
This is not an exhaustive treatment of the issue of BRCA testing, nor is the author's personal privileged East Coast background (and current Hollywood life) going to resonate with all readers. Most working poor and middle-class women with breast cancer risk or BRCA mutations have their situation seriously complicated by finances and health insurance.
Ultimately, though, there are just two books with personal stories about BRCA genetic mutation testing (this and Blood Matters), and I recommend reading both. It's important to have a plurality of views and experiences around an issue where the patient drives so much of the decision-making process.
January 11, 2010
PRETTY IS WHAT CHANGES by Jessica Queller chronicles the intertwining journey of Jessica's mother's death from complications of ovarian cancer, as the result of her first bout of breast cancer, and Jessica's discovery of inheriting the breast cancer gene and the difficult decisions she must face as the result of her knowledge.
When Jessica learns about the genetic test for the breast cancer gene, she decides to get tested to put her mind at ease. But she tests positive for BRCA-1 and her life spirals out of orbit. Now she is faced with a decision: to get tested regularly for breast cancer or have a preventative double mastectomy to eliminate 90% of the risk of developing cancer.
Although the topic is serious, the book is written with life-affirming warmth and gentleness. The tender mother-daughter relationship flowers with unexpected urgency. Jessica's own internal battle about what to do with her knowledge is heart-wrenching and poignant.
I never expected the magnetic pull of the book or the magical impact it would have on my life. Suddenly my desire to become healthier has taken on a new meaning and challenges I once thought insurmountable have instead become the proverbial molehill.
If you get a chance, please visit Jessica's website at
When Jessica learns about the genetic test for the breast cancer gene, she decides to get tested to put her mind at ease. But she tests positive for BRCA-1 and her life spirals out of orbit. Now she is faced with a decision: to get tested regularly for breast cancer or have a preventative double mastectomy to eliminate 90% of the risk of developing cancer.
Although the topic is serious, the book is written with life-affirming warmth and gentleness. The tender mother-daughter relationship flowers with unexpected urgency. Jessica's own internal battle about what to do with her knowledge is heart-wrenching and poignant.
I never expected the magnetic pull of the book or the magical impact it would have on my life. Suddenly my desire to become healthier has taken on a new meaning and challenges I once thought insurmountable have instead become the proverbial molehill.
If you get a chance, please visit Jessica's website at
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