Twisting Fate

Twisting Fate: My Journey with BRCA―from Breast Cancer Doctor to Patient and Back is aptly named. Not only is it the personal story of Dr. Pamela Munster, an oncologist, whose life takes a fated turn when she is diagnosed with cancer, but also brings to mind the colorful, twisted structure of DNA, a component of our genes.

Being a patient is often a life changing event for a doctor. Hearing Dr. Munster's viewpoint from the other side of the examining table was expected but I didn't realize how much more this book would have to offer. Dr. Munster's thorough and easy to understand explanation of her breast cancer from diagnosis to treatment is what makes this book a must. If you'd like to know more about the BRCA1 or BRAC2 gene mutations, I believe Twisting Fate will make the subject less confusing. In addition to her own experiences she shares many of her patient's case histories.

I highlighted many of Dr. Munster's thoughts as I read. I can not share them verbatim as the ARC I'm reading is possibly not the finished product. Dr. Munster expresses and experiences much the same questions and feelings any breast cancer patient would? “Why me?” proves to be a universal thought. She is frustrated by unhelpful information about the risk and prevention factors available to those trying to understand this disease. She struggles with decisions and outcomes of surgery, the staging and prognosis of her cancer. Knowing the statistics, even when there is a chance to be 97 percent cancer-free, is not as reassuring when it is your body that is being talked about. She questions whether she is making the right choices.

Dr. Munster is the first to admit that her breast cancer taught her a great deal, not only about the disease she thought she knew so much about, but also honed her skills in empathizing, caring and listening to the patients she treats. I hope doctors and patients alike will read Twisting Fate. It delivers valuable lessons and needed information.

Dr. Pamela Munster is an oncologist, professor, and researcher in San Francisco. In 2012, after treating patients with advanced breast cancer for twenty years, forty-eight year old Munster had a feeling that she should ask the nurse practitioner in her San Francisco clinic to schedule her for a mammogram. Normally, women under fifty with no family history are not screened for breast cancer. Pamela did not think about the fact that her father's mother once had breast cancer, probably because "no one ever talked about it." Munster's x-rays showed multiple irregularities, and she was advised to go for further testing.

"Twisting Fate," is an enlightening, poignant, and sensitive account of what the author experienced from her first inkling that something was wrong to the diagnosis that proved her instincts correct. Even as she and her physician/colleague, Dr. Michael Alvardo, were deciding how to proceed, Dr. Munster continued to see patients in her practice. Nowadays most surgeons do not perform radical mastectomies. Instead, they remove the abnormal areas and the patient then receives chemotherapy, radiation, and/or medication. In Pamela's case, a lumpectomy was not practical, because of the amount of breast tissue that would need to be excised. Her doctor stated that he must remove the breast containing the cancerous cells.

Munster lucidly and candidly describes not just what she went through, but also explains how decisions about surgery and breast reconstruction are made. Afterwards, also on a hunch, Munster took a test for the presence of the BRCA gene; those who carry it have a higher than average risk for breast and ovarian cancer. Her extensive medical knowledge, the love and support of her friends and family, and the compassionate care of a network of skilled practitioners helped Munster cope during this traumatic time. She needed to make crucial decisions, not just for her patients, but also for herself. "Twisting Fate" is a timely and informative exploration of a painful and complex subject. Her illness made Munster more mindful of the way she communicates with the frightened people who turn to her for expert care and reassurance. To her credit, Pamela Munster has established "a research center dedicated to learning about the BRCA gene and the risks of hereditary cancer" for men and women who carry the mutation. Dr. Munster is a courageous and thoughtful individual whose outstanding book will help readers become more knowledgeable and proactive about their health.

I decided to read this book because over twenty years ago, I was diagnosed with breast cancer. I was twenty-two at the time. There are many books about the medical aspects of cancer out there, but there aren't many whose authors share both medical and personal experience with a breast cancer diagnosis. Because I can't ever seem to step away from cancer support and advocacy (and believe me I've tried), I wanted to update my knowledge on medical protocol and terminology. I've now survived so long that many of the ways and methods that were part of my treatment are now antiquated and out of date.
Even though decades separate our diagnosis and our age at diagnosis, I found Dr. Munster's experience highly relatable. No moment in my life has felt more dissociatively surreal than the moment a surgeon looked at me and said, "I'm so sorry. You have cancer." From that moment on., life becomes a literal free-fall into a nightmare. I appreciated Dr. Munster's candor about this truth and her ability to share about the terror and grief of cancer without making herself or other survivors out to be victims. It's a fine line and one she handles gracefully.
The medical aspect is thorough without being overwhelming for the layperson. Of particular interest to me was the discussion of treatment evolution over time, which helps me relate my own experience to the experience of survivors who are currently undergoing treatment as well.
If you or a loved one has experienced cancer or is currently undergoing treatment, I highly recommend this book.

Munster does a masterful job of weaving together her personal breast cancer experience, stories from her patients and her family, and solid medical information. Four years out from my own diagnosis, this book helped me continue to put the disease in perspective. Every cancer patient is different, but for the person who responds to Munster's style, this is highly recommended.

I absolutely recommend this book for anyone who is interested in knowing about breast cancer and the different treatments available. Dr. Pamela Munster is an oncologist, professor, and researcher in San Francisco. in this poignant and sensitive book, Dr. Munster found out she had breast cancer. This book tells about her experience of taking care of her patients with breast cancer to having breast cancer herself.

This is a very informative and true account of this amazing woman and physician. A must read book.
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