World Ovarian Cancer Day occurs in early May, the same week as Mother’s Day. This year Jennifer Coken is observing both days with the publication of her new memoir, “When I Die, Take My Panties: Turning Your Darkest Moments into Your Greatest Gifts.” The book chronicles her journey through her mother’s diagnosis and 2011 death.
Coken, a political activist, stand-up comic, and life coach, aims to “find the funny” in everything. Yes, even in sickness and death. She uses humor to embrace what she calls “the ridiculousness of life.”
In an exclusive interview, Coken told The Forward, “Before my mother went to hospice, we went through her belongings. At one point, she’d held up a stack of thong underwear and said, ‘Here, take my panties. I’ve hardly worn them. They cost $20 a pair so they shouldn’t go to waste!’” Coken’s mother, Jan Storti, was 71-years-old when she died.
The book is a wake-up call to Jewish women over 40. Ovarian cancer is the fourth leading cause of cancer deaths among American women, and Jewish women are ten times more likely to get it due to the inherited Ashkenazi genes, BRCA1 and BRCA2.
Coken learned that the “faulty” genes occur more frequently in Ashkenazi Jews than in the general population:
“That’s because Ashkenazi Jews kept marrying each other! We were so geographically and culturally isolated for so many centuries that most Ashkenazi Jews can trace their ancestry back to a small number of members known as ‘founders.’ The genetic traits of these early Ashkenazi founders have been passed down through generations and the mutations of the BRCA genes increase the risk of ovarian and breast cancer.”
According to the Centers for Disease Control, 1 in 40 people of Ashkenazi Jewish ancestry have the gene mutation, compared to 1 in 800 people in the general population. “Not everyone who carries the gene mutation becomes stricken with the disease,” said Coken. “Lifestyle strategies can help with prevention and women need to learn to listen to their bodies.”
Coken shared an easy way to remember the telltale symptoms: “It’s the acronym BEAT: Bloating that’s persistent; Eating less but feeling fuller; Abdominal and/or back pain; Trouble with bladder or bowels.”
If these symptoms persist for two weeks, without any changes in diet, exercise, or lifestyle, Coken advised, “See your doctor and say, ‘Prove to me I don’t have ovarian cancer!’” But, that isn’t so easy to do, said Coken. There’s no actual test for ovarian cancer.
Women over 35 should get an annual rectovaginal exam. For those at high risk, or with an abnormal pelvic exam, your doctor can order a blood test for Cancer Antigen 125, although this isn’t always a marker for the disease. This was not an indicator for Coken’s mom.
“Your doctor can order a test for BRCA 1 and 2, and 11 to 40% of those who test positive may get ovarian cancer during their lifetime. Still, although this is the most significant indicator, it isn’t an actual test. If any of these are positive, a gynecological oncologist will do a CT scan and a biopsy,” said Coken.
“You want to know the hardest part about facing dying?” Coken asked. “Well, it’s facing dying.” She laughed. “It’s easy to be grateful when life is going well, but what do you do when life really sucks? Your mother is dying of cancer, the alarm clock didn’t go off, you step in dog vomit on the way to the shower, your kids are screaming at each other while breakfast is getting cold and you’ve barely seen your partner because you both work too much. Then, after you finally find your car keys, you get stuck in bumper-to-bumper traffic. After all that, your mother is still dying, but don’t be a victim. It is up to you to focus on ‘unsucking’ your life.”
She added, “Cursing your circumstances will leave you miserable and powerless. Put on your big girl panties and look within. Make a choice to stop fighting what is.”
She ended our talk with an analogous story about how trappers catch monkeys in the jungle. “First they cut a hole in a box big enough only for a monkey’s arm or a banana but not both. Then they put the bananas inside the box. A monkey comes along and grabs the banana but can’t get its hand and the banana, out of the box. The monkey will stay with its arm inside the box because it won’t let go of the banana, thus sacrificing its own freedom. Human beings are the same way. We’d rather sacrifice our own freedom and hold onto things that aren’t serving us instead of letting go. I had to learn to put down the banana.”
Dorri Olds is an award-winning writer whose work has appeared in The New York Times, Marie Claire, Woman’s Day and in several book anthologies. Olds is currently working on a memoir: “Running Amok: The Girl with 9 Lives.”