Pandora's DNA

Starred review from August 25, 2014
Stark (Leaving Mundania) unveils her family’s arduous cancer history with her own heartbreaking discovery of and treatment for a gene mutation that put her squarely on her stricken relatives’ frightening path. Cancer haunts Stark’s maternal lineage; she, her mother, and her aunt share “a certain mutation on our BRCA1 gene.” The “feeling that life is guaranteed only until the date of your mother’s first cancer diagnosis has infected other relatives as well,” she notes, including a great-aunt and two cousins. Their diagnoses, treatments, and outcomes fuel Stark’s engrossing exploration of the science of breast cancer, from the discovery of the BRCA1 gene in the mid-’90s to the legal fight over the diagnosis of a BRCA1 mutation. Moreover, Stark’s relatives dealt with breast cancer in the 1940s and 1950s when “social norms made it even harder” to talk about the disease. “Though none of us would know cancer, we would know the curse of fear,” she writes. For Stark, this also entailed a prophylactic mastectomy in her late 20s and the likely removal of her ovaries in coming years. With her remarkable memoir, Stark gives us medical history and personal testament that intelligently balances hard-edged science with boundless hope. Agent: Dystel & Goderich Literary Management.

Starred review from September 15, 2014
Freelance journalist and author Stark (Leaving Mundania: Inside the Transformative World of Live Action Role-Playing Games, 2012) has both fully researched her subject and poured out her heart in this blend of history, science and memoir. As the family tree in the book's front shows, cancer, and the threat of cancer, has plagued the author's family for generations. When she underwent genetic testing and learned that she had inherited her mother's BRCA1 mutation, which greatly raises the risks of both breast and ovarian cancers, Stark was well-aware of its significance. After coping with the hassles of close monitoring, she made the tough decision to have a preventative double mastectomy while still in her 20s. The story of that decision and all that follows from it is enough to make a book in itself, but the author goes much further. She provides a capsule history of breast surgery, from the pre-anesthesia days through William Halsted's now-outdated radical mastectomy to today's less disfiguring procedures, and she profiles geneticist Mary-Claire King, whose work led to the identification of the BRCA genes. In her discussion of the controversial issue of gene patenting, Stark presents all sides of the argument. Most impressive, she tells her personal story with considerable frankness and flashes of humor. The weekend before her breast-removal surgery, she and her husband threw a "goodbye to boobs" party for their closest friends. That lighthearted moment is followed by less sunny ones as Stark was forced to adjust to her new body and face the questions of whether to bear children and possibly pass on the gene mutation and deciding when to have her threatened ovaries removed. The book is a must-read for women questioning whether to be tested for the BRCA mutations and for women considering their options after testing positive. A gutsy, deeply revealing account that more than fulfills the promise of the subtitle.

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Starred review from September 1, 2014

Author/journalist Stark's cancer family tree would send most people running for cover and a huge hole into which to crawl. We're talking great-grandparents, grandparents, aunts, and cousins. Her mother has had several types of cancer and recurrences. Stark presents a fascinating history of cancer, especially breast and ovarian, with her relatives as a frame of reference. Once genomic testing became available, it made the picture simultaneously clearer and more ominous. What's a gal to do? VERDICT With incisive wit and a reporter's poke at the jugular, Stark delivers the goods on this disease that though now much discussed still creates anguish in most of us. For every collection.

Copyright 2014 Library Journal, LLC Used with permission.

October 1, 2014
Because Stark carries the BRCA gene mutation that greatly increases the risk of breast cancer, she decided to get a prophylactic mastectomy and implants. A journalist, she expertly weaves her own story into a thorough history of breasts and breast cancer. She talks about famous sufferers (Hitler's mom and First Lady Betty Ford), size (between the Middle Ages and the Renaissance, the ideal breasts were small, white, and wide apart), mammography (ironically, its radiation may increase the risk of cancer), reconstruction, and injectable fillers (paraffin in the late 1800s and loose silicone in the 1960s). Stark is eccentric but never dull. She planned a good-bye to boobs party, then chooses to increase her bust line, which she seems to regret: I might have been young, once, before this ordeal, but now I feel old, trapped forever in a body with a youthful chest, the rest of me doomed to wilt and fade. Stark writes stylishly and entertainingly about an all-too common experience and in-the-news topic.(Reprinted with permission of Booklist, copyright 2014, American Library Association.)