A Legacy of Cancer

Oct. 11, 2007 — -- Jennifer Davis is working her way through college with plans to become a doctor. On the outside, Davis seems like a normal 22-year-old. But inside, she lives with the knowledge that cancer has been stalking her family for generations.

It killed her great-grandmother, her grandmother and her grandmother's sister. And then her mother was diagnosed with cancer.

That's when the family learned about a genetic test that can predict the likelihood of getting breast cancer, a cancer that can strike both men and women. The existence of this test leads to a terrible, almost unimaginable decision -- whether to surgically remove parts of your body to prevent the cancer.

A Family Struggle

Davis' mother, Susan Davis, was diagnosed with breast cancer in 2003 and became the driving force encouraging members of her family to get tested for the gene, which took some courage. Experts estimate a million people carry the cancer risk mutation -- known as the BRCA gene -- and 97 percent don't know they have it. The stunning statistic in Davis' family is that eight out of nine members are positive for the gene.

But the Davis family is part of the 3 percent that do know. Both of Susan Davis' siblings, Linda Nicholson and Steve Halt, tested positive for the gene. And of the three siblings' children, six out of seven have the BRCA gene. (For a more detailed look, click here to view the family tree.)

"Nightline" talked to the family in two groups. The first group consisted of the more "senior" generation -- siblings Linda, Steve and Susan.

Then ABC News talked to their children, who range in age from 22 to 40 and in some cases have small children of their own. The family members were remarkably comfortable talking about their genetic bad luck.

"We're the mutant family, we all have mutated genes … so it's kind of our joke," said 40-year-old Jeff Garner. "I mean, what are you going to do?"

What are you going to do? The answer that doctors give young women like those "Nightline" met from this family could not be more serious. Women with the mutation have an 87 percent chance of developing breast cancer. They can reduce that number almost to zero, but there's a catch.

These women's doctors have recommended that in order to reduce their terribly high odds of getting cancer, they should have their uteruses, breasts and ovaries removed before the age of 35.

Difficult Decisions

It's a question they each must answer from the different places they are in life.

Gina Beavers, a 30-year-old mother said, "I've had half of it done. I've had my ovaries removed and my uterus removed. It was an easy decision for me. I have two children. Me and my husband had already decided there weren't going to be any more kids."

Beavers' sister Kristi Bruns, on the other hand, is taking the decision a little more slowly. She has one daughter and another child on the way, and is just starting to formulate her plan.

"My plan is to have a hysterectomy by the age of 30, and then I have not made … the other half of the decision as far as what I'm going to do with the other part of me," she said. "That's a much more difficult part to decide. It's external, not internal."

The prospect of a mastectomy for Bruns is much more daunting than the internal alterations of having her ovaries and uterus removed.

"I can see it. I can feel it. I see it every day," she said. "It's something I have to think about every day."

In terms of the psychological aspect of a mastectomy, sisters Gina Beavers and Kristi Bruns have different outlooks.

"Kristi was speaking about how there's an external part of her and I understand that, because, I mean, I think all women -- it's an external part of your body," said Beavers. "But I have a different take on it. They were given to us to feed our kids and I fed two. I don't know what else to say but that. I don't need them. They don't make me."

But in the process of the discussion, Beavers' cousin Garner brought a different perspective to the table: "You better talk to your husband a little bit."

In a way, there was some truth in that comment. What happens if your spouse opposes the surgery? Bruns' twin sister Amber Vickers has been married for only two months and has not yet had kids.

"I think [my husband] probably agrees," Vickers said. "If something arises, then take care of it and take those kind of steps."

But in terms of preemptive surgery? Vickers thought her husband would say no.

Not Just a Women's Issue

In the older generation of the family, sisters Susan Davis and Linda Nicholson decided -- after seeing their mother die of ovarian cancer -- to have their ovaries and uteruses removed. Even then, Davis eventually developed breast cancer.

For Nicholson, seeing her sister get breast cancer made up her mind. She took extreme measures, undergoing preemptive surgery to remove both her breasts.

"My sister was diagnosed," Nicholson explained. "By that time, I now had two first degree relatives who were diagnosed with breast and/or ovarian cancer, and that's when we said, together with a group of doctors, said, 'You know, I don't really have any options.'"

This is not just a female thing. A man who has the mutation -- like Davis and Nicholson's brother Steve Halt -- is also at a greater risk for cancer, including breast cancer. Halt put off getting tested for a long time.

"I was kind of in denial," Halt explained.

As a carrier of the BRCA gene, Halt is at greater risk for prostate cancer, colon cancer, pancreatic cancer and even breast cancer.

One member of the younger generation was not there on the day we talked with the family. Jennifer Davis' brother Richard Davis died earlier this year in a motorcycle accident. But Richard had the mutation, as does his cousin Jeff Garner.

The Next Generation

In a documentary called "In the Family," (Kartemquin Films) Richard Davis expressed that what he feared most was passing the gene down to future generations.

"If I had a female child, that's scary," he said. "My last relationship was with someone who was interested in kids. I definitely feel like [it] wasn't something she told me was a problem, but I definitely feel like it went through her mind and it was a concern of hers."

Richard's sister Jennifer still faces some of those very questions. Jennifer told "Nightline" that she will tell her next boyfriend that she has this cancer-causing gene, and she thinks that some men will be scared away.

"It's one of those things, you take it or leave it," Jennifer said.

Despite the high risk this family has for developing cancer, they are resigned to the way the genetic "dice" have fallen. There is not much self-pity among the group.

"What are you going to do?" Garner said. "You got what you got."

Of course it's not that simple, because there's a new generation coming along. The kids Jennifer said she hopes to have some day -- will they have the mutation? Maybe, but you can't test until someone is 18. That can be quite a long wait, with so much at stake, to find out if you got what you got.

To find out more about hereditary ovarian and breast cancer, visit FORCE (Facing Our Risk of Cancer Empowered).