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Cancer Health Center

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I Had the Cancer No One Talks About

After extreme gynecological surgery, writer Darci Picoult dug deep and found a whole new level of intimacy.

WebMD Feature from "Redbook" Magazine

By Darci PicoultRedbook Magazine Logo

It began with a bump. The size of a pinhead. Innocuous. An innocuous little pinhead of a bump on my vulva. Given that my gynecologist said the bump was probably nothing, I laughed it off. Which, in turn, made my bump mad. Very mad. It wanted my attention. And so it grew. I smeared it in medicine. It grew more. More medicine. More growth. Hanukkah came. Then Christmas. A war raged between us. I went to battle in the middle of the night with salt baths and creams. Prayed for its departure as my children lit menorah candles and friends came and went, toasting the new year.

My resolution that year, 2009, was to go back to my gynecologist. I moved my feet slowly into the stirrups and pointed to the bump. Her face grew very still: "How did this happen?" An hour later I was getting blood drawn for surgery to remove it.

This all felt a little too familiar: My first gynecological surgery was at age 12, after I discovered a dark spot on one of my labia that turned out to be a pre-cancer. It was removed, along with part of my inner lip, and I was fine. But then the news came out that DES - an anti-miscarriage drug that my mother and millions of other pregnant women used to take - increased daughters' risk of vaginal cancer, and scrutiny on that part of my body increased. Twice-yearly Pap smears and frequent biopsies became a "normal" part of my teens.

The intense focus on that part of my anatomy provoked me to write a play called My Virginia (my childhood name for my vagina), which explores the effect of DES on mothers and daughters. Prior to its debut, a photographer who resembled James Taylor was sent to take my photo. After he snapped the picture, I smartly asked him out. A few years later, we married. Larry and I traveled across the world as I performed My Virginia. We met women and men who would talk about the most personal parts of their bodies and lives, which, in turn, fed our talks. This intimacy defined our marriage and our sex life. It's what made us us. In 1998 and 2002, that "us" expanded to include our two adopted daughters, Olivia and Mollie.

The night before my surgery, I tell the girls about the bump and that my doctor wants to remove it. We are seated around the dinner table, and Olivia, then almost 11, raises her fork, as if it were a hand, wanting to know the exact location of the spot. "It's next to my vagina, sweetheart," I say as if it were my toe or cheek or belly. "Can we please not talk about this now? I'm trying to eat," says Mollie, then 7. "But I want to see it," says Olivia, shooting Mollie a you-are-too-young-to-understand look. I swallow hard. "You don't need to see it, Sweet-" Mollie jumps up, rips off her pants, a sudden change of heart: "Show her where it is on me!" Larry speaks up, finally, asking Mollie to sit down and finish dinner. She pulls up her panties, returns to her seat, and slurps a noodle.

Although the word cancer has been part of Larry's and my dialogue since we first met, we are still shocked by the biopsy results we get 10 days later: The bump on my vulva was malignant. After consulting several doctors, we finally meet with an oncologist whose measured approach makes me feel a little less panicked. His voice is calm and direct: "I think it's a two-step process. First, there are several more areas of abnormal tissue that need to be biopsied. What we find will tell us what to do next. If any of the new lesions are malignant, then we're talking about a much more invasive operation. I don't want to touch the clitoris, but we may have to." The clitoris? I glance at his resident, a young woman, who stares quietly at me. As does Larry. "Whatever needs to be done, I'll do," I say, determined to be a warrior despite wanting to run from the room, a mix of fear and shame at my heels.

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