BRCA & Beyond

What happens when your breasts go from simply being part of your body to something you’re suddenly afraid of?In the first episode of BRCA & Beyond’s Breast Cancer Awareness Month series, Marisa explores the emotional and psychological shift that can happen after a breast cancer diagnosis or after learning that you carry a genetic mutation or have a hereditary risk that significantly increases your chances of developing breast cancer.The medical experiences of a breast cancer survivor and a previvor are not the same. But there can be an emotional experience that overlaps: suddenly looking at your own body differently.For a survivor, it may feel like betrayal. How could this happen in my own body?For a previvor, the breasts may still be completely healthy, yet suddenly they can feel like something that needs to be watched, screened, managed, or even removed before cancer ever develops.In this episode, Marisa talks about what happens beneath the screenings, risk percentages, treatment plans, and surgical decisions. The shock of receiving life-changing news. The fear of your own body. Family cancer history suddenly becoming personal. The urge to immediately jump into research and planning. And the complicated reality of contemplating saying goodbye to your breasts.She also shares her own experience of learning she carried a BRCA2 mutation shortly after surviving colon cancer and why, looking back, she wishes she had given herself more time to emotionally process what she had learned before going straight into research and planning mode.Because the emotional impact of breast cancer and hereditary cancer risk does not begin with chemotherapy, radiation, a lumpectomy, or mastectomy.Sometimes it begins the moment you get the news.Whether you are newly diagnosed with breast cancer, living with an inherited cancer mutation, navigating high-risk breast cancer screening, considering preventive mastectomy, already in treatment, or living on the other side of surgery, this episode opens a conversation about the part of Breast Cancer Awareness Month that is not always visible beneath all the pink.This is Episode 1 of an eight-part BRCA & Beyond series exploring the emotional, mental, and psychosocial realities of breast cancer and breast cancer risk, from previvors to survivors, thrivers, and those living with metastatic disease.RESOURCESFORCE: Facing Our Risk of Cancer EmpoweredInformation, support, and gene specific resources for people and families affected by hereditary cancer, including inherited mutations such as BRCA1, BRCA2, PALB2, CHEK2, ATM, TP53, and others.National Cancer Institute: Genetic Testing for Inherited Cancer RiskEvidence based information about hereditary cancer syndromes, genetic testing, genetic counseling, and what genetic test results may mean for individuals and their families.National Cancer Institute: Breast Cancer Causes and Risk FactorsInformation about breast cancer risk, family history, and inherited genetic variants associated with increased breast cancer risk.American Cancer Society: Breast Cancer Survivorship and SupportResources for people living and after breast cancer, including emotional support, fear of recurrence, follow-up care, and survivorship resources.National Society of Genetic CounselorsInformation about genetic counseling and how genetic counselors can help individuals and families understand inherited cancer risk, genetic test results, and the decisions that can follow.If you are struggling emotionally after a cancer diagnosis, genetic test result, or major medical decision, consider talking with your healthcare team, genetic counselor, oncology social worker, therapist, or another mental health professional familiar with cancer and hereditary cancer risk.BRCA & Beyond shares personal experiences and educational information and is not a substitute for individualized medical advice, diagnosis, or treatment.

What happens emotionally after you learn you have an increased risk for cancer?A genetic test can give us important information about our health and our options. But living with that information is something else entirely.In this episode of BRCA & Beyond, Marisa sits down with Emily Epstein, LMSW, Genetic Social Worker with the Genetics and Personalized Cancer Prevention Program at Weill Cornell Medicine and NewYork-Presbyterian, to talk about the psychosocial side of hereditary cancer risk and the gap that can exist between receiving genetic information and actually learning how to live with it.They talk about the anxiety that can come with knowing your cancer risk, the emotional weight of ongoing surveillance and prevention decisions, navigating family dynamics, communicating genetic risk with relatives, survivor and previvor guilt, and why the emotional impact of hereditary cancer doesn’t end after the genetic counseling appointment.Emily also shares how her work provides long-term psychosocial support for people living with hereditary cancer risk and why this kind of care deserves a place alongside medical surveillance, genetic counseling, and cancer prevention.Emily is among the first clinicians in the country working specifically as a Genetic Social Worker in this capacity. At Weill Cornell’s Genetics and Personalized Cancer Prevention Program, she has helped build psychosocial services from the ground up, including individual counseling, care coordination, family testing support, and peer support. Before becoming a social worker, Emily worked as an actor on Broadway, national tours, and in voiceover.About the Genetics and Personalized Cancer Prevention ProgramThe Genetics and Personalized Cancer Prevention Program at Weill Cornell Medicine cares for individuals and families with hereditary cancer syndromes. The multidisciplinary program brings together genetic counseling, medical and surgical specialists, research, and social work to support cancer prevention and risk reduction over the long term.Innovations in Cancer Genetics SymposiumThe Innovations in Cancer Genetics Symposium takes place October 15–17, 2026, at Weill Cornell Medicine in New York City, presented with FORCE.Thursday, October 15 is Patient Wellness and Connection Day, a full day created for individuals living with hereditary cancer syndromes and their families. Emily organized the day alongside her colleague Laura Schneebaum. Emily will also present on Friday and moderate the patient panel closing the symposium on Saturday.Register at gpcpsymposium.com and use code THURSDAY50 for a discounted Thursday pass.Connect & Learn MoreEmily Epstein, LMSW:https://weillcornell.org/emily-epstein-lmswGenetics and Personalized Cancer Prevention Program:www.wcinyp.org/gpcpGPCP on Instagram: @WCMCancergeneticsEmily on Instagram: @emilyepsteinlmswResearch:Epstein ES, et al. Addressing the Psychosocial Gap in Hereditary Cancer Care. JCO Oncology Practice, 2026.https://ascopubs.org/doi/10.1200/OP-26-00307BRCA & Beyond is a hereditary cancer podcast exploring the medical, emotional, and psychosocial realities of living with inherited cancer risk. This podcast is for educational purposes only and is not a substitute for individualized medical or mental health care.

What does it really mean to be a previvor and live with hereditary cancer risk when you don’t have cancer, but your life has still been changed by it?In this special Previvor Day episode of BRCA & Beyond, Marisa talks about the parts of living with an inherited genetic mutation and hereditary cancer risk that often happen quietly, far beyond genetic testing results, cancer screenings, doctor appointments, and risk percentages.Because being a previvor can mean making life-changing decisions about a healthy body. It can mean choosing between increased surveillance and risk-reducing surgery, navigating fertility and family planning, worrying about what you may have passed on to your children, carrying the cancer history of generations before you, and learning how to live with information you can never unknow.And then there is the part we don’t talk about nearly enough: the emotional weight of it all.In this episode, Marisa gets personal about her own experience as a BRCA2 previvor and colon cancer survivor, including preventive surgery, body image, family history, guilt, grief, fear, gratitude, and the strange gray area of being neither a cancer patient nor completely untouched by cancer.She also explores why so many previvors struggle silently. When people around you are actively fighting cancer, it can feel like you don’t have the right to say this is hard. When a preventive surgery was technically your “choice,” it can feel like you shouldn’t grieve what it cost you.But being grateful for the opportunity to know your hereditary cancer risk and struggling with what that knowledge asks of you can both be true.This episode is for anyone navigating BRCA1, BRCA2, Lynch syndrome, PALB2, CHEK2, ATM, TP53, CDH1, or another hereditary cancer gene mutation. It’s for the person considering preventive surgery, living through high-risk cancer screening, waiting on genetic testing results, thinking about their children and family history, or simply trying to figure out where they belong in the hereditary cancer community.On Previvor Day, this is a reminder that you do not have to earn the right to find this difficult, and you do not have to carry it quietly.ResourcesFORCE: Facing Our Risk of Cancer EmpoweredHereditary cancer information, gene-specific resources, support programs, research opportunities, and resources for previvors and survivors:https://www.facingourrisk.org/National Hereditary Cancer Week & Previvor Day – FORCELearn more about National Previvor Day and Hereditary Cancer Week:https://www.facingourrisk.org/national-hereditary-cancer-weekFORCE Previvor ResourcesInformation and resources specifically for people living with an inherited cancer risk who have not been diagnosed with cancer:https://www.facingourrisk.org/previvor-resourcesFORCE Hereditary Cancer SupportFind peer navigation, previvor support groups, a helpline, community programs, and help finding hereditary cancer specialists:https://www.facingourrisk.org/supportNational Cancer Institute: Genetic Testing for Inherited Cancer RiskInformation about hereditary cancer syndromes, genetic testing, genetic counseling, and what genetic test results can mean for individuals and families:https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-testing-fact-sheetThis podcast is for educational and informational purposes only and is not a substitute for individualized medical advice. Decisions about genetic testing, cancer screening, surveillance, medications, or risk-reducing surgery should be made with qualified healthcare professionals who understand your personal and family history.

After a month of conversations about ovarian cancer risk, screening, fallopian tubes, fertility, preventive surgery, surgical menopause, HRT, and hereditary cancer, there’s one question left:What do we actually do with all of this information?In the finale of our Ovarian Cancer Awareness Month series, Marisa steps back to look at the bigger picture.Because learning your cancer risk is one thing. Understanding how that information applies to your body, your family history, your mutation, and your life is another.In this episode, we talk about how to find reliable medical information, understand the difference between established recommendations and emerging research, ask better questions during appointments, seek second opinions, and build a care team that can support more than just cancer prevention.We also talk about something that can easily get lost when discussing preventive surgery: what happens afterward. Who helps manage surgical menopause? When should conversations about HRT happen? What about sexual health, fertility, bone health, quality of life, and the emotional impact of making an irreversible medical decision?The goal of this series was never to tell you what decision to make.It was to help you understand the questions worth asking before you make it.Awareness gives us information. Advocacy helps us use it.RESOURCESFORCE: Facing Our Risk of Cancer EmpoweredHereditary cancer information, support, research updates, risk management information, and resources for people with inherited cancer risk.https://www.facingourrisk.org/National Cancer Institute: BRCA1 and BRCA2Information about BRCA1/2 cancer risks, genetic testing, ovarian cancer risk management, screening limitations, and risk-reducing surgery.https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheetNational Cancer Institute: Ovarian Cancer PreventionEvidence-based information about ovarian, fallopian tube, and primary peritoneal cancer risk and prevention.https://www.cancer.gov/types/ovarian/patient/ovarian-prevention-pdqAmerican College of Obstetricians and Gynecologists: Ovarian CancerPatient information about ovarian cancer risk, high-risk individuals, risk-reducing surgery, and surgical menopause.https://www.acog.org/womens-health/faqs/ovarian-cancerACOG: BRCA1 and BRCA2 MutationsInformation about BRCA-related cancer risk, preventive surgery, removal of the ovaries and fallopian tubes, and considerations surrounding surgical menopause.https://www.acog.org/womens-health/faqs/brca1-and-brca2-mutationsThe Menopause Society: Hormone TherapyEvidence-based patient education about hormone therapy, including different forms of estrogen and progestogen therapy, potential benefits and risks, and questions to discuss with a menopause-trained healthcare professional.https://menopause.org/patient-education/menopause-topics/hormone-therapyThe Menopause Society: Patient EducationAdditional resources on menopause symptoms, sexual health, nonhormonal treatment options, hormone therapy, and preparing for menopause care.https://menopause.org/patient-educationIf you are navigating hereditary ovarian cancer risk or considering risk-reducing surgery, talk with a genetic counselor, gynecologic oncologist, and other qualified healthcare professionals about recommendations specific to your genetic mutation, personal history, family history, age, and individual circumstances.This podcast is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment.

What does it actually mean when you're told you have an increased genetic risk for ovarian cancer?In this episode of BRCA & Beyond, Marisa is joined by Moffitt Cancer Center genetic counselors Stef Alastre and Tina Inman for a deeper look at hereditary ovarian cancer risk and what those risk numbers really mean for the individual person behind them.The conversation goes beyond BRCA1 and BRCA2 to explore other hereditary cancer genes associated with ovarian cancer risk, including Lynch syndrome, BRIP1, RAD51C and RAD51D. Stef and Tina explain why your specific gene matters, how risk can change with age, and why family history remains an important part of understanding genetic test results and making decisions about screening, prevention, and risk-reducing surgery.They also discuss how hereditary cancer can appear to move through families in unexpected ways, why a lack of ovarian or breast cancer in your family does not necessarily mean a mutation isn't important, what a variant of uncertain significance means, and why genetic counseling can help turn complicated percentages and test results into information that is actually useful for your care.The episode also introduces Moffitt Cancer Center's Project COURAGE, a community outreach initiative led by Tina that brings ovarian cancer education, hereditary cancer risk assessment, and genetic education directly into the community while helping address barriers to genetic counseling and testing.Whether you've already tested positive for a hereditary cancer mutation, have a strong family history of cancer, are considering genetic testing, or simply want to better understand ovarian cancer risk, this conversation offers a clearer look at how genetics, family history, and personalized care fit together.Resources Mentioned in This EpisodeMoffitt Cancer Center Project COURAGECommunity Ovarian Cancer Understanding through Risk Assessment and Genetic Education. Project COURAGE provides community education about ovarian cancer risk, family history, and hereditary cancer while helping connect people with genetic counseling and testing resources.FORCE: Facing Our Risk of Cancer EmpoweredExpert-reviewed, gene-specific hereditary cancer information, research resources, and support. FORCE also offers a Peer Navigation Program that can connect people with trained volunteers who share similar hereditary cancer experiences.National Comprehensive Cancer Network (NCCN)Clinical guidelines used by healthcare professionals for hereditary cancer risk assessment and management. Moffitt clinicians discuss using NCCN guidance alongside personal history, family history, and individualized clinical care.American Cancer SocietyCancer education and information, including resources related to ovarian cancer, genetic risk, and prevention.This podcast is for informational and educational purposes and does not replace individualized medical advice. Genetic test results and hereditary cancer risk should be reviewed with a qualified healthcare professional or genetic counselor.

Removing your ovaries can significantly reduce ovarian cancer risk for people with BRCA1 and BRCA2 mutations. But knowing what is medically recommended and feeling ready to actually do it are two very different things.In this deeply personal episode of BRCA & Beyond, Marisa shares where she is right now at 40, facing the decision of when to remove her ovaries because of BRCA2.At 38, she chose to remove her fallopian tubes while keeping her ovaries through the WISP study, giving her more time before surgical menopause. She knew ovary removal would eventually become part of the conversation. She just didn't expect the decision to feel this difficult when the time came.Marisa talks openly about her fears surrounding surgical menopause, HRT, weight changes, mood and mental health, sexual health, and the potential long-term effects of early ovary removal. She also explores one of the hardest parts of previvorship: making a permanent decision about healthy parts of your body to prevent a cancer that may or may not ever happen.How do you balance ovarian cancer prevention with quality of life? What happens when there is no reliable screening test to give you the reassurance you want? And what do you do when you understand the medical recommendation but still don't feel ready?There is no neatly packaged answer at the end of this episode. This is an honest conversation from the middle of the decision, before hindsight makes everything feel clearer than it actually was.Trusted Resources:National Cancer Institute (NCI)BRCA1 and BRCA2 cancer risks and risk reducing surgeryhttps://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheetAmerican College of Obstetricians and Gynecologists (ACOG)BRCA mutations, ovarian cancer risk and risk reducing surgeryhttps://www.acog.org/womens-health/faqs/brca1-and-brca2-mutationsThe Menopause SocietyMenopause, hormone therapy and menopause carehttps://menopause.org/patient-educationFORCE: Facing Our Risk of Cancer EmpoweredHereditary cancer education, research and supporthttps://www.facingourrisk.orgWISP: Women Choosing Surgical PreventionResearch on salpingectomy with delayed oophorectomy and quality of lifehttps://clinicaltrials.gov/study/NCT02760849TUBA WISP IIOngoing research evaluating the cancer prevention safety of salpingectomy with delayed oophorectomy compared with standard risk reducing salpingo oophorectomyhttps://clinicaltrials.gov/study/NCT04294927

What should you know about hormone replacement therapy before having your ovaries removed?For women with BRCA1, BRCA2 and other hereditary cancer risks, preventive ovary removal can bring another major consideration: surgical menopause and what comes next.In this episode of BRCA & Beyond, Marisa explores the questions many women have about HRT before risk-reducing ovary removal. What might surgical menopause actually feel like? How can hormone therapy fit into care after surgery? What happens if the first approach doesn't work well for you? And who should be helping manage your menopause care along the way?Through her own experience approaching this decision with BRCA2, Marisa discusses concerns around mood, energy, weight, sexual health, quality of life, and simply feeling like yourself after surgery. She also shares an important shift in how she's preparing: instead of waiting until after ovary removal to figure out menopause care, she's asking what that plan should look like before surgery happens.The conversation also explores why HRT experiences can vary so widely, why another person's experience isn't a preview of your own, and why preparing for risk-reducing ovary removal should include conversations about both cancer prevention and quality of life.Whether you're considering an oophorectomy, a risk-reducing salpingo-oophorectomy, navigating surgical menopause, or simply trying to understand HRT in the context of hereditary cancer risk, this episode can help you think through the questions to bring to your own healthcare team.Trusted resources:The Menopause SocietyPatient education on menopause, surgical menopause, and hormone therapy.American College of Obstetricians and Gynecologists (ACOG)Patient guidance on BRCA1 and BRCA2 mutations, risk-reducing surgery, and menopause care.National Cancer Institute (NCI)Evidence-based information on BRCA1 and BRCA2, hereditary cancer risk and risk reducing surgery.FORCE: Facing Our Risk of Cancer EmpoweredHereditary cancer information, research updates, and support for people with inherited cancer risk.This podcast is for informational and educational purposes and does not replace individualized medical advice. Decisions about risk reducing surgery, surgical menopause and hormone therapy should be discussed with your healthcare team.

What happens when your family medical history is something you have to fight to uncover?In this episode of BRCA & Beyond, Marisa sits down with Dayna A. Dorsey, also known as Dayna-Ashley and the founder of Little Orphan Ashley™, to talk about ovarian cancer, adoption, genetic testing, family medical history, and turning lived experience into advocacy.Dayna-Ashley was just one year old when she lost her biological mother, Mary Ann, to ovarian cancer at only 34 years old. As a two-time orphan, former foster youth, and adoptee, she grew up without memories of her mother and with limited access to her biological family’s medical history. As Dayna-Ashley approached the age her mother was when she died, the need to understand her own health and family history became deeply personal. She shares her search for answers, the fight to unseal her adoption records, navigating genetic testing, and what she ultimately learned about her own health.She also shares how her mother’s ovarian cancer continues to shape her advocacy today, why access to family medical history matters for foster youth and adoptees, and the story behind Little Orphan Ashley™, a name once used to hurt her that she transformed into a platform for advocacy, education, and impact.About Dayna-AshleyLittle Orphan Ashley™ is the national advocacy and impact platform founded by Dayna A. Dorsey (Dayna-Ashley), a two-time orphan, former foster youth, adoptee, 4x author, nonprofit leader, and National Advocate for Foster Youth Protection & Exploitation Prevention. She transforms her lived experience into purpose through advocacy, education, storytelling, and community impact focused on protecting and empowering vulnerable children and families.Dayna-Ashley also serves as an Ovarian Cancer Research Alliance (OCRA) Advocate Leader and Florida Statewide Facilitator for OCRA’s Survivors Teaching Students® (STS) Program, carrying forward the legacy of her late mother, Mary Ann, who lost her life to ovarian cancer at age 34. The Ovarian Cancer Research Alliance is the leading gynecological nonprofit in the world founded in 1994.A key focus of her advocacy is health awareness for foster youth and adoptees, particularly those with sealed adoption records or limited family medical histories who may unknowingly face increased risks for hereditary diseases, cancers, and genetic mutations. She promotes awareness of their rights and available pathways to accessing medical, adoption, and biological family health information.Through Little Orphan Ashley™, Dayna-Ashley champions foster youth protection, health equity, literacy, human trafficking prevention, poverty prevention, and youth empowerment.Resources & ConnectOvarian Cancer Research Alliance: OCRAHope.orgLittle Orphan Ashley™: www.LittleOrphanAshley.comDayna A. Dorsey: www.DaynaDorsey.comThis episode is for education and awareness and is not a substitute for individualized medical advice.

What actually happens to your body when your ovaries are removed before natural menopause?In Episode 6 of the BRCA & Beyond Ovarian Cancer Awareness Month series, we’re talking about the part of preventive ovary removal that can sometimes get reduced to a few words: surgical menopause.Removing functioning ovaries before natural menopause causes an abrupt hormonal change. And that change can affect much more than periods and hot flashes. Sleep, mood, concentration, bone health, cardiovascular health, sexual health, vaginal and urinary health, body composition, and overall quality of life can all become part of the conversation.But this episode is not about assuming the worst.It is about understanding what can happen, what may be manageable, what questions to ask before surgery, and why planning for life after ovary removal deserves just as much attention as planning for the surgery itself.I’m also sharing what this decision looks like for me as a BRCA2 carrier who is now having these conversations with my own care team. Because reducing ovarian cancer risk is incredibly important, but so is understanding how we care for our bodies afterward.IN THIS EPISODE:• What surgical menopause actually means and why it differs from natural menopause• How ovary removal can affect hormones and symptoms throughout the body• Bone, heart, sexual, vaginal and urinary health after early menopause• Why surgical menopause experiences can vary so much from person to person• Questions to ask your healthcare team before preventive ovary removal• Why menopause care should be part of the surgical conversation before the operating roomRESOURCES:The Menopause SocietyEvidence based patient education about menopause, premature and induced menopause, hot flashes, sexual health, bone health, treatment options and finding qualified menopause care.FORCE: Facing Our Risk of Cancer EmpoweredHereditary cancer education and support for people with BRCA and other inherited cancer risks, including information about risk reducing ovary removal, surgical menopause and sexual health after preventive surgery.OCRA: Ovarian Cancer Research AllianceOvarian and gynecologic cancer education, support and patient resources, including information related to menopause, sexual health, fertility and hereditary cancer.Project COURAGE at Moffitt Cancer CenterCommunity Ovarian Cancer Understanding Through Risk Assessment and Genetic Education. Project COURAGE provides education about ovarian cancer risk, hereditary cancer, prevention, genetic counseling and genetic testing.National Cancer InstituteEvidence based information about BRCA1 and BRCA2, risk reducing surgery and surgical menopause. The NCI also provides information about the physical and quality of life considerations that can follow premenopausal ovary removal.This podcast is for educational purposes only and is not a substitute for personalized medical advice. Decisions about hereditary cancer risk, preventive surgery, menopause management and hormone therapy should be discussed with qualified healthcare professionals who understand your individual medical history and cancer risk.