Filmmaker Joanna Rudnick was 27 years old when she discovered that she carried a mutated breast cancer gene. This virtually guaranteed she’d have the disease in her lifetime, but she’d never know when.
In essence, Rudnick was a ticking time bomb. She would need to make some difficult choices about her future — including the possibility of prophylactic surgery to remove her breasts and ovaries.
Her journey since that revelation is at the center of “In the Family,” a 90-minute POV documentary that airs on PBS on Wednesday, Oct. 1 at 10 p.m.
Some background: Everyone has the breast cancer gene (known as BCRA); it is one of several in the body that suppress tumors. It is when this inherited gene is mutated that the odds of getting cancer shoot up dramatically: up to as much as 90 percent for breast cancer and 40 to 45 percent for ovarian cancer. The mutation is particularly prevalent among Jewish women of Ashkenazi descent: 1 in 40 faces this problem.
The genetic test has been available since the mid-1990s. Rudnick, who received her master’s in science and environmental journalism, knew about the test, but for a long time chose to ignore it.
“No one said the word ‘cancer’ in our house,” she says, despite the fact that the women in her family have a long history of cancer, dating back to her great-grandmother. Her mother, Cookie, is a survivor of ovarian cancer.
When she got the bad news, Rudnick’s reaction was simply to continue her life. She told none of her friends or colleagues about the findings.
A primary concern, however, was how a potential partner would handle the news. “Fortunately, the men I’ve dated have been very supportive,” she says. “I’m hopeful for myself and other women who have this information.”
Holding out for children, she opted for frequent monitoring instead of surgery. But after she had an ovarian cyst removed she decided to reach out to others with the gene mutation. Ultimately, she set out to “de-stigmatize this information. I didn’t feel there was anything wrong with me because I inherited this bad gene.”
It was a major step for her. For while she’d been involved with several documentaries, including the well-received “Robert Capa: In Love and War,” she’d participated mostly as a producer, an ephemeral title that involves a lot of responsibility and decision-making, but rarely creativity.
Rudnick is the producer of “In the Family,” but she is also its director and writer — and, as it turns out, its star. Rudnick notes that she did not intend to be in the film, but couldn’t find another woman of similar circumstances — young, childless, not knowing what decision to make — who was willing to tell her story on camera.
That she appeared in the film was a mixed blessing. “I’m not the type of person who likes to talk about myself,” she says. “However, it afforded me a closeness to the other subjects in the film. It brought a level of intimacy that made it a much better picture.”
Others in the film run the full range of subjects, including one woman who died after her segment was filmed, an African advocate for a largely overlooked segment of the population, women who’ve had the surgeries and some who, like Rudnick, agonize over the decision.
Part of the problem is that most people are used to doctors telling them what to do: take this pill, have this surgery. But here’s a case where there is no definitive answer. And although the decision-making process is easier for women who already have children, it is still not a simple one.
Rudnick’s current plan is to have her ovaries removed at the age of 40. A decision about a mastectomy is more difficult: “No one in my family had breast cancer under the age of 55,” she says.
In an interesting twist, Rudnick meets a man during the filming, and her first thought is how — or if — she should tell him about her dilemma. But she doesn’t have to ponder for long: After their first date, the man Googles Rudnick and is directed to a site that describes her and the film she is working on.
The two try to make a go of it. They’re together for a year, but as this is a documentary and not a fairy tale, they ultimately break up.
Rudnick was raised in a secular, middle-class Jewish family in a suburb of Chicago. She did not curse, argue or try to bargain with God once she learned about her prognosis. On the other hand, she didn’t suddenly find faith.
However, the experience, which involved mining her family’s past, did bring her closer to her roots “through all those relatives I never knew,” Rudnick says. “It brought me much closer to a community of faith that I wasn’t brought up with. I feel much closer to my identity.”
On another front, there’s been no replacement for Jimmy, the man she dated for a year, though she remains optimistic.
“I’m single, and I don’t know how, but someone will find me,” she says. “Anyone who’s not OK with it, frankly, isn’t right for me.”
“In the Family” airs on KQED-TV channel 9 at 10 p.m. Wednesday, Oct. 1.