Friday, May 17, 2013

Would I Have Done What Angelina Jolie Did?

A host of emotions assailed me when I read about Angelina Jolie's double mastectomy.

With the announcement coming so close after Mother's Day I could resonate with her motive. She said, "I can tell my children they don't need to fear they will lose me to breast cancer." Which mother could bear the thought of leaving her children, especially her young children, orphans?

Other good things have also resulted from her revelation.

I have never heard of the BRCA1 and BRCA2 gene mutations and I believe there are many who are just as clueless. By sharing her experience, she has helped to create an awareness of the presence of these faulty genes and the availability of screening for them.
About one in 500 women have a mutation in genes called BRCA1 or BRCA2, which are involved in repairing genetic mistakes.

Having a mutation in BRCA1 gives women a 54% chance of developing breast cancer and a 39% chance of ovarian cancer by age 70, according to the Mayo Clinic Cancer Center. Having a double mastectomy can reduce those risks by more than 90%, although there is still a small risk that cancer could develop in the skin left behind, or in the armpit. 

However, such tests are costly and not everyone can afford those tests. Most of us will have to fall back on regular breast examinations, ultra sound, MRI screening etc.

Furthermore, due to her fame as a high-profile celebrity, her announcement has given courage to and she has been an inspiration to other women with breast cancer who are fearful that such an operation will diminish their femininity or make them less a woman.

All these are some of the good things that have come out of her announcement.

Nevertheless as I gave the matter further thought, I couldn't understand how, despite her laudable reason to spare her children the loss of mother, she could have opted for such an aggressive preventive measure when she doesn't even have breast cancer.

“Once I knew that this was my reality, I decided to be proactive and to minimise the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex,” Jolie wrote.

I am not judging her nor am I questioning the wisdom of her decision, but as I put myself in her position, I seriously doubt that I would have done what she did.

In the first place, all of us have cancer micro-tumours in our bodies. We aim to minimise our risk through better nutrition, healthy lifestyle choices and regular check-ups but we cannot totally reduce our risk to zero. In Angelina's case she said that she reduced her risk of breast cancer from 87% to a mere 5% which means that mastectomy is still not a guarantee against breast cancer. But what about other cancers?

From her statement it would appear that she would be removing her ovaries next. If we pursue this line of logic, people with a risk of colorectal cancer should cut out their colons, so how about cutting off your head to prevent brain cancer? Nobody does that because it just doesn't make sense.

We must not forget that a mastectomy is a major invasive procedure and carries all the risks of one. I would not resort to such an aggressive invasive procedure as a preventive measure when there are other less dangerous ways to screen for cancer and seek early intervention.  

So, no, I wouldn't do what Angelina Jolie did. 

I believe it was not an easy decision for her and she has exhibited a true mother's heart in her selfless decision to save her children the loss of a mother at a young age. 

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