Her Medical Choice

May 14, 2013 by Tagged with:   
Posted in: Breast CancerIllness Narrative

I awoke today to a Facebook feed full of people praising Angelina Jolie. While that may be the norm on your feed, I don’t hang out with too many of those types.  So what’s the hubbub bub?

She wrote an editorial that appears in today’s NY Times, My Medical Choice.  She carries an identifiable genetic mutation, BRCA1, that greatly increases her risk of developing breast and ovarian cancer.  Earlier this year, Jolie underwent a series of surgeries to remove her breasts.  I was intrigued by this line:

On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.

I feel like this is what we are going to remember from this Op/Ed.  As a person who had a bi-lateral mastectomy in 2009, my ears perked up.  See!  The most beautiful woman in the world says she doesn’t need her breasts to feel feminine!  Maybe she’ll start a trend or a line of clothing for breastless women like me.  Maybe everyone’s going to want to be breastless like everyone wanted those pouty lips of hers.   

Whoa, Nellie.  

The piece details her reconstruction surgery.  So technically, she still has breasts, just not the ones she had this time last year.  One can surmise that Jolie did feel like she needed breasts to be beautiful, since she went through multiple surgeries to get them.

I would have thrown a party if Jolie had the mastectomy without the reconstruction and called that beautiful.  But, I know, I’m being selfish. I give her big ups for bringing up some really important points.

1) Only a small percentage of breast cancers are caused by BRCA1/2 mutations. Like less then 10%.  Individually, that mutation matters, but as far as the global population goes, it’s a small number.

2) Being tested for the BRCA1/2 mutation is costly.  That is largely because Myriad Genetics holds a patent on those genes. That’s right.  They have a patent on the genes.  We all have that gene, by the way.  It’s just that it is mutated in some people in a way that leads to breast and ovarian cancer.  In fact, the validity of this patent is in the hands of the Supreme Court right now.

3) Poverty is a risk factor for cancer.

4) Medical self-empowerment is crucial. You need the financial means and the cultural literacy, but she sets a good example.

On a personal note, I wonder if these preventative surgeries will play out as effective in the long run.  If we just had a cure, or a vaccine for cancer, these radical approaches wouldn’t be necessary. Can we please continue to focus on that and not be lulled into the false believe that breast cancer is preventable?

So Angelina, thank you for this public service.  I wish you’d made a few different decisions, but I am glad we are having this conversation.  


4 comments on “Her Medical Choice

  1. Gayle

    Yes, there are some BIG issues to reflect on with this story, including the trend toward aggressive medical interventions, the price, the potential legal implications of genetic status, the role of poverty, the role of the environment itself, the fact that the vast majority of breast cancer cases do NOT involve mutations on the BRCA genes and the reasons for this are unknown, the patenting of genes (such as the Myriad Genetics case), health literacy, celebrity status, a culture of fear in a risk-focused society, body image, patient empowerment, medical ethics…. so many issues to consider with this type of case. I’m glad the conversation has started.

    -Gayle Sulik


  2. Gayle

    YES, there are some BIG issues to reflect on with this story, including the trend toward aggressive medical interventions, the price of diagnostics and treatments, the potential legal implications of genetic status, the role of poverty, the role of the environment itself in cancer, the fact that the vast majority of breast cancer cases do NOT involve mutations on the BRCA genes and that the reasons for this are unknown, the patenting of genes (such as the Myriad Genetics case), health literacy, celebrity status, a culture of fear in a risk-focused society, body image, patient empowerment, medical ethics…. so many issues to consider with this type of case. I’m glad the conversation has started.

    -Gayle Sulik


  3. Jody

    Poverty is a carcinogen. And BRCA 1/2 mutations are most common in women under 40.

    Within the population of BRCA 1/2 survivors this aggressive intervention does substantially reduce risk. Right now they have few options other than “watch and wait” with very aggressive screening.

    Just another set of lousy choices for a crappy disease. You can still do all the right things for the right reasons and get cancer. No guarantees.

    Thanks for writing today, Katie.

    love,
    jms


  4. afterfiveyears.com

    There is some sweetness that echoed for me beyond all the “statement stuff” in that she realized the pain of losing her mom at a young age, and didn’t want that for her children. I think we are missing this in the movie star cuts off breasts headlines, that the “movie star” is a mom like a lot of us, who would walk to the end of the earth to be there for her kids. I would have done the same if I had the mutation…


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