Quoting Wikipedia about Angelina Jolie,
"On February 16, 2013, at the age of 37, Jolie underwent a preventive double mastectomy after learning she had an 87% risk of developing breast cancer. She has a defective BRCA1 gene resulting in an increased risk of developing breast cancer and ovarian cancer. Jolie's family history warranted a BRCA mutation genetic test: her mother, actress Marcheline Bertrand, had breast cancer and died from ovarian cancer at the age of 56, while her maternal grandmother had ovarian cancer and died aged 45. Jolie's mastectomy lowered her chances of developing breast cancer to under 5 percent. Testing of the removed breast tissue showed no signs of cancerous cells. She reportedly intends to undergo a preventive oophorectomy, as she still has a 50% risk of developing ovarian cancer."
Link to her own account "My Medical Choice" (May 14, 2013, New York Times): http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html
What do you think about her decision? I'm sure it was a tough call for her. And I support her decision.
In the net there have been many responses to her decision. Certainly she is an influential person in this world.
I thought some responses were somewhat off-target. Some off-target responses were made because the speaker did not know much about cancer.
One response assumed all breast cancers are the same or similar. No, they are not. Cancer is a collection of diseases, and each case is different. In this case she is talking about breast/ovarian cancer predisposed by the BRCA1 mutation, and it is different from sporadic breast cancer.
A majority of breast cancer is sporadic. In general, the development of sporadic cancer is a slow, age-influenced process with progressive acquisition of genetic mutations and/or epigenetic alterations under the influence of environmental and other external factors. Sporadic cancers tend to develop later in life. The right diet and life habits can reduce the cancer risk further, although the risk cannot go down to zero. In fact, a part of my research concerns this cancer chemo-prevention aspect. I am an expert, you know.
There is a class of cancers that are strongly influenced by genetics, or cancers caused by pre-existing gene mutation(s) passed down in a family. In many cases the gene product plays a major role as a signaling hub in the cell, and the gene mutation has a devastating effect on operations in the cell. A consequence is much accelerated cancer development. Cancers influenced by familial gene mutation tend to develop early.
She knew her family history and she knew she might carry one of familial mutations. It was wise to check that out.
Another response questions efficacy of mastectomy and the reasoning for cutting off an apparently "healthy" (non-cancerous) body part.
The familial mutation(s) is carried in all cells in the body, but in many cases only certain organs are affected, as in breast and ovarian cancer development with the BRCA1 mutation, or colon cancer development with an APC mutation. The organ specificity is interpreted to have something to do with how the gene product is used in the particular organ. Different organs do different things, and express different set of genes and proteins for the function. Surgically removing the body part at high risk can effectively take away the target organ for the particular type of cancer and provide a much better chance to live cancer free for the rest of your life.
As I understand, Angelina Jolie's advocacy goes toward genetic testing for women with a family history of cancer. These women are likely to carry a gene mutation that makes them prone to cancer development, and gene testing can justify further preventive steps that can include a mastectomy. She is not advocating everyone to test gene mutations.
Sure, in an ideal world everyone should know their genetic strengths and weaknesses (well, come to think of it, is that really an ideal world?) and people don't have to worry about the cost of genetic testing. In this world, it may still be too costly. I think limiting the genetic test to a certain segment of population, like to the people with notable family history or already identified risk, is a reasonable compromise.
She made a choice that leads to a better chance to live a life without developing cancers she is genetically predisposed to. She made a rational choice to increase her chances of living with her family and doing many things only a living person can enjoy. And she is in a position far more influential than many others. In this case, I think she made the right decision, and I want her case to be a champion to others.
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After writing about half of this, the tornado siren went off, and the news said there was a tornado touchdown about a mile away from our place. We decided to drive to house of my wife's family to get out of the possible danger. Although I am still very optimistic about the slimness of the possibility of a tornado blowing away our place, apparently this kind of precaution is common among tornado alley locals. After a while of weathering, we drove back in nice weather right after the storm was gone.
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Last night our Swing Dance club invited a champion WCS dancer Robert Royston for workshops. I'll write about it later.
