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Jolie's public personal decision starts a conversation

1:20 PM, May 20, 2013  |  Comments
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Among the national news bites last week was one jaw-dropping tidbit: Actress Angelina Jolie announced she recently had her breasts removed after learning she carried the BRCA1 gene mutation.

There is evidence the BRCA gene mutation (there are several varieties) dramatically increases risk for developing breast cancer in both men and women. For women, there is also an increased risk of ovarian cancer.

Angelina's mother died from ovarian cancer - a notoriously difficult disease to detect early. (Jolie has indicated she was planning on having her ovaries removed as well.)

Jolie's very personal decision has caused a firestorm of both support and, conversely, judgmental derision.

Admittedly, I haven't been Jolie's biggest fan over the years. But I watched the news with interest because I, too, have the BRCA1 gene.

Unlike Jolie, I found out after being diagnosed with cancer.

I've asked myself: If I had known earlier in life that I carried the gene, would I have pursued such a drastic preventative surgery? I may have.

As it turned out, by the time I discovered my cancer, it was a large, invasive tumor. I opted for an aggressive treatment of chemotherapy and surgery like Jolie's. Four years later, I'm in better health than ever, thankfully. But it was a hell of an ordeal to go through, and an agonizing one for my family to endure.

Knowing she carries the gene and having watched her own mother die, Jolie had to answer the not-so-rhetorical question the best way she could, for herself and her family.

Supporters understand her logic and applaud her openness. They say it starts a conversation about a somewhat taboo subject and helps make the decision acceptable.

I fall in this camp.

The detractors have several arguments.

They say the decision to endure such drastic preventative surgery is preposterous. One writer called the choice "sick," and went so far to argue: If she had a risk of brain cancer, "would she chop off her head?"

Perhaps there is some ethical controversy about removing perfectly healthy body parts. However, there is such a strong correlation between cancer incidence and BRCA gene mutation, it can be viewed more like disarming a time bomb. Perhaps it's better to do that before it actually explodes.

Other Facebook posters and article writers suggest having the BRCA gene is not a certain cancer sentence. With proper monitoring and a healthy lifestyle, they say, you can go on with regular life. Eat the right foods, take the right supplements and you'll be fine.

That's only conjecture, however, with no real research to back it up.

We've only known of the BRCA gene mutation for 20 years, so there are no true long-term studies showing that doing "such-and-such" over the course of a lifetime will reduce the chance of cancer in a BRCA carrier.

If you have the gene and you want to sign up to eat raw broccoli every day for the next 30 years, be my guest. Maybe science will discover a sure-fire preventative magic bullet. I would applaud that and advocate it to my descendants.

But Jolie and I only have today's science to turn to.

Now, I won't claim to be perfect - heck, I've eaten a few fast-food meals in my life - but by most standards, I've lived a healthy lifestyle. Any doctor looking at my history would have considered me a very low risk for the disease. (By the way, most doctors also ignored the history of breast cancer on my father's side, whence the gene came.)

I exercise and maintain a very healthy weight. I never smoked and rarely drink. Beyond that, I breastfed my children for an extended time. That alone should have dramatically lowered my breast cancer risk.

But I got it anyway.

How about advocating extra monitoring and vigilance? Well, my large tumor didn't even show up on a mammogram.

So, do I need to feel guilty about not taking some miracle supplement? Or for eating an unhealthy dessert at a potluck? Can you imagine the pressure of perfection and the guilt of not attaining it? The punishment, according to Jolie's detractors, is cancer. Possible death.

Besides, the reality is: There was cancer before the invention of pesticides and Big Macs.

It comes down to this: If a woman decides preventative mastectomy is best for her and her family's well-being, both mental and physical, there are no grounds for argument from anyone else.

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