By now, you’ve heard about and read the March 24th New York Times article, “Diary of a Surgery” by Angelina Jolie. In it, Jolie shares her decision to have a laparoscopic bilateral salpingo-oophorectomy because of her risk factors for both breast and ovarian cancer after having tested positive for carrying the BRCA1 gene mutation.
As I woke up that morning and scrolled through my emails where I have a daily google search on breast cancer so that I see any new articles that appear on the topic, Jolie’s article was the first I saw. As I read it, I began to tear up. As a woman who has experienced breast cancer myself, I immediately felt a deep sense of empathy for what she was going through. For me, this is not a discussion about a celebrity, about whether or not you like the way she lives her life. It’s a discussion about another woman, who like myself and many other women I know is going through a tremendously difficult life decision because of cancer.
What hit me the hardest was when she very matter of factly spoke of the fact that the procedure was going to throw her into early menopause at the age of 39. I hate to think of a woman at the age of 39 having to deal with the negative impacts of menopause. I realize that this could perhaps be considered a minor thing, given the important end benefit of extending her life, but menopause is not an easy thing for anyone to go through even at the typical age of 50-55 and to be thrown into it through this procedure at the age of 39 is quite difficult.
I was pre-menopausal until I started chemotherapy and then went into menopause literally overnight once I started treatments, with very immediate and intense results like hot flashes, night sweats, insomnia and joint pain. My oncologist told me that it’s much harder to be thrown into menopause via chemotherapy or surgical intervention, as your body goes from 0 to 1,000 immediately with these treatments, vs. when your body more naturally goes into menopause over several years without them.
The second piece that most hit me was when she spoke of meeting with her surgeon who also treated her mother, and how the two of them broke down as the surgeon told her that she looked just like her mother. I can only imagine what it would be like, to face the fact that her mother died of cancer and then use that knowledge to make the decision to test for the BRCA1 gene which in turn, is what ultimately informed her decisions for preventative surgeries which will hopefully allow her to live long past her own mothers life span. There’s something very bittersweet about that.
What surprises and disappoints me are the harsh comments on Facebook and in blogs about Jolie from other women. I’m saddened and surprised at those who don’t show empathy for her, whether or not they like her politics, celebrity or her lifestyle. It’s not about being a celebrity anymore, it’s about another woman faced with a very difficult choice who has chosen to share it with others in the hopes that she can help them by sharing what she’s learned from her own experience.
Wouldn’t a community of women who’ve gone through breast cancer empathize with someone else, no matter what their lifestyle, who has to undergo the same difficult choices we had to make?
I truly believe that because of Jolie speaking out so candidly about her experience, many more women will be aware of the BRCA1 and BRCA2 test. And also, by discussing her treatment options and choices, Jolie brings awareness to the fact that women have choices in their own medical treatment decisions and should be their own advocates. It’s also important that Jolie explains that because her mother, grandmother and aunt all died of breast or ovarian cancer, in addition to her BRCA1 results, she made the difficult decision to have the procedure. Her ability to share how she reached this decision can benefit anyone else going through this difficult choice.
When I was first diagnosed with breast cancer, I was very surprised because no one in my family, other than a cousin, had ever had breast cancer and no one in my immediate family ever had any type of cancer. It was only later as I did my research that I learned that in fact only 5-10% of all breast cancers are thought to be hereditary and caused by genes passed from parent to child.
I had the BRCA1 genetic testing when I was diagnosed over 5 years ago, well before Jolie shared her story, so wasn’t directly impacted by her story. I was lucky that my hospital had a breast care coordinator on staff who made me aware of the BRCA1 and BRCA2 test and other genetic tests like Oncotype DX, so that I could research them and learn more about whether or not they would be beneficial in my specific case.
Not only was I was fortunate to be advised by my hospitals breast cancer coordinator about the BRCA1 and BRCA2 test, but my hospital also had a team of genetic counselors who championed my case with my insurance company in order to get the test paid for, as the $3,000 cost was yet another worry and financial strain in the midst of all the other things that a breast cancer diagnosis brings.
I know there are many readers who would also have found the uncovered out of pocket cost for the test to be difficult and I would encourage you to ask your oncology team for help with options such as mine. I tested negative for the gene and so at least had the solace that comes from knowing that both of my sisters and my own children don’t have a genetic predisposition for breast cancer, which I found reassuring.
Even with all the awareness and information that’s out there about breast cancer, many of the women I’ve spoken to still don’t really know that they can take an active part in making treatment decisions in partnership with their doctors, vs. having their doctors dictate their treatment plans without any collaboration between doctor and patient.
It’s not just women like Angelina Jolie who have these choices. We are all capable of becoming our own health care advocate. Ask questions, do the research, read, talk to others who may have gone through breast cancer, get 2nd opinions and don’t back down until you are satisfied with your team of doctors. I’m not saying that it’s easy, it’s not, but it’s critically important in matters of health to be informed and to be an active participant in your treatment.
I love reading your point of view. I recently read a criticism from another friend of mine and she was really appalled by Angelina’s decision saying that lifestyle change should be the choice before we start cutting parts of our body away as these were put there for a reason. I was ok with her opinion about alternative solutions but to criticize someone for their choices is wrong. What works for me might not be for another and I am sure that Angelina did a ton of research and thought long and hard about what she needed to do to save her life so she had a life! No matter what, the decision is always a difficult one. I personally celebrate Angelina because she is celebrating life! Good for her.
Thanks, hon! I agree with you, it’s all about individual choice and no one needs to judge someone else for how they choose to handle these decisions. xo
I hate that there have been such ugly comments because of a decision that I fully agree with. I would have done the same exact thing if it meant saving my life. I really enjoyed this piece Claudia.
Me too, Rena. Very sad, I was so disappointed. Thanks for your kind note!
Brava to you for addressing this. It’s so important for women at risk to not only be tested for BRCA 1 and 2, but also other genetic tests (as you mention). BRCA 1 and 2 testing has gotten all the media attention, but there are numerous other genetic mutations that put women at risk for breast cancer, so a negative BRCA test doesn’t necessarily mean all’s clear. That’s why it’s important to get genetic counseling and know your family history (of ALL types of cancer).
Thanks, Roxanne, I completely agree!
I love how you are shining a light on something that is kind of scary for women who might be at risk. Thank you for that.
Carol Cassara recently posted…Life after life: can science prove it?
Thanks for your kind comments, Carol.
Thanks for sharing your knowledge and experience with the rest of us!
Laura Lee Carter recently posted…Perception is Everything!
Thank you for the kind words, Laura!
Thanks for sharing your take on this important topic. I was also surprised and saddened by those criticizing Angelina Jolie for her decision. She was brave to go public with it, and any knowledge is a good thing!
Lana recently posted…Be Brave And Keep Blogging
Yes, I think empathy is important for anyone going through a medical crisis, thanks for the comment!
Touche, Claudia! I was also surprised by the anger I read on Facebook about Jolie’s decision. It was mostly about money and privilege and how many people can ill afford these procedures. But sometimes you can talk to hospitals and doctors about obtaining financial arrangements to help defray the cost.
The bottom line is I am glad she wrote about it, and glad you wrote about it as well.
Cathy Chester recently posted…The Comic Who Had Two Career Choices And Took Them Both
I found that when I was persistent, I was able to “work around” some of the financial obstacles (at least w/everyone except for my original plastic surgeon) and would imagine that others could also be able to help offset costs if they are very persistent and resourceful, although it’s stressful and not easy or simple. And, yes, I was saddened by people being so mean spirited. Thanks, Cathy!
Why people are so cruel and judgmental of others’ decisions is beyond me. Brava to Angelina for her courage and transparency. And Brava to you, Claudia, for being a force and voice for advocacy, clarity and choice.
With thanksgiving,
Dani
Dani recently posted…The Science of Compassion #1000Speak
I agree, Dani, we all need to have compassion for one another. Thank you for stopping by, it means so much to me. xo
Hello all! I agree that no one can judge us. It is her body anyways and she knows what is best for her. It was a very bold move and I applaud her for it. 🙂