In the midst of a very crazy last two weeks I received a call from The New Paper, asking me for a quote on Angelina Jolie.
At that point I hadn’t yet read that she had undergone a double mastectomy and removed all her healthy breast tissue because she had tested positive for a harmful mutation of the BRCA1 gene.
But TNP quickly brought me up to speed, and asked me what I thought.
I spoke honestly, and said I felt it was too drastic a move to make, to get rid of all of one’s breast tissue in the off chance that one might get breast cancer.
The reporter asked me if, like some other breast cancer survivors, I thought Angelina was brave. I replied I did not.
In fact, I felt that was she was doing was really taking action out of fear.
My belief is this: God has not given me a spirit of fear, but power, love and a sound mind.
Can I understand what Angelina Jolie went through? Yes. My mother battled breast cancer for 13 years, just as her mother battled ovarian cancer for eight. My mother never lived long enough to meet my youngest child. Do I share Angelina’s fear that my children have to suffer the agony of seeing me die of cancer? I most certainly dread the thought.
I can absolutely understand what must have gone through her mind:
1. She’s had her babies and probably isn’t thinking of birthing anymore, so not having to breastfeed, she can safely jettison her breast tissue.
2. Getting rid of her breast tissue before cancer has a chance to form ensures that she maintains the beauty of both breasts. Unlike me, she wouldn’t have to sacrifice her nipples.
If my doctor told me, like Angelina Jolie, I had an 87% chance of getting cancer, there is a chance I might feel differently. But I guess I live in hope — as my oncologist did tell me, there is also a chance I will never get cancer again. My doctors have all said to me that for every patient they have seen suffer a relapse, they have seen another one live a long healthy life, never to be plagued again by the disease.
My point? Only God knows the future. I choose to live as fruitful and fear-free a life as I possibly can.
My best friend Karen did ask me, when I was studying the finer points of my breast reconstruction, if I would have both removed since I was at it. My answer was no, and it hasn’t changed.
When I saw my oncologist three months after my mastectomy, he suggested I go to NUH and get tested for mutations in my BRCA1 and BRCA2 genes.
These were my thoughts:
1. What would I do if I discovered I had the mutated gene? Would I opt for breast tissue removal of my left breast? I could not confidently answer yes, yet I knew it would be on my mind for the rest of my life. I treasure my peace, which I now have.
2. As my oncologist pointed out, not every woman who has the mutation will for sure get cancer. How much faith do I have?
3. If my daughters knew I went for the test, it would be natural for them to also go for it. Am I robbing them of a future—they may opt to have breast tissue and their ovaries removed, in which case they will never have children.
Here are the facts:
• Studies show that 60% with a harmful mutation in the BRCA1 or BRCA2 genes will contract breast or ovarian cancer. This is why Angelina is also now contemplating having her ovaries removed.
• Such a mutation in the BRCA1 gene is also linked to cervical, uterine, pancreatic and colon cancers. Would she remove all of these too?
• BRCA1 mutation is just one mutation. Other mutations linked with hereditary breast cancer include BRCA2,TP53, PTEN, STK11/LKB1, CDH1, CHEK2, ATM, MLH1, and MSH2. Would she test for them all? Would I? I don’t think so.
All said, do I think that, given the circumstances, Angelina did a wise thing? I do. Upon discovering a mutation in the BRCA1 or BRCA2 genes, women have options: you can keep a close eye on things (be vigilant about mammograms and other screenings, cancer marker tests etc), you can opt for chemoprevention, you can avoid risky behaviors (smoking, excessive alcohol consumption, chemical ingestion etc), or you can opt for a prophylactic surgery like Angelina did.
If I had to choose among these 4, I guess I would have done like Angelina and maximised my chances of avoiding cancer. Even so, there is still a chance for women to develop breast, ovarian or primary peritoneal carcinomatosis despite such a surgery, because not all at-risk tissue can be removed.
What I have found is, there is no guarantee against death. The only guarantee is death itself. Fear is a greedy animal — once you let it in, it will eat you up from the inside.
I choose to do the best I can, live as prosperously as I can, enjoy all the time I have with my children and my husband, and do what God has tasked me to do, in the days He has already numbered for me.
Recommended reading on BRCA mutations.