I’ve never been much of an Angelina Jolie fan. I vaguely remember long ago reports of her wearing Billy Bob’s blood in a vial around her neck and something about her kissing her brother. Then, I recall the whole Jen vs. Angelina hullaballoo when “Brangelina” was born. I never bought a t-shirt but if I had, I would have been Team Jen.
Now, I keep hearing about Angelina’s “brave” choice to have her ovaries removed after having her breasts removed a couple of years ago to reduce her cancer risk. Oddly, I can’t help but feel some kinship with her. I may soon be faced with some of the same decisions. Don’t worry, I won’t be issuing any press releases when I do. I know that some people are annoyed with her “TMI-oversharing.” If you feel that way, you should probably stop reading now. I actually understand why she’s sharing her story and why I feel it’s important to share mine.
Just as in hers, cancer runs in my family. Maybe it runs in yours, too. Because I wanted to be proactive about my health, I started getting regular mammograms before my 40th birthday. Last year, my results came back and they wanted to do some additional testing. It’s apparently hard to read my mammograms because of my dense tissue. I had an ultrasound and then they ordered an MRI. All came back clear (whew!) but I decided to meet with someone in the high-risk program to get a risk evaluation completed.
After a five-month wait for an appointment, I met with a nurse who is one smart cookie. She completed a risk assessment based on my health and family history. The general population has a 12% chance of getting breast cancer. Based on my assessment, my current risk is 31%.
After some discussion, I decided to be tested for the breast cancer genes, BRCA1 and BRCA2 next month. If I test positive for either gene, it will mean that I have either an 80% or 60% chance of developing breast cancer before the age of 70 (factoring in my family history).
As if that isn’t enough to deal with, these same genes also increase the chance for ovarian cancer. About 1% of the general population will develop ovarian cancer, which is notoriously hard to diagnose in early stages. In contrast, those with a BRCA1 or BRCA2 gene have a 39% or 17% possibility of developing ovarian cancer.
So, for anyone who hears the choices that Angelina has made and thinks it’s crazy to have perfectly healthy breasts and ovaries removed, what would you do if you knew you had an 80% chance of developing cancer if you did nothing? What about a 60% chance? Where do you draw the line? What is an acceptable cancer risk? Is 31% acceptable? I haven’t decided yet.
For now, I’ve joined the high risk surveillance program. That means that every six months, I’ll rotate between having a mammogram and an MRI. They’ll keep a close watch on me to check for any early signs of cancer. Next month, I’m being tested for the BRCA1 and BRCA2 genes. If I’m positive for either one, it will mean that I have either an 80% or 60% chance of developing breast cancer and a 39% or 17% (depending on which gene) of developing ovarian cancer before the age of 70.
Depending on the results, I’ll decide what comes next. If my results are positive for the gene, I may opt to have a prophylactic mastectomy, which is a preventive surgery. I can make that choice now but I’m waiting for more information before I decide. Because of my high cancer risk, insurance will pay for it. I would be able to have reconstructive surgery, too (possibly at the same time). This would reduce the cancer risk to about 5%. I’ll also have to make a decision about the ovary surgery.
Even though Angelina is (and now I am) sharing a lot of personal medical choices, I think it’s important for women to really think about why. It isn’t because I’m trying to gross you out. I’m taking charge of my health. I’m not just burying my head in the sand because cancer is scary. I’m not waiting for it to happen to me because I know it could be coming at me. I bet it you asked any of my friends who have had cancer, if they knew they had a high chance of getting it and they could do something to prevent it, would they? If they could avoid radiation and chemo and reduce their risks, would they? I bet they would. I will have some important decisions to make in the coming months, depending on the outcome of the genetic testing. Please keep us in your prayers.
I strongly encourage you to take charge of your health. Everyone has a story, a family history, and not everyone would make the same choices. They are yours alone to make. This one is mine. But, please, be diligent about your preventative exams. Get tested. Get your mammograms. If something doesn’t look or feel right, please get it checked out. Early detection is key and could save your life. If I can make a choice that will prevent something that has a high chance of happening to me so that I may be around to watch my children grow up, I’m going to do it. Whatever will increase my chances of being here for my family is worth the pain. I guess I’m still Team Jen but in this case it’s my team I’m on. Sometimes, sharing is caring and I hope you’ll see that this is the case. I care about my health and I care about yours.