“MY MOTHER fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.”
Angelina Jolie starts her op-ed in The New York Times with the above poignant recollection of her Mother’s passing. It was published on 14 May 2013, and in the article Jolie detailed her decision to undergo a preventive double mastectomy, sparking off global interest and discussion on the topic of breast cancer. The op-ed is entitled “My Medical Choice”.
Angelina Jolie’s brave decision is emblematic of a new direction in cancer prevention: by understanding the disease, she was able to take informed and appropriate preemptive measures to significantly reduce her risk of cancer.
What are the BRCA1 and BRCA2 genes?
BRCA1 and BRCA2 are genes that are classified as tumor suppressors.
In normal cells, BRCA1 and BRCA2 are useful genes that produce proteins responsible for repairing DNA. They also have a very important task of preventing uncontrolled cell growth (hence the term ‘tumor suppressors’).
Mutation of the two genes impairs this important function of suppressing cell growth, leading to uncontrolled proliferation of cancerous cells. BRCA gene mutations have been linked to the development of breast and ovarian cancer. According to the NCI website, a woman with an inherited BRCA1 or BRCA2 mutation has about 60 percent chance of getting breast cancer. This is about five times the normal risk!
In her op-ed, Angelina Jolie reveals that her inherited BRCA 1 mutation gave her an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. This was according to her doctors. In light of these risks, Jolie bravely chose to undergo a prophylactic bilateral mastectomy, which vastly reduces her risk of developing breast cancer.
A New Direction: Understanding Cancer So We Can Prevent It.
In his definitive book on the history of cancer treatment and research, entitled “The Emperor of All Maladies: A Biography of Cancer”, Siddhartha Mukherjee describes new directions in our battle against cancer. One of these new directions is to understand cancer better so that we can try to prevent it.
In recent years, we have managed to improve our understanding of cancer through developments in cancer research. For example, Bert Vogelstein and his team at The Johns Hopkins Medical Institutions have made extensive progress in cancer genetics by identifying gene mutations in cancerous cells. To date, the Vogelstein team has managed to sequence the genomes of ovarian cancer, pancreatic cancer, lung cancer and several forms of leukemia (among others). This is a colossal task due to the multitude of mutations.
Consequently, we have been able to integrate these new insights in oncology with cancer prevention efforts. Angelina Jolie’s prophylactic mastectomy is emblematic of this new direction. Progress in cancer genetics has helped scientists to identify the BRCA gene mutations as high risk factors for breast/ovarian cancer. Therefore, women with such mutations can then choose to undergo more intensive MRI to screen for traces of cancerous cells, and/or take the anti-estrogen drug Tamoxifen. As a last resort, they can also choose to undergo radical surgery to remove their breast tissues, as Jolie did.
Angelina Jolie’s brave action helps to raise awareness of this new direction in Cancer Prevention
In my opinion, it is important that awareness of this new direction is passed into public consciousness. People need to know that they have options when it comes to cancer treatment and prevention.
Hence, it is commendable that Angelina Jolie helped to spread the message. Her action may have saved many lives: according to Mukherjee’s book, “BRCA1 can be found in up to 1 percent of women in selected populations, making it one of the most common cancer-linked genes found in humans”. Jolie’s story also transcends inherited BRCA mutations and breast cancer: by choosing to make her decision public, she has raised public awareness of this new direction in cancer prevention, which can be applied to other forms of cancer as well.
Angelia Jolie may have removed the superficial part of her body that was symbolic of her sexuality, but her feminism is in no way diminished.