Hearing so much press on Angelina Jolie has really brought attention to breast cancer and the BRCA1 and BRCA2 genes this morning. It seems like in one day, she's gotten more attention than Christina Applegate and Giuliana Rancic combined (the previous celebrity faces of double mastectomies). I have to say I am so proud of her though. As a sex symbol, undergoing a bilateral mastectomy is a tough choice – I’m talking about Angelina, not me! I love how she said "I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity." Well – right, because you are going to be alive! Definitely more feminine and attractive than cancer taking your life. I’m just sayin. When you're told you have an 87% chance of getting breast cancer, you'd have to be dumber than Lindsay Lohan declining a plea deal if you didn't decide to get those body parts replaced with some silicone, before you have to go through cancer, chemo, and all the emotional trauma.
I’ve already had several people ask me more about the BRCA genes today. First of all, everyone has the BRCA1 and BRCA2 genes, which are tumor suppressors. The names BRCA1 and BRCA2 stand for BReast CAncer susceptibility gene 1, and BReast CAncer susceptibility gene 2. We all have ‘em. But what Angelina and I have (as well as about 5-8% of the population) is a mutation in the gene. Meaning these genes don’t suppress tumors like they are supposed to, especially in breasts and ovaries, so tumors are more likely to grow and become cancer.
What’s the difference between the two? The BRCA 2 gene mutation (that I have) means that I have an 84% chance of breast cancer and 27% chance of ovarian cancer by age 70. Ding! It got me at age 35. At age 36, the hysterectomy that I had will prevent the ovarian part. It also means I have a 12% of a second primary breast cancer within 5 years of the first. So, good thing I got the double mastectomy! In case that’s not enough excitement for one person, I also have a 7% chance of pancreatic cancer, and I’m at a higher risk for melanoma, uterine, and fallopian tube cancer – although they don't have exact numbers on those at this time. Well, at least I got rid of the uterine and fallopian tube risks. In men, BRCA2 mutations can cause male breast cancer, early onset prostate cancer, pancreatic cancer, testicular cancer, stomach cancer, and melanoma. My dad and granddad both had prostate cancer AND melanoma 3 times. Thankfully, my dad is alive and doing great! And thankfully, neither my brother nor sister inherited the gene mutation that I did.
The BRCA 1 mutation (that Angelina has) means she has up to an 87% chance of breast cancer, a 50% chance of ovarian cancer, and is at increased risk for cervical, uterine, pancreatic, and colon cancer. This gene mutation tends to show up sooner, causing cancers at a younger age. I’m so impressed that she was pro-active enough to get the prophylactic bilateral mastectomy. I hope she decides to do a hysterectomy and/or oophorectomy (removal of ovaries) too, especially since she lost her mom to ovarian cancer at such a young age (56).
Obviously such major surgery is a very personal decision. Even getting tested for the mutation in the gene is a pretty big deal. It can cost up to $3,000, although for us, insurance covered most of it, so it was only $400 out of pocket. Pretty crazy bill for just spitting mouthwash into a cup though. (Mine was not a blood test like they keep saying on tv today.) But just remember, even if you have BC in your family, it does not mean you have the gene – only 5-8% of people do. And even if you have the gene, it does not mean you will definitely get cancer. According to estimates of lifetime risk, about 12 percent of women in the general population will develop breast cancer sometime during their lives, compared with about 60 percent of women who have inherited a harmful mutation in BRCA1 or BRCA2. In other words, a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.
"For any woman reading this, I hope it helps you to know you have options," Jolie said. "I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.” But for her, the decision ultimately came down to her kids. "I can tell my children that they don't need to fear they will lose me to breast cancer," she said. With a 1-year-old daughter at diagnosis, I can definitely relate to that. Deciding to do a double mastectomy and hysterectomy was a no-brainer for me, so that I have the best odds possible to be around for my daughter and husband.
I’m hoping Angelina will do the hysterectomy/oophorectomy next. You would think have 6 beautiful children is enough for her! And I hope reading this helped you become just a little bit more informed about your health and those you love.