Tuesday, July 30, 2013

Angelina Jolie's Personal Choice

On May 15th, I was called by a major TV network inquiring if the PBCN had a similar case like Angelina Jollie. When I replied that we know of no cases of prophylactic mastectomy, the TV researcher then asked if we knew of any scheduled case of mastectomy who they could interview. I told her to best contact any major hospital because for sure, they would have mastectomy cases. Then on May 21st, I was invited and accepted a live early morning TV interview to publicly air the PBCN's view on the matter. The entire TV staff and crew listened intently as I spoke and even another guest of the Department of Health promoting one of their many health programs kept nodding. Because of the public interest generated, I was interviewed live the next day over a radio program. Following were my main points:

1. Breast removal for preventive purposes is not a guarantee or assurance that breast cancer will be prevented. In fact this option belongs to the age-old Halsted era when it was said by prominent surgeons that to prevent breast cancer, it would be best to simply remove the breasts of a female the moment she is born. "no breast - no breast cancer." The truth is that breast cancer can develop even without breasts because it is a hormonal disease that does not exempt flat-breasted women or lesbians.

2. In the Philippine setting, most if not all females value and treasure their breasts and in fact will not just agree to breast removals. Note that majority of women place their hands on their chest whenever they bend so as not to expose the cleavage of their breasts, wear shirts when swimming and do not wear clothes which easily expose their breasts. This cultural practice will withstand medical options for breast removals just for preventive purposes.

3. Regardless of hereditary risk factors or genetic dispositions to breast cancer, there are non-invasive options that are kinder that will not permanently damage a woman's self-esteem - avoiding and eliminating known environmental risk factors and causes of breast cancer!

4. Angelina Jollie does NOT represent the common woman NOR can she be made an example to follow. Personalities remain to be media materials and their individual choices or views can not and should not influence the general public as being even close to the truth. Her personal life does not even have to be discussed to see why she is very far from being like you, your daughter, your sister or your mother.

5. A woman with the stature of like Angelina can do anything with her body and still maintain her status and even increase her public image just as others have done - change the color of one's skin, tatoo one's entire body or even change gender. Definitely not the case with most women who live ordinary lives. And not every woman has a Brad Pitt by her side!

6. Lastly, my own wife was diagnosed with late stage breast cancer when our youngest daughter was only five years of age.  Because it takes 5 to 10 years before the first symptoms of breast cancer are manifested, our daughter was definitely conceived when her mother already had breast cancer! Our daughter is genetically predisposed - in vitro! So does that mean that our daughter, now aged 18 will have to loose both her breasts to prevent her from getting the disease that took away her mother at an early age? NO WAY! There are other ways of preventing a woman from getting breast cancer no matter the genetic predisposition!

Breast surgeon Shelley Hwang, MD, chief of breast surgery and professor of surgery at Duke University Medical Center and Duke Cancer Institute, who did not treat Jolie, when interviewed by WebMD stated the following salient points:

1. Only about 5% of all breast cancers are in women who have this genetic mutation.

2. Most breast cancer experts would agree that the choice is really the patient's to make, and I really want to emphasize, it is a choice.

3. The women who should absolutely consider genetic testing are those who themselves have had a triple-negative breast cancer, the kind associated with BRCA mutations, at an early age, under 45, people who have had both ovarian and breast cancer in family members, and people who have breast cancer in the family and are of Ashkenazi Jewish descent.