Angelina Jolie’s recent op-ed in the New York Times has got the whole world talking about preventative surgery. Is this the future of medicine? Is this what the fight against cancer is coming to?
Some are praising Jolie for her choice to undergo a double mastectomy, which is being touted a supreme act of bravery. Critics are condemning her: maybe it wasn’t brave, maybe it was cowardly and maybe she was setting a bad example.
So which is it? A supreme act of bravery or a disappointing act of cowardice? Let’s look at the facts.
On the one hand, genetic testing seems like a no-brainer. This testing is able to determine if a person carries certain gene mutations (BRCA1, in Jolie’s case, which can lead to breast and ovarian cancers) and pinpoint the likelihood of getting certain types of cancer. The actress, for example, was given an 87% chance of developing breast cancer and a 50% chance of developing ovarian cancer. In her op-ed for the NYT, she reported that the surgery reduced her chances of getting breast cancer to a piddly 5%.
An obvious choice, yes? Except this initial testing costs upwards of $3000 USD, a cost many women will have to pay out of pocket. Why? In order for this kind of testing to be covered by insurance companies, a patient must first be classified high risk, meaning they’ve either been diagnosed with cancer before the age of 45 – in which case genetic testing seems a little redundant – or they need to have multiple close blood relatives such as mothers, sisters and aunts who have.
The tests themselves are not infallible, and their implications can be grave. According to one study, only 40% of primary care physicians felt qualified to recommend genetic testing. This same study came to other shocking conclusions about genetic testing: 81% of doctors agreed that positive test results would lead to insurance discrimination. Also, one quarter of respondents indicated that results to genetic testing for cancer susceptibility can be ambiguous or inaccurate.
In the case of a positive result, doctors usually recommend yearly mammograms and MRI scans, at the very least. In the US, a double mastectomy followed by reconstructive surgery comes with a price tag of over $100,000 USD, and that’s without accounting for time away from work, child care costs, etc., or costly cosmetic extras like nipple and skin-saving techniques.
Most people simply don’t have that kind of money. In the US, there’s no federal law saying insurance companies must cover prophylactic mastectomy (that’s the preventative kind). As such, coverage varies from state to state.
Surely there must be an alternative.
In most countries, doctors aren’t trained in healing. They’re trained in quick-fixes and solutions you can sell. Surgery is an obvious choice for anyone at high risk for cancer. Think about it. Got a blockage in the heart? No problem. There’s a surgery for that. After a surgeon removes the life threatening blood clots from a patient’s vital organs, he’s sent home with a prescription for a daily dose of aspirin and recommendation to eat less steak.
What about the “why”? This is something doctors don’t get training in.
Angelina Jolie’s critics point out that preventative surgery is fear-based – or statistics-based, which isn’t much different. The doctor does some tests, makes a grim diagnosis followed by some frightening data that more or less guarantee certain death and voilà!, patients are booking in for life-altering surgery. The possibility of an agonizing death by cancer makes extreme surgery look like a cakewalk.
But tell that to someone who’s lost their mother, grandmother and aunt to cancer. They don’t care about fear. They just want to live. They want to stop being afraid of leaving their children motherless, leaving their husbands to raise the family alone.
We need the Angelina Jolie’s of the world to speak for the women who are making the choice to undergo preventative surgery. We need her to keep on being bold and beautiful and cancer-free. But we also need people to speak up for alternatives to traditional methods. We need someone to ask “why”. We need someone to do it publicly.
Surgery is only one option. Great: now we all know about it. Now who’s going to speak for not getting surgery. Who’s going to look at the why? Why are we all getting cancer? Why does it seem like cancer is eating us alive? Most importantly, what else can I do to prevent it.
Let’s be frank. Most preventative care just doesn’t turn a profit. No one makes money when a patient goes home and plants an organic garden instead of getting their ovaries removed.
We mustn’t go around blaming Angelina Jolie and “the system”. Doctors only know the techniques they get trained in. Most medical schools don’t offer much in the way nutrition education and any other type of health care than can’t be bottled up and sold for profit.
In the end, we all have to make our own healthcare decisions. Let’s not condemn anyone for making the decision that feels right. Ultimately, we must all be responsible for our own health and make decisions to the best of our abilities.
It’s important to remember that it’s the most profitable types of medicine (ie. the western kind) that can afford the largest amount of press. The pharmaceutical industry has a vested interest in making traditional and natural medicines look ineffective and/or dangerous. There’s simply too much money at stake. What happens to the medical industry if people start healing themselves?
But let’s not get political. We need to search ourselves, do our own research and make our own conclusions. The kind of treatment you believe in is the one most likely to heal you. Even placebos have an incredible power to heal. Hey – if it works, why condemn it?
