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.
We often speak of “Mommy’s mommy,” and I find myself trying to explain
the illness that took her away from us. They have asked if the same
could happen to me. I have always told them not to worry, but the truth
is I carry a “faulty” gene, BRCA1, which sharply increases my risk of
developing breast cancer and ovarian cancer.
My doctors estimated that I had an 87 percent risk of breast cancer and a
50 percent risk of ovarian cancer, although the risk is different in
the case of each woman.
Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a
65 percent risk of getting it, on average.
Once I knew that this was my reality, I decided to be proactive and to
minimize the risk as much I could. I made a decision to have a
preventive double mastectomy.
I started with the breasts, as my risk of breast cancer is higher than
my risk of ovarian cancer, and the surgery is more complex.
On April 27, I finished the three months of medical procedures that the
mastectomies involved. During that time I have been able to keep this
private and to carry on with my work.
But I am writing about it now because I hope that other women can
benefit from my experience. Cancer is still a word that strikes fear
into people’s hearts, producing a deep sense of powerlessness. But today
it is possible to find out through a blood test whether you are highly
susceptible to breast and ovarian cancer, and then take action.
My own process began on Feb. 2 with a procedure known as a “nipple
delay,” which rules out disease in the breast ducts behind the nipple
and draws extra blood flow to the area. This causes some pain and a lot
of bruising, but it increases the chance of saving the nipple.
Two weeks later I had the major surgery, where the breast tissue is
removed and temporary fillers are put in place. The operation can take
eight hours. You wake up with drain tubes and expanders in your breasts.
It does feel like a scene out of a science-fiction film. But days after
surgery you can be back to a normal life.
Nine weeks later, the final surgery is completed with the reconstruction
of the breasts with an implant. There have been many advances in this
procedure in the last few years, and the results can be beautiful.
I wanted to write this to tell other women that the decision to have a
mastectomy was not easy. But it is one I am very happy that I made. My
chances of developing breast cancer have dropped from 87 percent to
under 5 percent. I can tell my children that they don’t need to fear
they will lose me to breast cancer.
It is reassuring that they see nothing that makes them uncomfortable.
They can see my small scars and that’s it. Everything else is just
Mommy, the same as she always was. And they know that I love them and
will do anything to be with them as long as I can. On a personal note, 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.
I am fortunate to have a partner, Brad Pitt, who is so loving and
supportive. So to anyone who has a wife or girlfriend going through
this, know that you are a very important part of the transition. Brad
was at the
Pink Lotus Breast Center,
where I was treated, for every minute of the surgeries. We managed to
find moments to laugh together. We knew this was the right thing to do
for our family and that it would bring us closer. And it has.
For any woman reading this, I hope it helps you to know you have
options. 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.
I acknowledge that there are many wonderful holistic doctors working on
alternatives to surgery. My own regimen will be posted in due course on
the Web site of the Pink Lotus Breast Center. I hope that this will be
helpful to other women.
Breast cancer alone kills some 458,000 people each year, according to
the World Health Organization, mainly in low- and middle-income
countries. It has got to be a priority to ensure that more women can
access gene testing and lifesaving preventive treatment, whatever their
means and background, wherever they live. The cost of testing for BRCA1
and BRCA2, at more than $3,000 in the United States, remains an obstacle
for many women.
I choose not to keep my story private because there are many women who
do not know that they might be living under the shadow of cancer. It is
my hope that they, too, will be able to get gene tested, and that if
they have a high risk they, too, will know that they have strong
options.
Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.
Angelina Jolie is an actress and director.
13/5/13
