Tuesday, May 14, 2013

What does Angelina Jolie's announcement mean to all of us?

Today, Angelina Jolie surprised us all by announcing she had a preventive double mastectomy. Jolie recently learned that she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer. Her mother died of ovarian cancer in 2007 at the age of 56.

"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," Jolie declared in her New York Times op-ed article. "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."

All of which got me thinking about my own family history.

My maternal grandmother was in her mid-40's when she died of ovarian cancer.
My mother was 62 when an annual mammogram revealed a lump of 1 cm. She is now a 16-year breast cancer survivor.
[My sister was about 50 when she had half of her thyroid removed, the cancerous half. I know that's not in the same category as breast and ovarian cancers, but it is still cancer.]

I just had an all-clear at my annual mammogram and physical exams.

I haven't been tested for BRCA1 and BRCA2 gene status. My mother said hers was negative. My next question for my doctors will be, should I get tested?

I know many women who have battled breast cancer, certainly well within the 1 in 8 women. I remember so many of those women having to decide whether to have a lumpectomy or a mastectomy. My mother, and many others, survived breast cancer with a lumpectomy. Others had mastectomies. My dear friend Laurel had a mastectomy when they discovered a very aggressive cancer in her breast. She then had a preventative mastectomy for the other breast. She still died of breast cancer. So did Mary my neighbor, and so many more.

I found this excellent link regarding the pros and cons of preventative mastectomies. http://www.cancer.gov/cancertopics/factsheet/Therapy/preventive-mastectomy

There is a lot to learn, and many factors to take into consideration. Jolie's announcement will have a lot of women asking themselves important questions. I hope they take all the facts into consideration before they consider a double mastectomy. I wonder if preventive double mastectomies will become as standardized as mammograms? That is, will doctors recommend them and will insurance companies pay for them?

Not a very good Mother's Day

My knee started getting sore Sunday, Mother's Day, after lunch, and continued getting stiff and sore throughout the afternoon. I took puppy for a slow walk, thinking maybe that would help ease the joint. I lasted 30 minutes at a very slow pace, so slow that my pedometer didn't register the middle 10 minutes!

By evening, I couldn't bear any weight on my left leg, and some movements had me gasping in pain. I took some Tylenol for the pain. I barely made it up the stairs at night.

I saw my PCP this morning. He was able to move the joint in its full range of motion (but I was in tears from the pain), and declared that all the parts seem to be in their proper place and working. He believes there is inflammation in the knee, although why is a mystery.

He has me on an anti-inflammatory and rest for 10 days. If that cures it, wonderful. If the pain comes back, we will begin "the cascade of radiological testing." (Insurance companies will insist on starting with an X-ray, although the X-ray will not show us what we need to know.)

I was enjoying my walks with puppy, and the weather was just getting nice. I was 12 for 12, exercising every day so far in May and I was even dropping a few pounds again. Phooey to be sidelined.