Friday, 17 May 2013

BRCA – Genetic testing and the NHS


The story this week that has been impossible to miss, and that everyone has been talking about, has been that Angelina Jolie has revealed in an article in the New York Times that she chose to undergo a double mastectomy. Her decision to have the surgery was based on the results of a genetic test of the BRCA gene – BRCA 1 or BRCA 2, which can determine if you are at risk of developing breast cancer or ovarian cancer. According to the article, Angelina Jolie had an 87% risk of developing breast cancer, and so opted to take preventive measures to reduce her chances of ever getting breast cancer down to just 5%.

Angelina Jolie lost her mother to breast cancer, and as most people know – not only is Jolie a world famous actress and an UN ambassador, she has six children. In my opinion, and to the opinion’s of most people supporting her on twitter and Facebook, her decision was brave and heroic. She is taking the fight to cancer, and she’s saying I won’t wait for you to come for me. She’s taking the offensive, and she’s on the attack. Ultimately she’s being clever. Just look at the statics and the percentages of her genetic testing!

For someone like Jolie to have done this, in her profession where looks count for everything, I think she is going to have given courage and self respect back to thousands – if not more, of woman around the world. Woman who have doubted themselves, felt self-conscience and even ashamed at times, when they have looked in the mirror after having undergone lumpectomy’s and mastectomies – singular or double.

Yet it is not just about confidence, but – as Jade Goody did before she died, Jolie has also raised awareness. There is no one not talking about this story. Whether you agree with what Jolie’s done or not? Whether you would get tested or not? Whether you would opt for the mastectomy or not? Everyone has an opinion on this story, and so everyone is once again thinking and talking about cancer. People often say that cancer is never forgotten, but sadly all too often I fear that it is. All too often I think it becomes all too easy to ignore what does not affect us, what is not in our day to day life.

We should also not forget when talking about BRCA that for many there isn't a preventative genetic test. For many they have to wait for cancer to strike, and then hope like hell that they can fight it off and survive. Yet for some it is a fight that they cannot win. Cancer is brutal and cruel, and it affects not only those with the disease but also their friends and families.

So for me, the significance of my breasts compared to my life I feel cannot be compared. I would choose my life every single day. Surgeons can give me back replicas of my breasts. They can’t always give me back my life, not if the cancer takes hold too fast. Cancer is, let me say it again, brutal and cruel.
Jolie’s test, it is said, revealed an 87% chance of her getting breast cancer. Yet following her actions this has now been reduced to 5%.  I honestly cannot see how her decision was not the right one, and in any other avenue of life you would follow that course of action. Why would you run the risk when the odds were so against you? 87% chance of being faced with cancer, now it’s just 5%?

In The Guardian this week there were concerns raised about how the NHS was going to cope with the increase in the number of women wanting to be genetically tested. I appreciate that this will be a strain on the NHS, and any women choosing preventive surgery will obviously add a burden to the already over stretched NHS. Yet my argument would be this. Bevan’s philosophy for the NHS was that it was intended so that people would get better so that the NHS might one day not be needed. Granted this has not happened, and there has become a greater reliance on the service.

However in regards to genetic testing, if you offer women from having what could be preventative life saving treatment then they would hopefully not get breast cancer / ovarian cancer (if they had like Jolie the double mastectomy or in the regards to ovarian cancer an oophorectomy.) This would therefore save the NHS money in the future with regards to treating future possible cancer patients who would need further care, and it would also save money in regards to the additional treatments that these cancer patients often require such as radio and / or chemo therapy. It would also – as one of the credit card adverts say, be priceless in terms of the psychology benefits of not having to deal with the disease itself.

Some people may read this and think that there is a flippancy to the tone in regards to mastectomies, but let me assure you that there isn't  Cancer is a subject that touches very close to home, but I just feel that each woman that has the opportunity to be genetically tested should be. Then, in my opinion, it is that woman’s choice as to how she moves forward.

Ovarian cancer is a more sensitive issue for me, especially depending on the age of the woman, as it will remove any chances of her bearing children. Yet for me if removing your breasts can save your life, or have a high percentage / probability of saving your life, then I cannot see any reason not to do it.

Jolie’s attitude is truly inspirational, and she remains confident, beautiful, and one of Hollywood’s most glamorous women regardless of her surgery. Also I feel it would be wrong not to mention the attitude of Brad Pitt in all of this. He has appeared to be amazingly supportive, kind, and loving. He too has been an inspiration for men that will be put in a difficult position for their wives, girlfriends, sisters, mothers, and even friends, that may turn to them at some point in their lives over this issue.

What a couple Pitt and Jolie seem to be? They have certainly risen above the naysayers of Hollywood. They seem to have defied all the odds, and I hope that Jolie will continue to be a tour de force for women. She is a voice now, and I hope that she will continue to be.