By Dr. Jennifer Ashton– Imagine you are a 30-something year old mother and you have just learned you carry a mutation in the BRCA1 gene which dramatically increases your risk of ovarian and breast cancer. Now imagine you are not a multi-millionaire with access to the best surgeons and treatment in the word, but a woman without insurance or with very restrictive health insurance.
Your story will not make the front page of every newspaper in the United States, nor will it be the lead on the morning news shows or included in all nightly news broadcasts. And let’s say you decide to have prophylactic surgery to reduce your risk of developing breast cancer. Luckily, there is increasing legislation now that mandates that women even without insurance be offered reconstruction. You may have to call around to find a surgeon who will perform your reconstruction, but eventually you are successful.
Every single mother worries about what would happen to her children if she were to get cancer and die.
You have your surgery, and you go home from the hospital. Not to a luxury rehab facility or to an expansive mansion complete with house staff who help you with things like bathing, brushing your teeth, eating, cooking. You, Ms. Regular Woman, go home and wonder how you will care for your children with drains in your chest, bandages on your body, and a temporarily decreased range of motion. Maybe you are alone.
This is the situation faced by thousands of women every single day. It couldn’t be more different than the experiences of a world-famous actress. But here is where it is similar: every single mother worries about what would happen to her children if she were to get cancer and die. Every single woman has her own self-image ideals and worries about changes in her body (some worry more than others). Every single woman feels differently about risk and how much she is comfortable with in her day to day life.
As a woman, as a mother, and as an Ob-Gyn who offers BRCA testing to the appropriate patient with various risk factors, and then helps that woman make a decision based on her personal situation, I think that Angelina Jolie’s story should be looked at for what it is: hopefully an increase in awareness about BRCA genetic testing and surgery to reduce risks of certain cancers. It is also important to realize what it isn’t: it isn’t every woman’s story, and it isn’t applicable to the regular women in this country or worldwide.
For me, it underscores the importance of a good understanding of risks (the risks of testing, the risks of surgery, and the risks of watchful waiting), the benefits (benefits of testing, of having surgery and of NOT having surgery) and the options or alternatives (like chemoprevention or nontraditional therapies).
About Jennifer Ashton MD
Dr. Ashton is a Board-certified Ob-Gyn, women’s health expert, author and TV medical correspondent, currently serving as the ABC News Senior Medical Contributor.
Hailing from a family of 6 physicians and 1 nurse, this Ivy League graduate, wife and mother of two marries an unparalleled medical background with an accessible ‘girl’s-girl’ attitude.
She opened her private medical practice, Hygeia Gynecology, in Englewood, New Jersey in 2008.