Is Angelina Jolie's Medical Choice Available to All Women?

Tuesday, May 14, 2013

Director Angelina Jolie and DP Dean Semler discuss a shot while filming In the Land of Blood and Honey Director Angelina Jolie and director of photography Dean Semler discuss a shot while filming In the Land of Blood and Honey (Dean Semler/Courtesy of FilmDistrict and GK Films)

In an op-ed piece for our partner The New York Times, actress and director Angelina Jolie announced that she recently underwent a double mastectomy after learning that she is a carrier of the BRCA1 breast cancer gene and was at high risk of developing the disease.

After battling breast cancer for nearly a decade, Jolie's mother died of the disease at the age of 56. So in an effort to be proactive and minimize her risks, Jolie began going through the treatments and surgery in February of this year.

Gisella Alvarez, a charge nurse at Mercy Medical Center, shares her experience undergoing a double mastectomy after being diagnosed with breast cancer.

Nita A. Farahany is a bioethicist at Duke University and professor of genome sciences and policy. She sits on the Presidential Commission for the Study of Bioethical Issues. Dr. Kevin Hughes is a surgical oncologist at Massachusetts General Hospital. They discuss the ethics of knowing your genetic information and the decision making process that leads to this life transforming operation.


Gisella Alvarez, Nita Farahany and Dr. Kevin Hughes

Produced by:

Rupert Allman and Elizabeth Ross

Comments [8]

unkerjay from Puget Sound, WA

Is Angelina Jolie's Medical Choice Available to All Women?

No, it's not.

Angelina Jolie can go wherever she wants and pay whatever it takes to have it done. She can go where it costs less and pay someone where it's possible to have it done.

The vast majority of Americans just don't have those options.

If insurance won't cover it and you can't afford it or afford to go where that's not a problem, guess what?

Good luck. Because that's all you'll have left going for you.

May. 14 2013 09:55 PM
Eva Moon from Redmond WA

Kudos to Angelina for opening up publicly about this. I also have the BRCA1 mutation and had the same surgery last year - as well as a hysterectomy, all while helping to care for my mother who was dying of cancer. I also wanted to be open about my journey to help educate women. I wrote a musical show about it called "The Mutant Diaries: Unzipping My Genes"

For those commenting on the cost, you should know that in the US it's federal law that if your insurance covers mastectomy (and most do for BRCA) it MUST also pay for reconstruction. It's not considered elective or cosmetic.

May. 14 2013 05:10 PM
Paul Dorsey from Portland OR

There are several important points that are not being discussed. First, it is very important that people thinking about this test be evaluated by a genetics professional prior to testing to be sure that the correct test is being ordered. Only 10% of breast cancer is hereditary but when it is hereditary BRCA1 and BRCA2 account for 65% of hereditary breast cancer syndromes. We currently know of 28 genes that predispose to breast cancer and we can determine which gene to test based on the spectrum of cancer seen and other physical features (not cancer) that are running in the family. It does no good to test the patient for the wrong gene. Furthermore, the discussion focused on breast and ovarian cancer in BRCA gene mutations but those two genes also predispose to prostate, gastric, colon, melanoma and pancreatic cancer.

May. 14 2013 01:17 PM
Marilyn A. Kay from Texas

I know it was a hard decision for Ms. Jolie to make, but probably a wise one. Sadly, I think she should consider a hysterectomy as well.
I am a breast cancer survivor, age 65, (diagnosed 2001), my twin (not identical) also had breast cancer at age 42. She opted for double mastectomy. She did not have to undergo chemo or radiation. I had to do both, but only had a lumpectomy. Our mother, still living, diagnosed with breast cancer at 82.(she is 94) She only had a lumpectomy, which I encouraged, because of serious side effects of chemo and radiation. With such a history, I chose to have the BRCA test done. It was negative. My sense of cause was related to excessive hormones through early birth control pills, hormone replacement therapy for 10 years and/or environmental. Anxious about my 4 nieces and potential for breast cancer, though seemingly, not genetic based.

May. 14 2013 01:14 PM
Geena from Dallas TX

It's unfortunate that your report is more sensational than responsible. While I applaud your and Angelina Jolie's efforts to comfort women facing such a choice, your lack of information regarding the total costs of testing, surgeries, reconstruction, etc., most of which are NOT covered by increasingly prevalent high-deductible insurance plans which do not cover any exams or procedures that are diagnostic, is appalling at best. The professionals in your report are self-serving and have little if any clue about total costs when advising patients, and we can all agree that while arguably admirable, Angelina Jolie has unlimited resources, and costs are of little consequence to her and certainly are not at the forefront of her decision-making. Most women facing these choices would be stunned to find, after the fact in most cases, that their out-of-pocket costs will be in the tens of thousands of dollars. They may save themselves from dying of breast or ovarian cancer but the stress over the resulting bills will kill them.

May. 14 2013 12:36 PM
Dan Brook, Ph.D. from California

Angelina Jolie's decision is fine for what it is, and I applaud her for proactively looking out for both her health and the interests of her children, but breast cancer (as well as other cancers, including prostate cancer, in addition to heart disease, stroke, diabetes, gout, kidney disease, hypertension, etc.) can be better prevented, halted, and even sometimes reversed, with a low-fat whole foods plant-based diet.

As a bonus, this low-fat whole foods plant-based diet has many other benefits as well, not only for your health (without surgery), but also for public health, for the animals, for your spirit, and for our environment.

I urge you to watch

and to peruse

This non-invasive, perfectly safe dietary choice is readily available to ALL women!

May. 14 2013 12:11 PM
G L Sweetnam from Woodstock, CT

My wife had the BRCA test done because several close relatives had ovarian or breast cancer. When it came back positive for the BRCA 1 gene, she immediately scheduled surgery and had a bilateral oophorectomy (ovaries) and bilateral mastectomy, with reconstruction. When we went to our surgeon for a follow-up consultation, she told us that a biopsy had discovered a cluster of cancer cells that had not yet affixed to the wall of one fallopian tube. "If you had waited a year for this surgery, we would be having a very different conversation." she said.

May. 14 2013 11:31 AM
Angel from Miami, FL

I learned about BRCA last year from watching 90210.

May. 14 2013 10:20 AM

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