According to a press release by the Food and Drug Administration, the drug Lynparza was approved for patients whose breast cancer has metastasized and who carry a mutation in the BRCA1 and BRCA2 genes. The genes’ purpose is to repair damaged DNA and keep cells healthy; however, when they don’t function properly, the odds of developing breast or ovarian cancer increase significantly.
Jolie, 42, raised public awareness for BRCA genes with her decision to remove both breasts, a process she detailed in a 2013 New York Times op-ed titled “My Medical Choice.”
Explaining that she carried a “faulty” gene inherited from her mother, who died of cancer at age 56, Jolie wrote, “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.”
Describing the eight-hour procedure to remove breast tissue as a “scene out of a science-fiction film,” Jolie wrote of the aftermath, “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.”
Jolie also shared how the experience brought her and Brad Pitt closer together at the time. “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.”
She added, “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.”
Jolie’s viral essay triggered a worldwide phenomenon called “the Angelina Jolie effect,” leading to “enormous interest in hereditary breast cancer/genetic testing,” which scientists directly attributed to the actress. “This reported a 2.5-fold increase in referrals of UK women with family histories of breast cancer 3–4 months following Ms. Jolie’s revelation,” wrote researchers in the journal Breast Cancer Research. And a Harvard study found that two weeks after Jolie’s essay was published, there was a 64 percent increase in testing rates.
Two years later, Jolie shared her decision to remove her ovaries and her fallopian tubes in a New York Times essay titled “Diary of a Surgery,” a procedure that forced her into menopause. “I had been planning this for some time. It is a less complex surgery than the mastectomy, but its effects are more severe,” wrote Jolie.
Sharing that her doctor was concerned about elevated inflammatory markers that signified early cancer, Jolie wrote, “I called my husband in France, who was on a plane within hours. The beautiful thing about such moments in life is that there is so much clarity. You know what you live for and what matters. It is polarizing, and it is peaceful.”
Although the actress tested negative for cancer, the fear prompted her to undergo a second preventive procedure. “I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this,” she warned. “A positive BRCA test does not mean a leap to surgery. I have spoken to many doctors, surgeons and naturopaths. There are other options. Some women take birth control pills or rely on alternative medicines combined with frequent checks. There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally.”
Celebrities have a surprising influence on public health. For example, according to two studies conducted by San Diego State University, Charlie Sheen’s 2015 disclosure that he was HIV-positive triggered increased sales of HIV home tests and internet searches for the disease.
However, it’s important for people to weigh their diagnoses individually. The Harvard study found that mastectomy rates didn’t increase due to the Angelina Jolie effect, and in fact they declined by 3 percent. Wrote the researchers, “This suggests those who received the genetic test had a low risk of carrying the mutation in the first place.”
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