Guest Author - Dr. Denise Howard
The recent death of Charlotte Brosnan (daughter of Pierce Brosnan) from ovarian cancer at age 41 and the announcement by Angelina Jolie (age 37) of her decision to have a bilateral mastectomy to prevent breast cancer has brought forward the issues of breast and ovarian cancer for public consideration. The specific issue of hereditary gynecologic cancer and the potential to prevent this devastation should be stressed. The discussion should focus on awareness and understanding the available options to prevent the untimely death of mothers, sisters, daughters and friends.
Angelina Jolie’s mother died of ovarian cancer at age 56 and recently her aunt died of breast cancer. Jolie reportedly carries the genetic mutation BRCA1. She elected to undergo preventative bilateral mastectomy when she learned of her personal lifetime risk of 87% of developing breast cancer and also a 50% risk of developing ovarian cancer. Charlotte Brosnan’s mother also died from ovarian cancer, she was 43 years of age.
After reflecting on the cancer battles these young women and their families have undergone, many questions come to mind. Could Charlotte’s death have been prevented given her known family history? Should Angelina Jolie have her ovaries removed to prevent ovarian cancer given that she is at increased risk of ovarian cancer and ovarian cancer is notoriously difficult to detect early? What can individual women learn from their stories that will hopefully help decrease the likelihood of becoming a victim of breast or ovarian cancer?
Subject experts will have varying opinions on the answers to these questions and of course, the decisions are up to the individual; based on their personal circumstance and risk tolerance. But here is what I would like women to know.
1. There maybe a hereditary genetic mutation in your family if you have 1st or 2nd degree relatives who
• Develop ovarian cancer before age 50
• Develop breast cancer before menopause (the earlier age, the greater the risk)
• And multiple family members with these types of cancers (including colon and endometrial)
2. Genetic testing for many of these mutations is available and could save your life.
3. If you are at high risk of developing breast or ovarian cancer, you have options.
• Birth Control pills decrease the risk of ovarian cancer
• Hormonal therapies are available and can decrease the risk of developing breast cancer
• Prophylactic surgeries such as mastectomy (removing the breast) and bilateral oophorectomy (removing the ovaries) can significantly reduce the risk of developing breast and ovarian cancer.
4. Screening Mammography is effective in detecting breast cancer early enough where the chance of survival is quite high.
As with all health concerns, it is incumbent on you to get as much information as possible. Knowledge is power and understanding your options can be the difference between life and death (yours and your daughters, sisters and mothers).
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!