Having been a big fan of Melissa Etheridge’s music for many years—and cheering her on in her own very public battle with cancer—I was dismayed to read today her opinion regarding Angelina Jolie’s choice to have a double mastectomy. To recap, Ms. Jolie elected to have a double mastectomy because she tested positive for the BRCA1 gene, which according to her doctors, gave her an 87% chance of developing breast cancer and a 50% risk of developing ovarian cancer. After having her breasts removed, her chance of developing breast cancer dropped to less than 5%. She was commended for bravery, not only in choosing to have the surgery but in telling her story, which she told in the hopes that more women will understand the risks of having the BRCA1 gene and what it could mean for their future health. She also wrote in her op-ed in the New York Times that she hopes the $3000 that it costs to take the test isn’t a deterrent going forward for the vast majority of women who will inevitably want to take the test and make a conscious decision about their health.
Ms. Etheridge called Ms. Jolie’s choice “a fearful choice” and also said that she thinks that cancer stems from within and is not completely determined by genetics or mutations. (I’m paraphrasing.) She understands why she “got cancer”—in other words, it was due to stress and poor nutrition and presumably a host of other things that she now has control over, nine years after her diagnosis.
This issue—and Angelina Jolie’s decision—isn’t without controversy and I have had spirited discussions with friends about gene testing and the decision to remove one’s breasts in the face of a positive diagnosis of BRCA1. But as someone who has had cancer twice, I feel that I have a little more insight into the discussion. A two-time metastatic melanoma survivor, I am hoping that one day my children can get tested and do preventative maintenance to avoid a devastating diagnosis like the two I got. I hope that by studying me for eight long years, my doctor has come a little closer to understanding how the sun changes the DNA in some people like me and alters their genes so that their cells become cancerous and malignant later in life. Yes, we now know to wear sunscreen or UV protectant clothing, but for some of us, the damage is already done. We know to get yearly skin checks but sometimes it’s too late. We need to know more, to do more. Education and knowledge are power and I believe that by going public with her decision, Angelina Jolie contributed to helping some women take control over their lives.
It does a disservice to cancer patients and survivors to say that by being stressed or by not eating right, we are putting ourselves in harm’s way or that by just minimizing stress and being careful of what we put in our bodies, we are lessening our risk of disease. In theory, both of these things may be true—and probably are—but they are only one piece of the puzzle. One of the well-meaning things that people say to you when you’re diagnosed is “Have a positive attitude!” which is a lovely sentiment but when it’s four in the morning and you’re tired and nauseated and scared to death—feeling the opposite of positive—you wonder if the negative thoughts that flood your brain are also giving cancer cells the fuel they need to prosper and thrive, dampening the immune system that is supposed to be fighting them. Isn’t trying to feel positive or stress free in face of life’s stressors, both great and small…well…stress?
We were with a group of friends a few weeks back and in that group was someone who had lost a daughter, too young, to cancer. Another in the group complimented me on how well I looked and proclaimed that the reason I had gotten better was because I had “been so positive.” She was sure that was the reason that I was still here, despite being given a slim chance for survival. Does that mean that the man’s daughter wasn’t a positive thinker? Or did it just mean that she and I had different types of cancer, different health circumstances, different treatments, and ultimately, different prognoses? I believe it’s the latter. She died because her situation was different—not because she didn’t smile as much as I did or put on the happy face while undergoing treatment.
I believe, and this stems from being in the trenches of cancer diagnosis and treatment for four years, that getting well and staying well is a mixture of faith and science. Faith on its own is great but science needs to support it. Science, in the form of treatment, is wonderful if it’s the right one and you respond to it, but you need to have faith that you will triumph. Together, treatment and your belief in a healthy you go a long way toward helping you achieve the goal of being disease free.