There is a story in the news this week about Angelina Jolie who has had a double mastectomy to reduce her chances of developing breast cancer. She had a BRCA test and found she was a carrier of the faulty gene that gave her an 87% chance of developing the disease and now, post-mastectomy, her chances have been reduced to around 5%.
My question is this: Would you have a test to see if you had the faulty gene that could potentially raise your chances of developing cancer? And if you did have the test, what would you do about it if you tested positive?
This is one of those questions that raises itself from time to time as scientific advances are made, and gene testing becomes more common. The test that Angelina Jolie had is quite expensive (up to around $3000) and it is not covered by medical insurance in the US. There is a different system for testing here in the UK, and referrals to specialists are done by the family doctor (GP – General Practitioner) which don’t cost the patient at all providing there is a strong family history of the disease and there is a high chance the test will be positive.
So for some people, the cost of the test could be prohibitive and would put them off having it done, but if the test was offered to you free of charge, would you still have it?
I am fortunate that there is no history of breast cancer in my family which I think is something that colours my response to these questions, but if I broaden it to include tests for other hereditary health issues then I feel quite strongly that no, I wouldn’t have the test. Of course, my Christian faith also colours my view too. I believe that whatever will be, will be and however life pans out I am not alone in dealing with it. I am quite content to leave my chances at developing a particular disease, whether it is breast cancer or something else, to nature and to leave that set of worries and anxieties until symptoms appear and then deal with it at that stage. I wouldn’t want to go looking for problems that may or may not occur in the future.
Say that if I did have a test and it showed an 87% chance of developing breast cancer, then I see it that there is a 13% chance of NOT developing it. And that’s good enough for me! How I would feel if that was a real scenario for me, I couldn’t say, but I am confident that I can trust my doctor to refer me to the appropriate specialist at the right time when and if symptoms present themselves. I am also confident that my family and friends would support me, as would my faith, should that situation arise.
And what about the next step? Angelina Jolie decided that she would have a double mastectomy to reduce her chances of developing breast cancer, but the key word here for me is “reduce” and not “eliminate”. I’m not a scientist or a biologist or a doctor, but speaking from my womanly viewpoint, I don’t think I could go through the trauma of such drastic surgery, especially if there was still an element of chance that I would still develop cancer. After all, if I was genetically predisposed to it then who is to say that 5% is enough of a chance NOT to develop it anyway? I know that removal of breast tissue means that there won’t be anywhere for the cancer to grow, but as men can develop breast cancer too and they don’t have the same sort of breast tissue as women, the chances of developing breast cancer is still possible. If it is in your biological make-up to be predisposed to cancer then I think you will get it whether or not you take steps to eliminate it before it develops. To only reduce my chances is not enough of a reason to go through such surgery.
Of course Angelina Jolie can afford top quality breast reconstruction surgery so perhaps for her that aspect of the process is different to most other women’s experience and may have been a deciding factor for her. I just don’t think I could go through it all and not be guaranteed to have eliminated all chances of developing breast cancer at the end of it. The anxiety over the test results, the surgery to remove the breasts, recovery, then more surgery to reconstruct them, recovery again, then mammogram after mammogram to see if cancer was developing in the years to come which would happen anyway if there was a family history… it all seems a bit too much for me.
I do have to point out that I do respect those women who are facing this decision for real, and I would never advocate that people shouldn’t have surgery if they feel it is the right course of action for them. Every woman is different, with a different viewpoint and different expectations from life, and I am not making a judgement on anyone who wishes to do this. Whatever people decide to do will be exactly right for them – test or no test, surgery or no surgery. Everyone has their own particular set of circumstances and there is no right or wrong thing to do here.
You know my personal view, and I’m curious to know how you see this issue.
- Would you have a genetic test to determine your chances of developing a particular disease or not?
- Would you have surgery or other treatment if you tested positive?
- Do you think we should just leave nature to take its course and trust the doctors to treat us if we develop problems later in life?
- Do you think science has gone too far in genetic testing and is crossing an ethical line now?
- Would you say science hasn’t gone far enough and there is much more work to be done on testing for more diseases and health issues?
- Should we all be tested as a matter of routine?
Please drop me a comment and let me know how you respond.
If you would like some more information about breast cancer please click here to be directed to Cancer Research UK’s website.