On whether Angelina Jolie made the right decision to have a double mastectomy

‘Absolutely heroic!’  That was Brad Pitt’s description of his wife Angelina Jolie’s decision to have a double mastectomy and subsequently to tell the world about it.

I thought the description entirely apt.

No one, least of all one of the world’s most famous and  glamorous movie stars, makes a decision like that lightly. And it is hard to imagine any woman deciding on such a drastic course of action without compelling cause.

That cause, in Jolie’s case, was that she had been diagnosed with the faulty BRCA1 gene, a common predictor of breast cancer and ovarian cancer.

Her doctor put the risk of her developing breast cancer at 87 percent and of ovarian cancer at 50 percent. The assessment was in part based on hereditary factors. After a decade-long battle with cancer, her mother had succumbed to the disease at 56. Jolie is 37.

Last Wednesday the Herald republished a Telegraph Group story in which Jolie told of her reasons for having the double mastectomy, described the process in detail and explained her reasons for going public:

‘I wanted to write this to tell other women that the decision to have the mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent.  I can tell my children that they don’t need to fear they will lose me to breast cancer.

‘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.’  

Less impressed than me with Jolie’s actions was Weekend Herald columnist John Roughan whose piece ‘Genetic Risk Poses Dilemma’ effectively questioned whether Jolie had made the right decision to have a double mastectomy to prevent breast cancer.

I thought the question itself presumptuous. Only the  person facing a possible lingering death from cancer, or any other crippling disease, can decide whether a particular course of action is right for them or not.

In his column Roughan questioned the medical evidence behind Jolie’s decision and took issue with her expressed motivation in writing about her experience – ‘To any woman reading this I hope it helps you to know you have options.’  There were, he argued, other less drastic options.

But it was the chauvinistic and condemnatory tone of parts of Roughan’s piece that most concerned me:

‘Isn’t it a little disturbing that genetic science has caused Angelina Jolie to remove a perfectly fine pair of breasts…

‘Men too can inherit the BRCA2 mutation, increasing their risk of prostate cancer. I don’t know what I would do, but I hope I would choose to keep any organ for as long as it remained healthy. The idea of excising living tissue that has not yet let you down seems like a betrayal somehow, a premature surrender to what might never happen…

‘Angelina Jolie saw her mother die at age 56 after 10 years of treatment for breast cancer. Now she writes, “I can tell my children they don’t need to fear they will lose me.”

‘That is one less fear for them but her article did not mention whether they also carry the gene mutation. How sad if a girl or a boy should come to maturity regarding an organ of their developing sexuality as a death sentence unless they get rid of it. Sad and unnecessary.’

Reading these comments it seems to me that Roughan, a religious conservative, approaches the topic of Jolie’s ‘perfectly fine pair of breasts’ almost as if their removal were in the same category as an abortion: ‘disturbing, excising living tissue, a betrayal somehow, a premature surrender to what might never happen, a death sentence unless they get rid of it, sad and unnecessary.’

And the question as to whether Jolie made the right decision to have a double mastectomy to prevent breast cancer, has echoes at least of the question of whether the terminal cancer sufferer has the right to end his or her own life or to be assisted to do so. Those who oppose voluntary euthanasia argue the sanctity of human life; Roughan seems to argue the sanctity of human flesh.

Suffering and the fear of suffering and a premature death are central to such matters and it is my submission that any decision on the right course of action must ultimately rely first and foremost on the informed wishes of the person directly facing the dilemma. Courage comes easily to the unaffected.

Media trainer and commentator Dr Brian Edwards has retired from posting blogs at Brian Edwards Media.