Yesterday, I read Angelina Jolie’s New York Times piece where she shares her decision to have a laparoscopic bilateral salpingo-oophorectomy or, in other words, to remove her ovaries and fallopian tubes. The weight of her article, however, falls on the notion of ‘choice’ and knowledge as empowerment.
I just come from Argentina from supporting my mother through her second cancer operation and one thing that I know is that each cancer is a world of its own. Although there is much one can do to prevent it, there is no way of actually doing so. From a psychological perspective, cancer has been for my mother a double edged sword for it is both an opportunity to have my full attention (as a devoted only child) and an also the source of a very primal fear of death. My own illness (I am recovering from my addiction to drugs among other things and I am HIV positive) taught me that there is a limit to what we can control and, a consequence of this, is that there is also a limit for what we can understand. There is a difference between data and knowledge. To know one, firstly, needs to understand.
Angelia Jolie said that two years ago she had a preventive double mastectomy. The reasons for this are according to her that: ‘A simple blood test had revealed that I carried a mutation in the BRCA1 gene. It gave me an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. I lost my mother, grandmother and aunt to cancer. I wanted other women at risk to know about the options. I had been planning this for some time. It is a less complex surgery than the mastectomy, but its effects are more severe. It puts a woman into forced menopause. So I was readying myself physically and emotionally, discussing options with doctors, researching alternative medicine, and mapping my hormones for estrogen or progesterone replacement. But I felt I still had months to make the date. Then two weeks ago I got a call from my doctor with blood-test results. “Your CA-125 is normal,” he said. I breathed a sigh of relief. That test measures the amount of the protein CA-125 in the blood, and is used to monitor ovarian cancer. I have it every year because of my family history. But that wasn’t all. He went on. “There are a number of inflammatory markers that are elevated, and taken together they could be a sign of early cancer.” I took a pause. “CA-125 has a 50 to 75 percent chance of missing ovarian cancer at early stages,” he said. He wanted me to see the surgeon immediately to check my ovaries’.
In the following paragraph, however, Jolie jumps from the probable to the tragic by saying: ‘I went through what I imagine thousands of other women have felt. I told myself to stay calm, to be strong, and that I had no reason to think I wouldn’t live to see my children grow up and to meet my grandchildren. 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’. Well, it does not sound very peaceful to me. Within a second, Jolie became the center of attention of not only her family but the whole world and, at this point, one wonders whether her real problem is cancer.
Actually, her problem was not cancer for after bringing her husband from France and imaging the worst scenarios her tests results were back and they were negative. In spite of that, she says: ‘I was full of happiness, although the radioactive tracer meant I couldn’t hug my children. There was still a chance of early stage cancer, but that was minor compared with a full-blown tumor. To my relief, I still had the option of removing my ovaries and fallopian tubes and I chose to do it. It is not possible to remove all risk, and the fact is I remain prone to cancer. I will look for natural ways to strengthen my immune system. I feel feminine, and grounded in the choices I am making for myself and my family. I know my children will never have to say, “Mom died of ovarian cancer.” Well, they might just say: ‘Mom was totally crazy’. J A T