Hold off on the Halo for Angelina Jolie, Please!
I’m not knocking Angelina Jolie, even if she’s beautiful, dizzyingly famous and apparently soon to be married to Brad Pitt. The thigh-thrusting performance at last year’s Oscars, as well as other questionable antics, don’t cancel out her humanitarian work with refugees or her role in setting up nonprofits that serve children in trouble spots of the developing world.
Recently Jolie wrote an op-ed for the New York Times stating that she’d undergone a double mastectomy and reconstruction of her breasts after discovering she carried the BRCA1 gene, which she says signals an 87 percent risk of her developing breast cancer and a 50 percent chance of ovarian cancer.
Jolie’s decision was a reasonable one, according to most oncologists, although not the no-brainer some people might think, given that breast cancer is often successfully treated without mastectomy.
‘Truly the most beautiful woman in the world’
But if I can’t fault Jolie, I can fault the sycophantic fluff that has followed her announcement. To give a few nauseating examples: A Swedish artist has tried to convey her “ethereal feminine look in a topless post-mastectomy portrait,” according to E online; actor David Krumholtz has tweeted, “now Angelina Jolie truly is the most beautiful woman in the world;” the New York Daily News editorialized her decision as “gut-wrenching;” and a Beverly Hills surgery center that performs breast reconstruction has described her story as “heartbreaking and courageous.”
Actually Jolie’s decision is neither more nor less “courageous” than those BRCA mutation carriers who decline prophylactic mastectomy and decide to check for disease with regular MRIs and mammograms; or those who undergo “chemoprevention” with tamoxifen — other reasonable options, according to oncologists. As for “heartbreaking,” the Beverly Hills surgery center needs to visit the young patients at the pediatric brain tumor unit of our hospital to witness the true definition of that word.
Perhaps what’s most troublesome about these gushing tributes is they’re amping up public attention to a cancer that has already fallen prey to “overawareness,” leading to women opting for mastectomy even if they have ductal carcinoma in situ, a stage zero cancer.
Any headway Jolie has made in helping cancer patients pales in comparison to the admissions of other lesser-known women of Hollywood. When the late Dana Reeve, the widow of “Superman” Christopher Reeve, told the world she had lung cancer, she bolstered the profile of the nation’s #1 cancer killer of men and women, and revealed a potent message. Yes, nonsmokers get lung cancer, too. Similarly Farrah Fawcett, as well known as Jolie back in the day, destigmatized anal cancer when she shared her experience of the disease that claimed her life in the documentary “Farrah’s Story.”
Breast cancer patients not necessarily the winners
While Jolie’s decision will probably ease her own psychological burden — something that she says has weighed heavily on her since her mother’s cancer death at 56 — the real winners of her revelation might not be women at high risk of breast cancer. Myriad Genetics, the company that developed the $3,000 test for the BRCA1 and 2 genes saw its shares climb by 4 percent just one day after the publication of Jolie’s op-ed.
One more thing: I lost my 12-year-old to a brain tumor, the #1 cancer killer in children, a disease that’s decades behind in both the scientific understanding and treatment developments of many adult cancers. Wouldn’t it be fantastic if Myriad or another molecular diagnostic company developed a blood test that identified newborns at high risk of developing pediatric brain tumor? That way, at-risk children could be scanned at frequent intervals and treated while the disease was at its earliest, most curative stage. That never happened in Natasha’s brief lifetime. And it’s highly improbable it will happen during the lifetime of those children who will be diagnosed with malignant brain tumors for many years or decades to come — if ever. Now that’s “gut-wrenching” and “heartbreaking.”
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THE MOURNING AFTER NATASHA 
Spot on as always. One day children’s cancer will matter too.
I am not surprised she immediately went public….it’s been awhile since she had her needed dose of attention……
15 year breast cancer survivor……no big public deals necessary…
Congrats, Pam!
wow, please ladies stop being haters. i hope that we all can find a cure for whatever we need to help us in this life. it had to be hard on her just like everyone else. she and just wanted to help other women. i dont get the need to hate. HATRED KILLS YA! love each other and carry on like a good person loving each other. just be nice. Pam i am so sorry for any of your pain and hope that you continue to stay healthy. smile and much love
I agree with you that some of my most heartbreaking experiences as a doctor in training were seeing the children with cancer. It was at that point I realized that I could never be a pediatrician nor an oncologist. It just doesn’t seem fair that a child should have to die from cancer. So sorry for your loss.
Thanks for saying so, Jennifer. I was surprised to discover our neuro docs were themselves all parents of young children. I couldn’t understand how they could reconcile their role as parents with their role of treating children — a significant percentage of whom would die. Don’t know if that requires great detachment, the ability to compartmentalize or extreme stoicism??
Unfortunately you have to have some degree of detachment in order to do that kind of work. But that doesn’t necessarily mean that they weren’t feeling your pain and sadness. I have told women they have cancer so many times that it almost seems routine. But there are still many moments where I want to cry with my patient but don’t in order to remain professional.
Do you remember all the times that people spoke about your experience as if they knew what you were going through? I would imagine that it happens very, very frequently. I’m so sorry for that.
It has been the hardest part of being BRCA1 positive for me. While it may seem like we have a privileged position, knowing about impending cancer (especially ovarian cancer that is almost impossible to detect early) is a lonely road. Angelina’s Op-Ed made that road feel a little less lonely.
I would trade anything–BRCA times a thousand–to keep my child healthy and safe. Because of that–because of the sheer unimagineableness of what you have gone through–I’m not upset that you wrote about Angelina, and me, in a way that sounded dismissive.
However, it would have been great if you hadn’t. Please remember that, while your loss trumps them all, it doesn’t help to dismiss others’ very real pain.
Johanna, I am so sorry that you are BRCA1 positive. Trying to highlight the frustration and agony of being a parent of a child with a grossly underfunded cancer that ultimately took her life does not mean that I have no compassion for adults with cancer or high-risk factors for cancer (did you read my piece “Shocking Pink,” part of which was about a woman who died of breast cancer at 40?).
What I said was that “if I can’t fault Jolie, I can fault the sycophantic fluff that followed” the op-ed. I stand by that opinion and also feel sympathy for those women who are BRCA positive and did not opt for prophylactic mastectomy (were they not “truly beautiful” or as “courageous” as Jolie in making their own decision?). In no way was my piece intended to be dismissive of people like you (or Jolie) who are BRCA positive, regardless of how they chose to treat it.
Wishing you well.
Thanks so much for your response.
The ways in which certain cancers (and certain responses–prophylactic mastectomy, for example) get the lion’s share of public attention and sympathy is unbelievably unfair. Thanks so much for writing your blog and helping your readers recognize that children and their families affected by cancer are very real and very under-recognized. When I really think about it, the unfairness of it all is astounding.
All the best to you and to your family.
Thank you, Johanna.