Star’s mastectomy highlights need for gene tests

With actress Angelina Jolie revealing she underwent a double mastectomy because of a mutated gene that made it highly likely she would have developed breast cancer, researchers hope more women in Cayman will come forward to avail of free genetic testing. 

In a self-penned article titled “My Medical Choice” that appeared in The New York Times on Tuesday, 14 May, Ms Jolie said her doctors estimated she had an 87 per cent chance of getting breast cancer and a 50 per cent chance of developing ovarian cancer. 

“Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action,” the 37-year-old actress wrote in the newspaper.  

“I wanted to write this to tell other women that the decision to have a 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 per cent to under 5 per cent. I can tell my children that they don’t need to fear they will lose me to breast cancer,” she said.  

The cost of testing for BRCA1 and BRCA2 is approximately $3,600 in the Cayman Islands. Last week, cancer researcher and oncologist Judith Hurley and genetic counsellor Talia Donenberg from the University of Miami Miller School of Medicine visited Grand Cayman to carry out DNA tests on women from a variety of Caribbean backgrounds in the Cayman Islands. 

“It is great for women with the BRCA gene mutation to have a fearless spokesman like Angelina Jolie,” Dr. Hurley said. “I hope that it encourages more people to come forward for testing.” 

Dr. Hurley carried out a second round of free BRCA tests in Cayman last week. In the first round, 30 Caymanian women, who were breast or ovarian cancer survivors or who currently had the disease, were tested. Last week, her team tested 35 women, the majority of whom were of Jamaican descent.  

“I am not sure if there are no more Caymanian women with breast cancer left or if we are not reaching the ones that remain. It is a vexing problem because I want a true sampling of the Caymanian population in order to draw conclusions,” Dr. Hurley said. 

The results of the first round of tests showed that none of the 30 women had the mutated BRCA gene that can lead to breast or ovarian cancer. The latest tests were expanded to include women from Jamaica, Barbados, Dominica and Trinidad and Tobago, while remaining open to Caymanian women. 

Ms Jolie’s mother, Marcheline Bertrand, died at the age of 56 from ovarian cancer, which she had battled for nearly a decade. 

The actress said she underwent three months of medical procedures that she completed on 27 April. She kept the surgeries and procedures to remove and reconstruct her breasts private while she was undergoing them, but decided to reveal she had undergone a double mastectomy in the hope that other women benefit from her experience.  

Ms Jolie highlighted the importance of having a support network when undergoing these surgeries. “I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has,” she wrote. 

She urged women reading the article to seek information and talk to medical experts if they have a family history of breast or ovarian cancer and to make an informed choice. 

Breast cancer kills some 458,000 people each year, according to the World Health Organisation, Ms Jolie said, adding that it must become a priority for more women to access gene testing and preventive treatment, “whatever their means and background, wherever they live”.  

A third round of free BRCA tests will be done at the Cancer Society in Cayman in September.  

“With Angelina Jolie suddenly raising awareness, maybe more women will be interested,” said Jennifer Weber, operations manager of the Cancer Society. “Angelina Jolie can afford any tests she wants and we can make that same test available free to women who qualify.” 

Ms Weber said it was important that more women avail of the BRCA gene testing. “This is science so we need more data so we can make sure we are really getting accurate information. The public doesn’t seem to ‘get it’ yet, so hopefully Angelina will get more women talking about it,” she said. 

She added that Ms Jolie opted to get a double mastectomy, “but that doesn’t mean that women who test positive for the BRCA gene mutation will do the same as the Hollywood starlet, but no one knows what they will do or how they will use the information until they have it. The level of relief we have seen in the women who received their BRCA test results was incredible. They were happy to know that they don’t have the BRCA gene for themselves, their family and their country.” 

Ms Weber added: “This test won’t answer every question about breast cancer in Cayman but it will tell us if our community is like the Bahamas where the study showed 25 per cent of the women tested positive.”
If a breast cancer survivor tests positive for BRCA genes, she has a 70 per cent chance of developing ovarian cancer, said Ms Weber. “This is powerful information for a woman to have. Knowing that she’s at higher risk, she can talk to her doctor about what to watch for so she can detect any issues early.” 

Determining the prevalence of BRCA genes locally is important, because “if we know our population is more likely to carry the BRCA gene, we’ll know to adapt our education programmes to younger women and then the medical community, everyone from parents to radiology techs to doctors, can be better prepared do more early detection,” Ms Weber said.  

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  1. THere is such a new development in medical science as Epigenetics-genes can be turned off by the body itself or they may remain dormant. Articles like this one create paranoia about cancer. Fear and anxiety can turn defective genes on.