Angelina Jolie is set for surgery to reduce risk of contracting cancer

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angelina jolie

After her double mastectomy, Hollywood diva Angelina Jolie is set for another surgery to reduce her risk of contracting cancer. Jolie tested positive for breast cancer and opted for mastectomy. She now also faces the genetic risk of ovarian cancer and hence is planning to undergo another surgery.

But does testing genetically positive for contracting cancer necessitate removal of body organs? Is it a complete guarantee from not contracting cancer?

Oncologists state that undergoing surgery can reduce chances by 90 per cent for contracting breast and ovarian cancer. But BRCA2 (a gene) carriers are at the risk of melanoma and also stomach cancers. They state that Angelina Jolie’s case is not applicable for all women. Ten out of 100 women can have breast cancer even without genetic mutation. The surgical option to reduce cancer is a debatable issue and if taken up, it is completely the decision of the patient and not the surgeon, state the oncology experts.

It Stresses out women

Dr S. Chandrasekhar Rao
Removal of an organ for prevention of cancer is a purely personal decision of an individual. Surgical removal of normal breasts causes immense psychological distress to women. Dr S. Chandrasekhar Rao, chief of surgical oncology, American Oncology Institute explains, “The impact of surgery on body image and sexuality should not be underestimated. Women suffer from bouts of depression and also face marital disharmony. The worst thing is that they believe their bodies have been tarred,  hence, their body image takes a huge beating.” For younger women, a surgery can cause abrupt onset of menopausal symptoms, hot flashes, insomnia, anxiety, decreased sex drive and also decreased bone density.

Consider risks

DR C. Sunkavalli
Genetic tests are done to find the mutation of gene which causes a predisposition for high probability of a particular cancer. While it is not for all, it is for those whose family history suggests an inherited cancer risk condition. The test results can be adequately interpreted as it clearly tells whether a specific gene change is present or absent. With these results it becomes easy to guide a person to take care of their risks. Dr Chinnababu Sunkavalli, consultant surgical oncologist at Apollo Cancer Hospitals, says, “When several close blood relatives have the same type of cancer then genetic tests are recommended. But the testing has to be done after thorough counselling. The patient needs to consider risks, benefits and the limitations of genetic testing. Risk-reducing surgery is not considered an appropriate cancer-prevention option for those women who are at a risk of developing breast cancer later but not at the highest risk. There are also drugs available which will reduce the risk. These have to be taken after proper counselling if the tests show high-risk status.” The treatment option for those identified as high-risk does not mean only surgery. Other options like enhanced screening, regular clinical examination and chemoprevention by drugs can also be offered. The patient must be given various options.

Surgery does not guarantee no cancer

Dr Amit K. Jotwani
Genetic tests undergone by Angelina Jolie are not required for all. Angelina was identified with a defined risk as her grandmother had ovarian cancer in 2004 and her maternal aunt and mother died of breast cancer. Her BRCA1 (a gene) tested positive and she opted for surgery. But genetic tests are not required for all as the chances of testing positive are less than one in 500 people.

Dr Amit K. Jotwani, senior radiation oncologist with Yashoda Hospitals, says, “A positive result cannot tell whether an individual will actually develop cancer. Many women who inherit harmful BRCA1 and 2 may never develop cancer.” Yes, women whose maternal family has a history of breast and ovarian cancer can approach hospitals for tests but the options of surgical removal are not advisable. Because prophylactic surgery does not completely guarantee that cancer will not develop. That’s because not all at-risk tissues can be removed.

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