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Jane Ahlin, Published May 18 2013

Ahlin: Angelina Jolie, cancer and health care choices

Only once did I come close to seeing Angelina Jolie in a movie and that wasn’t in a theater. While flipping TV channels, I happened onto “Mr & Mrs Smith,” the movie infamous for beginning her relationship with Brad Pitt. I remember watching for a few minutes and thinking, “Gee, this is dumb,” and changing the channel.

That said, Jolie is physically stunning and the celebrity appeal of “Brangelina” is understandable. (In a column years back, I think I categorized her role in ending the marriage of Jennifer Aniston and Brad Pitt as a modern – but lesser – version of Elizabeth Taylor’s role in ending the marriage of Debbie Reynolds and Eddie Fisher.) Vaguely, I think I also was aware that she and Pitt are parents of both biological and adopted children and that they support humanitarian work. But I didn’t think much about her.

Last week, however, I became Jolie’s fan when she wrote an op-ed for the New York Times about her decision to have a preventive double mastectomy to avoid breast cancer. She told her own story, and her telling – straightforward, full of empathy and encouragement – resonated, not only for women with BRCA gene mutations and those of us who have had breast cancer surgeries but also for every woman who makes difficult decisions for her health.

Given the reality that Jolie had inherited a “faulty gene, BRCA1,” and her “doctors estimated (she) had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer,” which had taken her mother’s life, she acted. Because her risk of breast cancer was greater and “the surgery was more complex,” her medical treatment began with mastectomy, although she left open the idea that she might later undergo oophorectomy (ovary removal).

As I read the statistics Jolie faced, I could not help but think of a family near and dear to my heart whose members know all too well the reality of the BRCA1 genetic mutation. Unfortunately, they had no opportunity to make Jolie’s decision because they didn’t know about the gene until it was too late. The mom with the gene, now in her late 80s, has survived two bouts with breast cancer. Two of her three daughters have the gene and both have had breast cancer. (The daughter without the gene has not.) Her son also has the gene and currently is fighting a virulent form of prostate cancer. In the past, the mom lost both her parents and her brother to cancer, and her brother’s daughter had breast cancer at age 28. One of the mom’s teenage grandsons – the son of a daughter with BRCA1 – has leukemia, which likely also is related.

In other words, BRCA1 and BRCA2 genes may account for only 5 percent of breast cancers overall; however, for families who deal with it, the consequences can be overwhelming. Jolie made clear that she sees knowledge of the genetic mutation as power to make use of preventive measures that are available, although she acknowledged that the cost of testing (more than $3,000) is prohibitive for many women unless they are lucky enough to have insurance that covers it.

Jolie also spoke frankly about trying to save the nipples of her breasts, about the importance of having a supportive partner, and about her desire to reassure her children so they could depend that “Mommy” was “the same as she always was” and would stay with them.

I remember wanting that reassurance for my children. Almost 20 years ago after stopping for hamburgers at a drive-up on our way to the lake following my mastectomy for breast cancer, our grade-school-aged son in the back seat suddenly asked, “Are you going to get that cancer back, Mom?”

“No,” I said, “I’m not.”

“Do you have any more ketchup up there?”

I think I smiled all the way to the lake.

At one point Jolie said, “I feel empowered that I made a strong choice …”

Women (and men) must be able to consult their doctors privately and make decisions about their bodies, choosing what is best for them and their families. And that’s true for more issues than BRCA genes and cancer.

Ahlin writes a Sunday column for The Forum.