Unlike Jolie, Indian women wary of mastectomy, say doctors

[prasad1]

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Hollywood actress Angelina Jolie's decision to go public about her double mastectomy to reduce the risk of breast cancer has been hailed as a brave move, but in India, doctors say there is very little awareness about it and many women are wary of taking the step due to societal pressure and apprehensions.

Jolie carried a "faulty" gene, BRCA1, which sharply increased her risk of developing breast cancer and ovarian cancer.


Bhargava said Jolie's public statement will encourage other women to come forward. "Jolie is an international celebrity and that makes a difference. She was bold enough to talk about it. Women in India feel scared even taking the test, forget about undergoing the procedure," Bhargava told IANS.

 

[biswa]

Does BRCA1 occur more among Caucasians? In that case, this discussion would become moot, wouldn't it?

 

[renuka]

I feel it is easier to remember the name of gene if it was BRAC1 instead of BRCA1 cos after all we are discussing about Breast Cancer here.

To me I feel Jolies move was too drastic and it was an individual choice..even experts doctors here voiced the same opinion.

She got her both breasts removed and did plastic reconstruction with saline implants.

Not all women have the money to do that and at the same time no one would want to be breastless when cancer has not even reared its ugly head yet.

The best is to get screening down annually and to act the moment the 1st signs of Cancer strike.

Jolie had a 85% risk of getting cancer but she should have remembered that she also had a 15% chance of not getting it too...so why be so negative in thoughts???

To me I feel she was too drastic.

 

[Sastri]

i feel it is easier to remember the name of gene if it was brac1 instead of brca1 cos after all we are discussing about breast cancer here.

To me i feel jolies move was too drastic and it was an individual choice..even experts doctors here voiced the same opinion.

She got her both breasts removed and did plastic reconstruction with saline implants.

Not all women have the money to do that and at the same time no one would want to be breastless when cancer has not even reared its ugly head yet.

The best is to get screening down annually and to act the moment the 1st signs of cancer strike.

Jolie had a 85% risk of getting cancer but she should have remembered that she also had a 15% chance of not getting it too...so why be so negative in thoughts???

To me i feel she was too drastic.

prevention is better than cure

 

[Naina_Marbus]

BRCA1 and BRCA2 are human genes that are known as tumour suppressors. In normal cells, BRCA1 and BRCA2 help ensure the stability of the cell’s genetic material (DNA) and help prevent uncontrolled cell growth that can lead to cancer. Mutation of these genes has been linked to the development of hereditary breast and ovarian cancer.

Not all mutations are harmful. Some mutations may be beneficial, whereas others may have no obvious effect (neutral). Only harmful mutations increase a woman’s risk of developing cancer.

Even without mutation, every woman has a certain lifetime (low) risk of developing breast cancer. This risk is greatly increased if she has a harmful mutation in the BRCA1 or BRCA2 gene. If these mutated genes are inherited, the risk factor goes up still further. If she has multiple, close family members who have been diagnosed with these diseases, her risk factor goes up even further.

The likelihood that a breast and/or ovarian cancer is associated with a harmful mutation in BRCA1 or BRCA2 is highest in families with a history of multiple cases of breast cancer, cases of both breast and ovarian cancer, one or more family members with two primary cancers (original tumors that develop at different sites in the body). However, not every woman in such families carries a harmful BRCA1 or BRCA2 mutation, and not every cancer in such families is linked to a harmful mutation in one of these genes.Furthermore, not every woman who has a harmful BRCA1 or BRCA2 mutation will develop breast and/or ovarian cancer.

According to estimates of lifetime risk, about 12.0 percent of women (12 out of 100) in the general population will develop breast cancer sometime during their lives compared with about 60 percent of women (60out of 100) who have inherited a harmful mutation in BRCA1 or BRCA2 . In other words, a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.

Estimates of cancer risk associated with BRCA1 and BRCA2 mutations have been carried out on large families with many individuals affected by cancer. Because family members share a proportion of their genes and, often, their environment, it is possible that the large number of cancer cases seen in these families may be due in part to other genetic or environmental factors.

Therefore, risk estimates that are based on families with many affected members may not accurately reflect the levels of risk for BRCA1 and BRCA2 mutation carriers in the general population. In addition, no data are available from long-term studies of the general population comparing cancer risk in women who have harmful BRCA1 or BRCA2 mutations with women who do not have such mutations. Therefore, the percentages given above are estimates only.

In the case of Angelina Jolie, because of her family history, her risk factor was calculated to be around 85% . So Angelina Jolie’s case is not a woman of average risk, and to take her experience and generalize it either to ordinary women of average risk or even women with a family history is a bit media sensationalism. Women concerned about this issue should read a recently published lengthy article on this issue by PEGGY ORENSTEIN in the NY Times: clickhere

Peggy Orenstein, who is also breast cancer survivor, says that, as a result of all such sensationalism, “the average woman has an exaggerated sense of her own personal risk, so that we make decisions that are not in our own best interest."

Orenstein had a recurrence of breast cancer 15 years after her first diagnosis and faced fresh set of decisions about her care. Here is what she had to say:

"We live with risk. And breast cancer is one of those risks. When your risk is not particularly elevated, removing a body part has its own risks. I've had a mastectomy; it's pretty tough. And the reconstruction, while it looks really good and Angelina Jolie's probably looks better, it doesn't have sensation. So you're going to lose that as well."

 

[KRS]

I was watching a woman on TV today, who said that this runs in her family and her mom who eventually got the cancer was screening herself for this since she was in her 30s.

She got the double mastectomy when she was in her early 40s, mainly because, her doctors told her that she ran a very high risk, and it is not a question of if, but when.

She said that, looking back, she would have done it sooner, had she known the feeling of relief she felt after the surgery. She felt liberated.

I lost my wife, in whose family this cancer was prevalent. We chose the periodic screening then, but we did not know that there are different types of this cancer, some very aggressive. I wish now that we were aggressive in our choice of prevention.

In India though, I think the Parsi's in particular have this disease through their genes the most. I may be wrong.

Regards,
KRS

 

[renuka]

At the end of the day...we really can not be too sure what will happen.

Just becos one has risk for one particular type of Cancer and tries to prevent that..that does not mean other types of Cancer or illness will not strike.

Not all Cancers have reliable Tumor markers too.

We also can not be leading lives in constant battle in fear of death in any form of illness.

I have noticed(not backed up with any clinical evidence) that those who are paranoid and fear Cancer and death are the ones who actually land up with Cancer.

As a doctor I can safely say medical field lags behind the importance of a calm mind and its benefit to the body.

Many patients even before taking the medication asks me 'what if the medicine does not work"

I would reply "if you think it wont work..then it wont work"

I would strongly advise people to have a more positive outlook towards life and not have the constant fear of death.

Annual screening and high risk cases should take extra care..and try to be more positive in outlook.

 

[KRS]

Yes, all of us have to die one day.

When it hits close to home, one looks for answers! That's all.

Regards,
KRS

At the end of the day...we really can not be too sure what will happen.

Just becos one has risk for one particular type of Cancer and tries to prevent that..that does not mean other types of Cancer or illness will not strike.

Not all Cancers have reliable Tumor markers too.

We also can not be leading lives in constant battle in fear of death in any form of illness.

I have noticed(not backed up with any clinical evidence) that those who are paranoid and fear Cancer and death are the ones who actually land up with Cancer.

As a doctor I can safely say medical field lags behind the importance of a calm mind and its benefit to the body.

Many patients even before taking the medication asks me 'what if the medicine does not work"

I would reply "if you think it wont work..then it wont work"

I would strongly advise people to have a more positive outlook towards life and not have the constant fear of death.

Annual screening and high risk cases should take extra care..and try to be more positive in outlook.

At the end of the day..we all have to die....it is the method of dying that differs.

 

[Raji Ram]

Dear Renu,

I wish to share one of my experience here.

My eldest sister bought a book on solar color therapy from Delhi. It is about charging water / oil / sugar kept in different

colored bottles, with solar power, to heal different ailments. I had strong belief in that idea and followed the treatment

suggested for curing migraine headache I had often. After about two month of this simple treatment, I really got rid of

the nagging migraine. My doctor brother says that the water in color bottle did NOT cure me but my faith had cured.

Anyway, I think the positive attitude DOES the trick! :thumb:

 

[renuka]

Yes, all of us have to die one day.

When it hits close to home, one looks for answers! That's all.

Regards,
KRS

Dear KRS ji,

My post was a general post and I hope you did not misunderstand my post as targeting any situation.

If my post came across as such>>..I apologize.

May be my post sounded a bit harsh especially my last line(Which I have Edited) but that was from a doctor's point of view minus emotions.

Yes I agree that when death hits close to home...one might want to seek answers..but that is just at the beginning stages and after the fear of death goes off..no one takes illness so seriously either.

My MIL died of Cancer Colon and so did her elder brother after 2 years of her expiry.

That puts my husband at a high risk too and I have told him to get annual screening done..when the wounds of the death of his mother were fresh he was keen to get tested but after the fear of death has cooled down he does not want to go for any test too.

So you see each human differs in mindset..some take extra precautions and get tested and some are complacent.

 

[renuka]

Dear Renu,

I wish to share one of my experience here.

My eldest sister bought a book on solar color therapy from Delhi. It is about charging water / oil / sugar kept in different

colored bottles, with solar power, to heal different ailments. I had strong belief in that idea and followed the treatment

suggested for curing migraine headache I had often. After about two month of this simple treatment, I really got rid of

the nagging migraine. My doctor brother says that the water in color bottle did NOT cure me but my faith had cured.

Anyway, I think the positive attitude DOES the trick! :thumb:

Dear RR ji,

You are right.

 

[renuka]

Dear KRS,

I have edited my post # 3 last line.


Just letting you know.

 

[Raji Ram]

Dear Renu,

Can a person person prevent blood cancer by means of surgery? :noidea:

 

[renuka]

Dear Renu,

Can a person person prevent blood cancer by means of surgery? :noidea:

Dear RR ji,

As far as I know bone marrow replacement therapy is done for certain types of Leukemia but the disease has to strike first.

The sad part of Leukemia is there seldom any risk factors.

So your the answer to your question is no as for now.

 

[Raji Ram]

Thank you Renu. My friend's husband has absolutely NO symptoms other than some tiredness,

which he thought was because he had crossed 60. Suddenly he became very sick and it was

diagnosed that it was leukemia. She lost him soon!

 

[amala]

While I understand what Angelina has done is be proactive and taken the pre emptive decision, I am in shock and awe of her.

 

[biswa]

Apparently now the recommendation for mammograms is also in doubt?

The PSA test for prostate cancer for men apparently results in way over-diagnosis for men and is not recommended any more.

 

[Raji Ram]

Our ancestors had no such tests. They believed in FATE!
I am reminded of the story of Pareekshit who took precautions not to be bitten by the mighty snake Takshaka. :lock1:

 

[biswa]

But fate may also dictate whether we go to the doctor and take preventive measures, isn't it?

There is an old saying. For one who keeps sleeping, their fate (or fortune) also stays sleeping.

 

[Raji Ram]

Yes! Fate might have made to approach the doctor.

But, heaven forbid if one's fate is to die of cancer, can these precautions prevent that too??

 

[Raji Ram]

One newbie in our forum wanted to get a 'good time' for delivering her baby by C-section.

And I started a thread, 'Can destiny be changed by fixing the time of birth'!
Our friend Ravi calculated a time for a good horoscope but there is NO follow up in that thread! :ranger:

 

[KRS]

Dear Srimathi Renuka Ji,

You did not need to edit.

It is just that past remembrances came to the fore. Did not mean to say that what you posted was wrong. As the quote goes, 'men suffer in quiet desperation'. Thank you very much,

Regards,
KRS

Dear KRS,

I have edited my post # 3 last line.


Just letting you know.

 

[KRS]

Dear Srimathi RR Ji,

Fate will always do it's part.

Bur as human beings we need to at least attempt our best. Is this not the teaching of Gita?

In the past our forefathers lived a much healthy life.

Today, a lot of us can live long with the assistance of medicine. There are too many genetic oriented maladies, like hypertension, diabetes, high cholesterol, cancer etc. We need to do our best, but let fate take it's course. 'Man proposes, but God disposes'.

Regards,
KRS

Yes! Fate might have made to approach the doctor.

But, heaven forbid if one's fate is to die of cancer, can these precautions prevent that too??

 

[renuka]

Yes! Fate might have made to approach the doctor.

But, heaven forbid if one's fate is to die of cancer, can these precautions prevent that too??

Dear RR ji,

One can only try to prevent illness and the final outcome only God knows.


I have seen young Cancer patients with small kids accept their fate after treatment and settle their duties and financial stuff and concentrate on God in the ward of the hospital and pass away blissfully.

At the same time I have seen men aged 80 above and have become grandfathers breakdown and cry and scream in the ward when they know they are going to die of Cancer.

So it all finally goes back to the mindset of the person to accept the outcome of fate.

 

[Raji Ram]

........... Today, a lot of us can live long with the assistance of medicine. There are too many genetic oriented maladies, like hypertension, diabetes, high cholesterol, cancer etc. We need to do our best, but let fate take it's course. 'Man proposes, but God disposes'.
......

Very true Sir!