PREVENTATIVE SURGERY, IS IT THE WAY TO GO? THE DEBATE

Preventative surgery is fast becoming a popular option for women at high-risk of developing cancer after actress Angelina Jolie chose to share her story with the world

THE CASE FOR

When given the option to prevent a life from being lost, the answer should be an easy yes. Cancer is one of the biggest killers in the UK, with 40,000 women expected to die from breast cancer in 2015 alone. If that thought isn’t terrifying enough, imagine being told you have a mutated version of the BRCA gene, BRCA1 or BRCA2, which means your chances of developing breast or ovarian cancer could be up to 65 per cent or 39 per cent likely compared with the normal 12 per cent and 1.3 per cent that everyday women face.

Patients who learn they have the faulty gene have three options: surveillance (regular blood tests and sonograms), medical management (taking medication to ward off cancer) or surgery (to remove the potentially affected area). And although it’s a tough call, surgery is often the most effective way of protection.

9309064_xxlIn 2013, six years after her mother lost the battle with ovarian cancer due to BRCA1, Angelina Jolie, who has inherited the gene, opted for a double mastectomy (both breasts removed) after finding out she had an 87 per cent chance of developing breast cancer. According to the National Cancer Institute, prophylactic mastectomy in high-risk women may be able to reduce the risk of developing breast cancer by 90 per cent. This was a bold move considering the actress’s status and image, but Jolie took the necessary action nonetheless, becoming an inspiration to women and taking massive steps for feminism, especially in body image and security.

In Jolie’s ongoing battle to prevent cancer leaving her children without a mother, she then had her ovaries and fallopian tubes removed in early 2015 to escape the fate of ovarian and fallopian cancer. Over 14,000 women in the USA alone die from fallopian cancer every year and although doctors have very good screening methods there are limited resources to catch it early enough. Instead doctors suggest that once women with the faulty gene finish childbearing, they should turn to surgery as women who have undergone the surgery say they feel a tremendous sense of relief and security afterwards.

Preventative surgery may be a costly procedure but most health insurance companies cover this after finding out the client has the faulty BRCA gene. Ultimately, preventative surgery is the way to go in lifting the terrible weight of potential cancer off hundreds of women’s shoulders.

THE CASE AGAINST

The impending pressure for women to take such a massive step in securing their health can be overwhelming, as many of them have not started a family and are not yet ready to give up their reproductive capabilities. To actively choose to become infertile over concerns of ovarian cancer is a daunting and unnerving thought and with women now entering this area with new found confidence after Angelina Jolie shared her struggle, many women can rush into things which can have permanent effects on their futures.

The test for the BRCA1 or BRCA2 in the first place can cost over £2,000. Ovary and fallopian tube surgery also costs around £2,000 and the full procedure of mastectomies (including breast reconstruction) can range from £10,000 to £35,000 depending on the type of surgery. Although some insurers cover this, they are not required to and so several don’t. Therefore it is unfair for only the financially stable to have access to a healthier, stress free life.

Even after all this preventative surgery, patients with the faulty BRCA gene are still at risk from cancers like colon, pancreatic and skin cancer. There are also several side effects caused by the surgery. In surgically removing the ovaries and fallopian tubes, a women will enter early menopause, (the earlier it starts the more symptoms a woman is likely to experience) resulting in hot flushes, night sweats, skin changes and sleep issues, although there are some procedures to help lessen these. Patients having their ovaries removed before natural menopause will also have an increased chance of osteoporosis.

Should we really be rushing into what seems like a last resort situation when there are already so many treatments and medications that help catch and battle cancer? Doctors have extremely sophisticated equipment ranging from mammograms and ultrasounds to MRI scans and more. In fact in 2011 over 50,000 women were diagnosed with breast cancer and in 2012 less than 12,000 women died from it. The survival rate in the UK for women living with breast cancer for 10 years is 78 per cent, and 27 per cent of cases found are preventable.

Perhaps it would be more effective to use our money to donate to charities and researchers like Cancer Research UK in hope of beating cancer altogether, rather than spending it on ourselves in the hope that preventative surgery will free the burden of cancer from our minds and bodies.

 

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