A question of informed choice

May 16, 2013 02:37 am | Updated December 04, 2021 11:19 pm IST

Raising awareness about a disease is something celebrities do well. What Magic Johnson did for HIV, and Amitabh Bachchan and Rajnikant for polio in India, Angelina Jolie has now done for breast cancer. The Hollywood actor is being feted worldwide for bringing awareness about genetic testing for the disease, and the options available to women who have tested positive for abnormal BReast CAncer genes (BRCA 1/2). Testing positive for either gene puts women at a 65 per cent risk of developing breast cancer on average. In April, Ms Jolie completed three months of treatment including surgeries to remove both her breasts to ensure that she did not develop the cancer that killed her mother. She has said she chose to go public with her story “because there are many women who do not know that they might be living under the shadow of cancer.” While the procedure that Ms Jolie has undergone is not new and several women in the United States have had a bilateral mastectomy before this, it is her celebrity status that could motivate women in similar circumstances to make what is a difficult decision. It would also help those cancer-stricken women for whom breast removal is no longer just a preventive option, but a necessity.

And yet, the excited urgency that Ms Jolie’s article has caused globally must not mislead women into thinking a double mastectomy is the only way to beat breast cancer before it gets to you. However appropriate the procedure was for her, there are clearly other medical options. Oncologists need to give full information on the alternatives available to women who test positive for the BRCA genes, including periodic screening. Equally important is the need to stress that a negative BRCA test result does not preclude the occurrence of breast cancer at a later date. Essentially, the lesson from Ms Jolie’s story is that cancer is preventable. Spreading awareness about this continues to be a mammoth task in India. A large number of cancers are still being caught when they are too advanced, at a stage where medicine can do little or nothing for the patient. While prevention is recommended and possible by following a healthy lifestyle, early detection is key to squashing the growth of these rogue cells. It is only recently that the concept of preventive annual checks has caught on in India. While those who are at risk stand to gain immensely from genetic testing, the dangers of this diagnostic tool being turned into another exploitative enterprise cannot be ruled out. The government will do well to ensure that a monitoring and regulatory mechanism is in place to meet the eventuality that Ms Jolie’s example will create both a demand for the test and its supply.

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