I’m not about to speculate on the pros and cons regarding Angelina Jolie’s recent medical decisions. I’m not a medical doctor; nor do I have any idea what her personal physicians have told her regarding HER risk factors.
She’s informed the public that a many of the females on her side of the family have died from, or are in the grip of, either early on-set breast or ovarian cancer. In fact, as I’m typing this, her sister is in stage IV breast cancer and is more likely than not to die as a result.
But you don’t have to be a medical doctor in order to research the topic of cancer, something I’ve been doing with great vigor since the very early 2000s when my own wife encountered a rude introduction to breast cancer.
She’s among the lucky ones, having passed that hopeful magic 5-year cancer-free mark several years ago. However—call us superstitious if you wish—neither of us goes around speaking of her “cure;” she’s cancer free, and hopefully will remain so for the rest of her life.
A screening test for BRCA1 is expensive: about $3,000 on average. While some health insurance policies cover it, most do not. But the buyer-beware-rule is critical. It’s not enough to merely read the fine print; make sure you understand it… FULLY!
I am an unapologetic nerd when it comes to discrete mathematics, especially inferential statistics. I love separating the SCIENCE of medicine from the ART of medicine.
My personal life’s philosophy has always been that dying isn’t the worst that can happen to people; it’s just the last. As such, I think it’s critical for us to recognize the point at which the science of medicine needs to back off and let the art of medicine take charge.
Most of the public responses to Angelina Jolie’s medical decisions regarding breast and ovarian cancer have been overwhelmingly positive, even the ones who have disagreed with her. But some of the responses have bordered on plain old pompous moral pontification.
My take is different; it’s based on the numbers. Personally, I think Angelina Jolie has taken a proactive position by deciding to trust the science of medicine—in this case, the applicable statistics—in the hopes of forestalling the need for the art of medicine to intervene early on.
Angelina stated that her lifetime chances of developing breast cancer were 85% greater than average due to both the presence of the BRCA1 gene in her DNA and HER family history.
So, everybody, let’s get ready to QUAN-TI-FY! Here are the most current statistical factors for female breast cancer taken straight from the American Cancer Society’s web site (latest referential medical evaluations as of late 2012).
As well, I’m reducing Angelina’s added risk by 5% because she originally stated that her added risk increased by 85% but that it dropped to only 5% with the removal of her breasts.
It is also important to know that these chances are projected over a lifetime. Lifetime chances are calculated by taking average periodic one year chances and dividing them by the life expectancy of the population over the period under evaluation.
So, on average, the lifetime chances of a woman DEVELOPING breast cancer are 12.38%; or stated another way: 1 in 8 (100 divided by 12.38). The lifetime chances of a woman DYING from breast cancer are 2.76%, or stated another way: 1 in 36 (100 divided by 2.76).
Angelina Jolie’s lifetime chances of developing breast cancer—and dying from it—are 80% greater than average due to the presence of the BRCA1 gene in her DNA, plus all of HER additional risk factors (family history, etc.).
Stated quantitatively, HER chances are 22.284% (1 in 5). HER lifetime chances of dying from breast cancer are 4.968% (1 in 20). So for women faced with the same circumstances as Angelina Jolie’s, ONE out of every FIVE of them will develop breast cancer, and ONE out of every TWENTY of THEM will die as a result.
But as I wrote above, in my opinion, dying may not be the worst thing that can happen to the deceased. And on a personal level, I think Angelina Jolie would probably agree. But, the state of her husband’s emotions aside, HER possibly avoidable early death from breast cancer may well be THE worst thing that could happen to the SIX small children who call her “MOMMY!”
I wish Angelina Jolie and her family all the best regarding this matter; she made an informed decision. And to those who have felt compelled to second-guess her decision, especially those not confronting such a horrible choice, along with the morally pompous pontificators, I bluntly suggest that you shut the hell up.