Angelina Jolie, Breast Cancer and Prevention: How Much Do We Control?

Angelina JolieIf you were told you had an 87% risk for breast cancer, would you undergo a double mastectomy as a preventative measure to eliminate or drastically reduce your risk? Essentially, this is what actress Angelina Jolie did. Just this week, she announced in a New York Times article that she underwent the double mastectomy after learning she carries a mutation of the BRCA1 gene, which is a marker for increased risk of developing breast cancer and ovarian cancer.

What a difficult decision. Brave, some might say. While others: over reactive. Personally, I believe it is an extremely personal decision. If it gives Angelina Jolie peace of mind, and makes her feel safer, then so be it. She did what was right for her. And, when the stakes are as high as they seem to have been for her, it sounds like she made a sound decision.

Her decision, however, raises the question: How much of a role do our genes play in our risk for disease?

Many individuals in the medical profession chalk disease up to genetics. And that is fair. Genetics play a big role. Yet, studies continue to show that our lifestyle choices, although not 100 percent fool-proof, play a huge role in making our genes for disease present themselves, or not. This realization, however, means that many people who are currently sick or become sick with preventable diseases such as diabetes, heart disease, cancer, and maybe even, Alzheimer's, would have to hold themselves accountable for the diseases they are faced with - and that is difficult to swallow. In speaking to many individuals about lifestyle and the importance of making healthy choices, it is relatively common to hear the following arguments for NOT choosing to be healthy:

  • "I could be hit by a truck tomorrow, so I'm going to eat and do whatever I want."
  • "It is all about genetics. If I'm going to get cancer, I'm going to get cancer."
  • "I only have one life to live, and I'm going to enjoy it."
These are all fair arguments, but I can't help but counter with the following points:
  1. Lifestyle's Contribution: Although we don't have all of the answers, we sure do know enough to know that lifestyle choices play a huge role in our health. Research continues to tell us that "food is medicine." What we eat and put into our bodies play a huge role in our risks for disease, and in our genetic predisposition for disease to manifest.
  2. Better Safe than Sorry: If you KNOW certain behaviors are risky and can increase risk for certain diseases, why not choose options that lower your risks? Why choose behaviors that put you at greater risk?
  3. Quality of Life: Let's say you cheat the odds and for years, you smoke, eat unhealthily, are sedentary, and drink heavily. You may be lucky for a good portion of your life. But, at some point, more likely than not, your lifestyle choices will catch up with you and you will end up sick with some disease. And disease isn't fun. Maybe you have a heart attack. Maybe you are overweight and are on numerous drugs to keep things in check. Maybe you don't "feel well" on a regular basis. Maybe, dare I say, you get cancer and have to go through some awful treatment plan, which often causes other health issues. All of this leads to a lower quality of life - if not temporarily, permanently from the time you are diagnosed.
  4. Taking Responsibility is a Small Price: Although many people will state that being healthy is a sacrifice, I can't agree. It is a privilege. And taking care of ourselves in the here and now is a small price to pay for a healthy tomorrow.
At some point, holding ourselves accountable for our health is the best way to prevent disease. In Angelina Jolie's case, maybe a double mastectomy will help drastically reduce her risks for breast cancer. I'm hopeful it will. That said, there are still, many other cancers and diseases she and many of us are susceptible to that can be prevented. And, starting with lifestyle choices is one of the best ways to take action, regardless of genetics.

What do you think about Angelina Jolie's decision? How much are you willing to sacrifice for the benefit of your health? Do you see prevention and healthy lifestyle choices as "giving up" or "protecting" your life?"