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Making Healthy Life-Threatening Decisions

making hard decisions

Angelina’s Shocking Decision

When I heard that actress Angelina Jolie decided to have a double mastectomy as a ‘preventative’ measure, her decision sent shock waves through me and those around me. It seemed like such an extreme course of action for someone who hadn’t received a cancer diagnosis. And at the time, I couldn’t understand why anyone would undergo such drastic measures.

In 2013, Oscar winner Angelina told the world she would have the surgery because she had a higher risk of developing breast cancer. Angelina has an increased risk because she has what’s called a BRCA1 gene mutation. With this gene mutation, doctors estimate she had an 87 percent chance of developing the disease.

What is BRCA?

What is a BRCA mutation? BRCA (a breast cancer gene mutation) is actually two genes (BRCA1 and BRCA2), each proteins that work as tumour suppressors. They help repair damaged DNA, and are important for ensuring the stability of each cell’s genetic material.

When either of these genes is altered, that mutation can mean that its protein product does not function properly, or that damaged DNA may not be repaired correctly.

To Cut or Not To Cut?

I can recall having many heated debates about whether I would have such a radical, preventative surgery if I were in Angelina’s shoes. Back in 2013, I had not yet been diagnosed with breast cancer nor had I had any genetic testing to verify whether I had a BRCA mutation. But what I did know was that there is a strong history of cancer in both my patriarchal and matriarchal lines.

I also knew about the power of positive thinking and the importance of leading by example as I was working as a coach. At that time, I had decided I did not want to know my genetic make-up and asked my family to kindly respect my wish to not know mine or their genetic findings. I felt this knowledge would in some way infiltrate my thoughts and encourage the onset of this disease throughout my body.

Genetic Lottery

My immediate response to having this surgery has always been a big ‘hell no’! Why would anyone opt to have such an extreme procedure when they potentially may never develop cancer at all? Wouldn’t it be better to proactively monitor the development of potential tumours with mammograms and MRI’s rather than undertake surgery to permanently remove your breasts?

Seven years on and two breast cancer diagnoses later, the question as to whether to have a double mastectomy or not has become a daily one. You see, I have won the genetic lottery having acquired both the BRCA1 and BRCA2 gene mutations. One from each parent. I am some sort of anomaly as my geneticist and breast surgeon have never met a person that carries both. There are plenty of statistics about the likelihood of developing various cancers with BRCA1 or BRCA2, but I can’t find any research which indicates my risks when carrying both mutations. Perhaps, this research has never been done.

Making BIG Decisions

The year of 2020 has been intensely challenging for me with a breast cancer diagnosis along with treatment. I have now completed chemotherapy and am facing a bilateral (double) mastectomy. Gulp! This is a massive decision and one that is not to be taken lightly. Unlike when I received my initial diagnosis and obediently complied with the surgeon’s recommendation for immediate surgery, I am taking some much needed time to make one of the biggest decisions of my life.

Step 1: Pause, breathe, take the time you need. Be calm.

I have had consults with three different breast surgeons to seek their insight, advice and approach to my current situation. And my findings were as unique as the individual surgeons I met with. In fact, the advice and approach varied dramatically.

Step 2: Start with the end in mind. What is your desired outcome? What’s most important to you?

Thanks to my coach training, I am crystal clear on my desired result post-surgery. As they say, ‘start with the end in mind’ and with that, I consulted these three surgeons to see which aligned most with what mattered most to me. And knowing what I wanted to achieve for me personally, made my decision as to which surgeon to work with so much easier.

Step 3: Be empowered. Ask good questions. Educate yourself. Be informed.

The Wrap Up

With all things considered, I have decided to proceed with having a bilateral mastectomy. Not because Angelina did but, because I have had breast cancer twice at the age of 49 and I definitely don’t want to travel down this road again. I have done my homework, met with three surgeons, connected with my own bodily wisdom and I am now ready to make an informed decision not blindly following the first surgeon’s recommendation as so many of us do. But instead, I chose the best course of action for me having clarity about the result I wanted most. After all, this is the body I will inhabit long after the doctors are gone.

Step 4: Decide with confidence.

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