Mindy Levine: Angelina Jolie’s choice may not be right for everyone

Evan Agostini/AP
FILE - This March 8, 2012 file photo shows actress Angelina Jolie at the Women in the World Summit in New York. Jolie says that she has had a preventive double mastectomy after learning she carried a gene that made it extremely likely she would get breast cancer. The Oscar-winning actress and partner to Brad Pitt made the announcement in an op-ed she authored for Tuesday's New York Times under the headline, "My Medical Choice." She writes that between early February and late April she completed three months of surgical procedures to remove both breasts. (AP Photo/Evan Agostini, file)

I was sorry to read that Angelina Jolie recently faced such a difficult medical decision. Surely, anyone who believes that they have a high-percentage chance of being the victim of a life-threatening disease would like to consider options to reduce the possibility of that threat.

It is scary to go through life with the feeling of impending doom, and it is scary to consider that you have the choice of reducing this threat through radical action on your own behalf. I respect Angelina Jolie’s right to make this decision, but unlike others, I worry that her willingness to share this experience so publicly could actually add to the anxiety of those fighting cancer.

You see, several years ago when I was diagnosed with breast cancer, several people had some very interesting responses to my diagnosis. They started out by asking if I was a smoker, and then if there was a family history, and then if I had had regular mammograms. What I began to realize was that people felt more comfortable themselves if they could blame me in some way for my cancer. If they could convince themselves that I had this disease because of something that I had done.

We are a quick-fix society. When the power goes out, we expect it to be restored in time for dinner. When a car breaks down, we fully anticipate a tow and an immediate rental car before the next appointment. We like to lose weight through lap-band procedures, and we expect rescue helicopters to retrieve us when we call them on our cellphones after getting tired of hiking in the wilderness. We prefer, as a society, clear solutions to problems, not ongoing processes.

But cancer is different. Being given a cancer diagnosis encompasses several challenges. First there is the immediacy of action needed in response to the diagnosis. What do I do now? What surgery is best? What treatments? Will I be OK? After that initial time period in which several actions will most likely occur there will be a period of recovery. The initial pressure for response will have eased, and trying to get back to normal will take up a much longer period of time.

So, if you are lucky enough to move through this process and make it back to normal, over time a small voice might develop in your head. This is the voice that says, What if that happens again? How can I deal with all that a second time? What if I don’t do everything I can to prevent a relapse? Maybe I should do more.

Are you, a breast cancer survivor, responsible for the recurrence of your disease if you did not have a double mastectomy? And, if you had made the choice to have this surgery performed, can you accept the fact that it may not have been necessary? Is it worth it for you, even if you have not had cancer, but fear its likely intrusion into your life because of family history, to take such a radical step against something that may not happen? Is it worth acting so strongly in such a pre-emptive way in order to calm your doubts and anxieties about the possible future diagnosis? This is obviously a complex and deeply personal issue.

I am worried that Jolie’s decision to have a double mastectomy in light of her genetic history will add another layer of anxiety to this decision-making process. She says she underwent a pre-emptive double mastectomy for her family’s sake, so does that mean that any mother who does not follow suit is less heroic than Jolie?

Inevitably, now, people will ask them: Did you consider doing what she did? Did you do everything you could to keep this from happening to you?

Did you have a preventive double mastectomy? No? Well then, maybe it is your own fault.


Mindy Levine of Dallas is self-employed and a Community Voices volunteer columnist. Her email address is mindylevine@aol.com.

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