Angelina Jolie can afford to save her own life; many women can’t

<i>This post has been corrected, as noted below.</i>

I’d like to raise the teensiest red flag on Angelina Jolie’s laudable decision Tuesday to go public about her health struggles in order to help other women benefit from her experience.

In an essay published Tuesday in the New York Times, Jolie wrote about opting for an elective, preventive double mastectomy and breast reconstruction after learning she carries the faulty BRCA1 gene, which greatly increases the risk of breast and ovarian cancer. That inherited mutation, she wrote, gave her an 87% chance of contracting breast cancer, and a 50% chance of contracting ovarian cancer.

Jolie, 37, a mother of six pre-teen children whose own mother died of cancer at age 56, clearly made the right decision for herself and her family.


She is a child of Hollywood, a narcissistic culture that puts its faith in the surgeon’s knife, so on some level, it may have been less terrifying for her to face surgery than to face the risk of cancer later on.

“Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness,” Jolie wrote in Tuesday’s New York Times. “But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.”

Possible, yes. But for many women, unattainable, as Jolie acknowledged at the end of her essay.

“It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live.” The $3,000 tab for genetic testing alone, she noted, “remains an obstacle for many women.”

That, I think, is the heart of the matter.

Even if women can get the tests, many will be unable to take action. Unlike Jolie, most people do not live in a world where cost, even to save one’s life, is no object.

Insurance plans vary widely in what they cover, but in online discussion forums, women who have undergone the procedure say that even when insurance does kick in, they end up paying many thousands of dollars out of pocket to satisfy deductibles and other expenses.

The Pink Lotus Breast Center, which treated Jolie, has promised that it will soon post “story details” of her procedure on its website.

The center’s executive chairman, Andy Funk, who co-founded the center in 2009 with his wife, breast surgeon Kristi Funk, was swamped Tuesday and did not have time to talk.

I wanted to ask him about options for women who don’t have Jolie’s means. I would also love to know whether Jolie received any kind of consideration for publicizing the center in her New York Times piece.

When I checked out the Pink Lotus website, I was happy to see that the center has a nonprofit arm that offers free screening, diagnosis, surgery and post-surgery treatment to women who are “uninsured, underprivileged and unable to pay for their own breast care.”

And Pink Lotus seems unafraid to dip into the sort of controversy chronicled recently by writer Peggy Orenstein , noting that their nonprofit arm does not put any money toward “research, walks, or self-serving marketing campaigns.”

Oddly, it’s nearly impossible to get a handle on how many women have done what Jolie did. Apparently, no one tracks how many women remove healthy breasts as a precaution without ever having received a cancer diagnosis.

But we do know that an increasing number of women who discover cancer in one breast opt to have both breasts removed, even when the second breast is healthy.

The Journal of Clinical Oncology reported in 2009 that the number of women opting for preventive mastectomies of a cancer-free breast doubled between 1998 and 2005. Celebrities have played a role.

Doctors in the survey said their patients cited well-known women like the actress Christina Applegate and E! News personality Giuliana Rancic, who have spoken openly about opting for double mastectomies even though they had cancer in a single breast. Like Jolie, Applegate had the BRCA1 mutation; Rancic did not.

So bravo to Jolie for sharing her story.

It would be a lovely thing if everyone had access to the high level of care she has received.

[For the Record, 2:38 p.m. PDT May 14: An earlier version of this online post gave an incorrect age for Angelina Jolie. She is 37, not 46.]

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