Preventative Surgery: Is It Really Worth It?

On Tuesday, March 24th, Angelina Jolie wrote an op-ed column for The New York Times, in which she announced that she had her ovaries and fallopian tubes removed to decrease her risk of ovarian cancer. This news comes two years after she announced that she had a double mastectomy, a decision she made due to her high risk of breast cancer.

Jolie’s doctors told her two years ago that she had inherited a mutated BRCA1 gene, a mutation which put her risk of breast cancer at 87% and her risk of ovarian cancer at 50%. In addition to the gene, Jolie has an extensive family history of cancer; she lost her mother, aunt, and grandmother to cancer. She has emphasized on multiple occasions that it was this loss that motivated her to  have preventative surgery, as she didn’t want her children to feel that loss as well.

The Angelina Effect

Since Jolie’s announcement in May 2013 about her mastectomy, testing for BRCA1 and BRCA2 genes has increased sharply. According to the Daily Mail, a widely read British newspaper, testing has increased two and half times. Because of Jolie’s influence from her film career and her work as a UN refugee ambassador, the term, “The Angelina Effect,” was popularized by Time magazine in May 2013 to describe the sudden rush for genetic testing.

While many medical experts applaud Jolie’s decision and her subsequent effect on testing popularity, doubt still remains about testing for these genes and preventative surgery. Genetic testing is a relatively new science, with many questioning its accuracy. Additionally, there are concerns about the invasiveness of preventative surgery, its long-term health effects, and its efficacy in reducing the risk of cancer.

The Truth About The BRCA1 Gene

According to Dr. Christine Horner, an expert on breast cancer prevention, most women who are diagnosed with breast cancer do not have the BRCA1 gene. According to the same Time magazine article that popularized the Angelina Effect, less than one tenth of one percent of women have the same gene mutation Jolie does.

In her op-ed article, Jolie wrote that having the BRCA1 gene shouldn’t mean a leap to surgery as a means of preventing cancer. She plainly stated that women in situations similar to her own should not jump directly to surgery; it was simply the recommended solution based on her unique circumstances. The procedure does carry significant risks, some of which Jolie is currently dealing with. Specifically, Jolie is currently receiving bio-identical estrogen through a patch and progesterone via IUD. Despite these steps, though, Jolie was honest in stating that she is now undergoing early menopause. Removal of the ovaries in women under the age of 45 carries a  fairly large list of risks, including:

  • Hormonal imbalances, caused by surgical menopause
  • Complications that are associated with any abdominal surgery
  • A 170 percent increase of premature death in women under 45
  • A 700 percent increase of risk of heart disease
  • An increased risk of long-term disease such as Parkinson's, dementia and osteoporosis
  • Decreased sexual activity
  • Uncertainties with mental health

Because of these risks, Jolie recommended that women seek out other options. Commonly used approaches include birth control pills or alternative medical treatments. In addition, Jolie herself wrote that she is currently looking for natural ways to strengthen her immune system. With this in mind, what are some of these other options? Are there natural ways to strengthen your immune system and reduce your risk of certain cancers instead of preventative surgery?  Yes.

Other Options

Dr. Christine Horner recommends these quick tips to strengthen your immune system and reduce your risk of cancers by up to 200 percent (even if you have the BRCA1 gene mutation):

  1. Adequate sleep.  One of the most powerful steps you can take is doing all you can to improve the function of your immune system.  The sleep hormone, melatonin, has many anticancer actions include suppressing the BRCA1 gene and strengthening the immune system.  Adequate sleep (at least 7 hours each night ideally between 10 PM and 6 AM  elevates melatonin to its highest levels and has been shown in numerous studies to strengthen your overall immune health. 
  2. Proper diet.    A diet rich in a variety of nutrient-dense foods – can also help to improve your immune system while fighting the oxidative damage that is associated with certain cancers. Specifically, cruciferous vegetables such as kale, broccoli, brussel sprouts and cabbage, omega-3 fatty acids, and flaxseeds have all been shown to be effective in reducing the risks of BRCA1-associated cancer. These foods are rich in antioxidants that help to repair damage done by free-radicals, as well as micronutrients that help to support a healthy immune system.
  3. AHCC® - A unique mushroom extract.  A natural substance derived from Japanese medicinal mushrooms, AHCC is the leading alternative cancer treatment used in hundreds of clinics throughout Asia to support the immune system in lowering the risk of cancer while improving survival.  Research has shown that AHCC increases the numbers and activity of several components of the immune system, such as cytokines (immune messengers), as well as natural killer cells, macrophages, T cells, and dendritic cells (all types of white blood cells that destroy pathogens and abnormal cells). This allows the body to better identify and react to foreign invaders – including cancer cells, which very closely resemble normal, healthy cells and which your immune system may not be able to recognize if it is not strong enough.  Supplementation with AHCC though, can help to strengthen your body’s natural defenses as proven in 25 human clinical studies.

Surgery is an option worth considering, but it should not be made into a fad, as it has several risks associated with it. There are other, easier and more natural methods of reducing the risk of cancer besides surgery that do not have these associated risks.