Hollywood actress Angelina Jolie's decision to undergo preventive double mastectomy after learning that she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer and to openly talk about the same is really brave. The radical step that she has taken for cancer prevention should be an inspiration for India that witnesses one lakh new breast cancer cases every year.
Mastectomy or prophylactic mastectomy is the removal of one or both breasts surgically to treat breast cancer; or as a preventive measure in case of people who are at a high risk of getting the disease. The surgery aims to remove all breast tissue that potentially could develop breast cancer. Although we can't be certain that this procedure will entirely curb the spread of breast cancer, preventive mastectomy may significantly reduce (by about 90%) the chance of developing breast cancer in moderate and high-risk women.
However, not everybody should opt for mastectomy. Going for regular screening check-ups still remains the best form of preventive measure. However, women who carry a genetic flaw and have been diagnosed as high risk should not hesitate in considering this as a preventive mode of treatment.
Unfortunately, in our country most of the population is oblivious to a preventive mode of treatment for a life-threatening disease like cancer. We doctors are also somewhere responsible for having failed to create awareness about mastectomy. What makes the situation worse is that even those who know about this choose not to go ahead with it. In spite of the advancements that we have seen in every field, the mindset of the people in our country is still very regressive. A big stigma surrounds this procedure because a woman's breasts, epitomising femininity, have a certain aesthetic value associated with them. Thus, patients who undergo mastectomy are sadly seen in a different light. The problem is further aggravated by the fact that the BRCA1 and BRCA2 cancer genetic tests are expensive and is therefore not affordable for everybody.
At least one-third of all cancer cases are preventable. For instance, vaccination for cervical cancer is easily available but not many women go for it.
Public education programmes, workshops and counseling sessions need to be conducted to create awareness regarding prevention of various kinds of cancer. For this the medical fraternity needs the staunch support of the government to implement these plans nationwide. Not only this, assistance is also required in subsidising the cost of the cancer genetic tests so that they are not beyond the reach of the common man. Witnessing the government eliminate a highly endemic disease like polio makes one really hopeful.
Moreover, a revolutionary change in the mindset of Indian society to accept this mode of treatment is imperative. As Jolie mentioned in her article that it would not have been possible for her to go through this without the support of her partner and children, it holds true for every woman for whom mastectomy is essential. She needs the constant support and motivation of her family in order to sail through the tough times.
Not only her immediate family, but also the society at large needs to stand by her and adopt a positive approach towards the whole thing. With this, she would get an encouragement to overcome the physical and mental trauma that she has to face during the crisis.
Rajesh Jain is Senior Consultant,
Surgical Oncology, Action Cancer
Hospital, New Delhi
The views expressed by the author are personal