We have all heard about the famous and beautiful actress Angelina Jolie having taken the preventative steps of having her breasts, and now her ovaries surgically removed due to the presence of her cancer causing genetic roulette make up. She made this decision after careful consultation with her medical advisors, and after watching her mother die of the same genetic cancer.  She is such an admirable and gifted human being with otherwise an amazing genetic makeup.  It takes us aback with this news to appreciate that she really is, indeed, human.

Many of you readers may have formed an opinion about this. Some have voiced disappointment in the media hype with their pontificating on conspiracy theories. That is “she was manipulated by big pharma” or having surgery to improve the coffers of the Medical establishment etc. this quite frankly does not make sense. There is very little pharmacy associated with surgical healing compared to cancer chemotherapy. It’s actually a much more straightforward procedure. Even a complete ovariohysterectomy is only a few days in hospital.  I am sure that a woman of such high regarded stature would have had excellent medical advice and care. It is very likely that she will also partake of nutritional medicine, including herbs and  antioxidant therapies replete in omega 3 rich meals.  Integrative medical care in the United States is much more advanced than here in Australia, although we do have the Olivia Newton John Hospital opening in Victoria.  http://www.austin.org.au/cancer/

Others are saying that she was not given adequate informed holistic advice, otherwise why would she have surgery, especially if her organs were not shown to be cancerous. I think this too is unlikely.  Angelina and her family are well connected and intelligent people.

It’s more likely that the general public is less informed.

As a veterinary surgeon who has performed thousands of ovariohysterectomies  and indeed some lifesaving surgeries, (pyometron, leiomyoma, adenocarcinoma) I can see their point.

I think it is most likely that Angelina had the best advice – she seems level headed and a smart cookie- and am confident it wasn’t about cosmetics. The public are probably not generally knowledgeable about the serum markers and DNA tests, as this is relatively new technology.  Given that her mother died a horrible death from this and that we are not privy to her exact BRCA figures, we are the uninformed. 

Because she is a public figure we can question her choice, but its likely that she did not have much choice from a statistic and genetic understanding. No doubt she will continue on with herbal, and nutritional supplementation, as did Olivia Newton John and all others. If Angelina had even a small cystic change on her ovaries, she would have been advised that there is no way to tell if this benign change could not become cancerous, and by the time it is “watched for change” it is often too late and peritoneal metastatases have spread. That is the dilemma in this diagnostic plan. You can read some more about it here:http://www.obermair.info/…/gynaecolo…/ovarian-cancer/…

 I think the real point is that there is a lot more to understand about the intricacies now known regarding BRCA genes.

Having just researched and gone over the “23 and me” genomics (you can read about testing yourself here: https://www.23andme.com/)   I think it is not as simple as black and white, “it is what it is” does not explain the complex interaction of multiple genes…that is people on the outside (not being privy to geneticists, medical teams and the individuals circumstances) and without that genetic map knowledge might lump everyone into yay or nay piles. Diet and preventative measures are helpful FOR SOME, but they have a poorer probability of cancer reversal for others. Its not as simple as “you have BRAC1 gene so you must chop off your breasts”. There are thousands of genes with several of them interacting to set off or disallow the telomerase/cancer restriction to occur. Its actually more like a calculus problem, with many arithmetic variations and its very complex. One can have a multiplying variation of cancer causing genes which factor into the equation. As we age and our telomeres contract (its inevitable really, none of us get out of this life alive in the end!) our natural killer cells and immune system struggles. If you have a few SNPs that code for cancer they may increase your risk with age to an unacceptable level.( http://www.snpedia.com/index.php/Rs1042838)  This predisposition may rear its ugly head at any time- its like a time bomb.. Surgical removal of the offending, out of control tissue is a realistic option and is likely life saving for some. Not everyone will need to do this procedure, but for those with the 80% risk factors its definitely something to consider. If the multiplying factors weigh in at say 10% the option is less straightforward and perhaps not something someone would want to do, as the surgeries are not without trauma and side effects. Its great to be optimistic and open minded, but not so open that your brains fall out. Nutritional  medicine and herbs have a place and Gerson diets, Budwig principle, http://www.budwigcenter.com/the-budwig-diet/#.VRT1nmeJhdg,  and essential oils can help and I encourage you all to review https://www.youtube.com/watch?v=LHKaVd_twIE

The risk factors based on genetic testing may also be misleading.http://www.survive-and-thrive-cancer.com/angelinajoliemastectomy.aspx#.VTcdF5WlBFR It may well be that the risk of breast cancer being passed down through the generations is seldom due to true genetic inheritance but rather due to an ‘inheritance’ of similar non-constructive dietary habits, lifestyle ways and emotional patterns.

I advocate careful choices–>health, nutrigenomics, herbal medicine and Surgery if it is indicated. It does very little to support the patient to say that “they must have eaten too many toxins or didn’t take enough tumeric, or didn’t pray enough or eat enough salad” if they, in fact drew the short straw in the gene pool. As more of us become thoroughly educated about the genetic risk factors, we may be seeing a whole new method of cancer treatment- genetic manipulation and deletion of some of our nasty genes. There is already the possibility of adding the mitochondria from a third person into an embryo making a “three person zygote”. Hmmm, now that is an interesting concept. We likely will not achieve immortality, nor would we want that- where will everyone fit on the planet? 😉

So the point is the oncological checks for ovarian cancer are so far poor diagnostic and prognostic indicators , ultrasound does not diagnose (It can’t differentiate a benign cyst from malignancy) , the cancer markers are somewhat inaccurate (benign uterine fibroids also elevate CA125), and the genetic potential is the only marker that is relatively accurate in identifying risks. The diagnosis of ovarian cancer is best made by excising the suspect ovary- the complete ovary within a bag carefully, with no Fine Needle aspirate- it seeds the cells into the peritoneum. The surgery is tricky, but curative.   If you have been given a big bundle of bad genes its probably better out than in, but if you have only a minor “bad hand” you might want to think about it – rest and digest, but pay closer attention to monitoring. (Ultrasound and serum testing CA125 and HE4). Eat healthy take in daily antioxidants and antitumour diets.  Avoid processed meat (ham, salami) and eat a largely plant based, preferably organic diet.  Avoid simple sugars. Joanna Budwig diet of flax seed oil and cottage or quark cheese with your salads is likely beneficial.  See our facebook site for more!    https://www.facebook.com/Naturopathvet?fref=nf