Selasa, 14 Mei 2013

Angelina Jolies brave message

.cnn_html_media_utility before color red content '>>' font size 9px line height 12px padding right 1px .cnnstrylccimg640 margin 0 27px 14px 0 .captionText filter alpha(opacity 100) opacity 1 .cnn_html_slideshow_media_caption a .cnn_html_slideshow_media_caption a visited .cnn_html_slideshow_media_caption a link .captionText a .captionText a visited .captiontext a link color 004276 outline medium none .cnnVerticalGalleryPhoto margin 0 auto padding right 68px width 270px > Angelina Jolie's announcement that she has undergone a preventive double mastectomy to lessen her risk of developing cancer places her at the forefront of stars who have been affected by the disease. Others include... Actress Christina Applegate had a bilateral mastectomy in 2008. Doctors had diagnosed her with cancer in her left breast and offered her the options of either radiation treatment and testing for the rest of her life or removal of both breasts. KISS band member Peter Criss sat down with CNN's Elizabeth Cohen in 2009 a year after his battle with breast cancer. The musician said he wanted to increase awareness of the fact that men can also get the disease. In 2006 singer Sheryl Crow underwent minimally invasive surgery for breast cancer. In 2012 she revealed she had a noncancerous brain tumor. Good Morning America co host Robin Roberts had been cancer free for five years in 2012 after beating breast cancer when she revealed she had been diagnosed with myelodysplastic syndrome also called MDS. Cynthia Nixon not only joined the cast of Showtime's The Big C about a woman battling the disease and portrayed a woman with cancer in the Broadway play Wit she was diagnosed with breast cancer in 2006. Three's Company star Suzanne Somers spoke with CNN's Piers Morgan in 2012 about her stem cell surgery and her bout with breast cancer. She was diagnosed in 2001 which is when she began researching alternative methods to reconstructive surgery. Olivia Newton John was diagnosed in 1992 and the singer has since become an advocate for breast self examination. Singer Melissa Etheridge has become an advocate for the use of medical marijuana following her 2004 breast cancer diagnosis. E co host Giuliana Rancic underwent a double mastectomy in 2011 following a breast cancer diagnosis. Actress Kathy Bates didn't share news of her battle until 2012 eight years after she was diagnosed with ovarian cancer. Australian singer Kylie Minogue was only 36 when she was diagnosed with breast cancer in 2005. 1 2 3 4 5 6 7 8 9 10 11 12

Editor's note Arthur Caplan is the Drs. William F. and Virginia Connolly Mitty professor and director of the Division of Bioethics at New York University's Langone Medical Center.

(CNN) By making public her story about how she dealt with the high risk of getting breast cancer Angelina Jolie has done a real service for women around the world.

By letting us all know about her decision to get genetic testing for susceptibility to breast cancer and then when the results came back positive to have a double mastectomy she has bravely helped inform women with a history of breast cancer in their families about the need to seek out testing and counseling. For a woman whose career is tied to her appearance her willingness to talk about her decision provides support to women and their partners who may face a similar difficult choice.

There are other lessons to be learned from her example. For one reconstructive surgery is better than it was a few decades ago. For another she chose not to have her ovaries removed which some women do despite the resulting premature menopause and other hormonal changes.

Jolie's choice carries risks along with benefits

Just as important is the issue of cost. Many insurance companies do not cover the cost of genetic testing for cancer and other conditions. The cost of the breast cancer test that Jolie had is prohibitive for many women. Some insurance companies won't pay for elective preventive mastectomy. And still others balk at the cost of reconstruction denying payment on the grounds that it is merely cosmetic or aesthetic.

Women with breast cancer and ovarian cancer in their families should talk to their doctors about the desirability of testing. If they are found to be at risk not all will follow Jolie's decision since even radical double mastectomy is not a 100% guarantee against getting cancer.

My preventive mastectomy Staying alive for my kids

Jolie 'I've decided to be proactive'

As the U.S. pushes forward into health reform Jolie's story reminds us that we need to adjust our health care system from one that pays for treatment to one that also covers prevention.

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The opinions expressed in this commentary are solely those of Arthur Caplan.

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