Growing Old with Grace
Forced Time Out

Elder Breast Cancer and Celebrities

It's no secret that the risk of breast cancer increases with age but did you know that 80 percent of breast cancers are found in women older than 50, and 60 percent of them in women older than 65?

It is also deadlier for old women. Those who are 75 and older die at a much higher rate from breast cancer than younger women. My mother was one of them.

These thoughts came to mind yesterday after reading actor Angelina Jolie's Op-Ed story in The New York Times about her bilateral mastectomy. She chose it as a preventive measure because she carries the BRCA1 gene defect which sharply increases the risk for breast and ovarian cancers:

”My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.”

Ms. Jolie, who acknowledged that BRCA1 and BRCA2 testing costs $3,000 in the United States, says she decided to go public about her surgery and reconstruction because

“...there are many women who do not know that they might be living under the shadow of cancer.

"It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.”

Is it possible she means strong options like the elite Pink Lotus Breast Center in Beverly Hills where she was treated.

Jolie's cavalier attitude toward cost ($3,000 just for the BRCA screening which is covered by Medicare only under severe restrictions) infuriated me. But I don't have to tell you about that because Ruth Fowler, writing at Counterpunch, has done a fine job of taking on the subject of a rich woman's privilege.

In response to Jolie's stated reason for her Op-Ed, Fowler writes:

”Really, Angelina? You honestly think that the 27 million (20%) of women in the US who don’t have health care, and the 77% who apparently have it, but still have to forego care because they can’t afford it even with insurance — you think that your Op Ed is actually going to do anything for these women except remind them that they don’t have access to the expensive screening tests you seem to think people don’t undertake simply because they haven’t read your article?”

And that's just the clean part of Fowler's rant. She is one pissed off woman – righteously so in my book even is she does put it a bit more profanely than I would - although not by much.

An important fact that Jolie omitted (among others) is that the BRCA1 and BRCA2 mutations cause only about five to ten percent of breast cancers. Another is that Ashkenazi Jews are more likely than other ethnic groups to carry the gene mutation.

It is hard to discern the point of a 37-year-old privileged woman of wealth writing about her expensive preventive and reconstructive surgery – something hardly any other women in the U.S., let alone the world, could even dream of affording.

I might be impressed if Ms. Jolie used her celebrity to promote more money for breast cancer research so that fewer people would die of it each year. But the media and others around the web I read mostly seem to think she has done something important and many say she is “brave” to write this.

I don't get it. Do you?

At The Elder Storytelling Place today, Henry Lowenstern: Day Dream


Ms. Jolie has no idea what life is like for the rest of us, it's a mechanism of privilege. I'm sure she really feels she has done something brave.

I think many Americans worship wealth and celebrity, it's perverse, but probably the reason Jolie's revelation has received so much praise. She is very very special, dontcha know.

Yes, I get it. By talking about it, she is reaching a wide segment of women who never heard of any of this before. She's reaching a wide group of women who won't get a mammogram out of fear. She's put a finger out and poked some women who won't listen to anyone, and maybe she shocked one or two enough so that they will at least go get a mammogram.

I volunteer at the Cancer Society, and my best friend died of breast cancer.

When I had my first breast surgery over 45 years ago, we went into the operating room sometimes not knowing for sure whether we had cancer or a benign tumor. I remember waking up in the recovery room next to another woman who had also had surgery. I'll never forget that her first words were not, "Did I have cancer?", but were, "Did they take my breast?"

That was because she was more afraid of the disfigurement than she was of having cancer.

So, yeah, I get it.

I have a dear friend who lost her mother and sister to breast cancer and then she became a victim. She lost her breast, but survived. Her daughter may have undergone the surgery that Angelina did as a preventative measure. I know she was planning to do so and her mother was not supportive of her decision. They are Jews and probably of the Ashkenazi group.

Yes, I agree that the wealthy do not have a clue as to the fact that the rest of us do not have the resources that they have. It was unfeeling of Angelina to fail to take that in account when she mistakenly thought she was helping. I do not consider her brave at all for telling her story.

It was stated on TV this morning that the company that does the testing for this gene has done over 5,000 of them for free.
I don't think about Jolie one way or the other, but I do think after reading the article that Fowler has a giant chip on her shoulder. This is another case of being damned if you do and damned if you don't. Had she not come forward, I can just imagine the repercussions she would face. In this day and age nothing is private.

Well, I'm thinking that Jolie, given that her career is pretty tied up with her sex appeal, took a risk by telling her story. Even though her reconstructive surgery might have produced spectacular results, and none of her future audiences would ever have been the wiser, she opted to tell her story with the hope that she might influence the decisions of other women faced with the possibility of needing a double mastectomy. It's not her fault that she's beautiful and wealthy and talented and tough. I can envy all of that and still appreciate the risk she took going public.

I'd be more impressed if she and Brad started a foundation to help those who can't afford healthcare.

As for the question of why she would write about this event...

Ms Jolie is an astute manipulator of her public image.

I suspect that AJ was about to be "outed" for having had the surgery, or at least knew it was likely to come out soon. To pre-empt the salacious nature of what would be written by the tabloids, she wrote the Op-Ed, turning bad publicity into a PR bonanza. Rationalizing that she would "do good for all" was part of this process, IMHO.

The kiss-up response by the media overlooks that her "revelation" makes no effort to address the absurd costs associated with cancer of any kind, let alone the cost of the genetic test.

Also, those who can't afford the test and whose mothers died of breast cancer will live in fear of being a carrier of the BRCA 1 and 2 gene mutation for the rest of their lives. While I am a devout believer that more information is best, I regret the lack of critical thinking by the media response to her Op-Ed.

Ms. Jolie is fortunate to be able to take action and I would not deny her that; the media are irresponsible in how they are covering it.

I am not impressed.


I don't know about "brave" but clearly she brought attention to an issue that is important to women. That's a significant good. The access and affordability issue will come along with that, from other directions and other people. I don't see the need for anger, resentment or higher expectations.

Many women who carry one of the mutations opt for increased frequency of screening, which has been available through Planned Parenthood Clinics, until the righteous right managed to close many of them down.

Angelina Jolie is privileged but what I heard on the news last night was gratitude from women who had chosen to have the same surgery, because if one of the world's "most beautiful" women had it, and was speaking out about it, they felt they too could admit they had made the same decision. All had lost their mother, aunt(s), and/or grandmother(s) to breast cancer.

To a young woman choosing to have one's breasts removed because of the risk of cancer is an agonizing decision. In this society where breasts are so closely linked with a woman's desirability, what is a woman without breasts?

I understand the anger over the gap between the privileged and the non-insured. (And I appreciate the Canadian Health care system that makes this a moot point here.)

What I don't understand is why we cannot feel compassion for *any* young woman who faces this dilemma, including one who is privileged. Would we all be happier if she died of breast cancer?

Since half of Americans are women, perhaps it's time to channel the anger felt toward women who can afford care towards politicians at every level who are using the 'abortion' excuse to limit less privileged women's access to breast cancer screening and treatment.

Your criticism should be directed not at Jolie (whom I applaud for making this announcement), but at a health care system that won't cover a test or surgery that would save lives. Her celebrity does have power--and now it has called attention to something that women with close relatives who have died of breast cancer may not have known. Perhaps if the US would move away from a health care system driven by the profits of insurance and pharmaceutical companies, your comments about cost would be invalid....but with a congress hellbent on repealing Obamacare and focussing on a non-story like Benghazi, not any time soon.

I too applaud Jolie whose breasts have been part of her mass appeal. Whatever her motives for going public, if she causes a handful of women to reconsider their options, it's a plus. Another plus is turning some male heads to the desirability of breast removal in certain cases. Perhaps the biggest plus is the discussion it raises about who can and cannot afford a similar path.

Thank you Ronni. Again, you have the courage to stand up and speak what others won't. I couldn't agree with you more!

I more than get it, I admire her enormously. Here’s an excerpt from the actual article by Jolie: “Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. 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 cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.

I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.”

Jeez guys! She acknowledges the problem of cost in her article. This woman has been a tireless advocate for the less fortunate her entire adult life! Why question her motives and pick on her?

There are far better celebrity targets for our disdain. Compare Jolie's efforts to give back with that of say….Lindsay Lohan.

I so agree with Lauren! She and Pitt have, over the years, used their wealth and celebrity to better the lives of the less fortunate--the world over. And here she is, doing it again. Should she have kept quiet because she is privileged
and might offend someone because of it?

I usually agree with you, Ronni, but in this I think you're being extremely ungenerous. I am no fan of Angelina Jolie in general, but here I think she did do something brave. In an industry where her breasts may be her most valuable asset, she revealed that she had hers taken off for the sake of her health. In our celebrity-obsessed society, her decision might encourage other women to consider making this difficult choice.

I don't know whether rich and privileged Angelina considered that most women would have trouble affording this surgery, but I do know that she and her husband have given of their time and money for those less fortunate more than many gazillionaires do. Okay, so she isn't Mother Theresa. What she did may not have been much, in the grand scheme of things, but I believe it was done with the best of intentions. Give her credit for that much.

No, I don't get it either. Prophylactic mastectomy is not new, and has been recommended in certain high risk patients for years. More than 30 years ago my stepsister underwent this treatment. If you are one of those patients, insurance may cover some costs.

Compassion? Yes, I have a boatload of it for her situation and for others. In addition to my stepsister, I lost my mother to breast cancer.

To me, the op ed piece had some other aroma that I couldn't quite identify (am I crass enough to say publicity and cash?). Yes, the choice of treatment is probably good for her. But there are many others, even celebrities, who have done the same even without genetic testing.

The Pink Lotus website has Ms. Jolie's picture on the home page (along with that of Sheryl Crow). I resent the idea that this is a "brave statement" intended to help others when she also is promoting a celebrity clinic in Beverly Hills.

Oh, and PS - this is the woman who sold her baby's photo for somewhere between $12,000,000 and $14,000,000. A lot for control of the circumstance when others like her have just promised an exclusive to a publication.

(OK - rant over.)

well............... it sounds to me like a way to get a boob job and not say it was a boob job.... it was a preventative

First let me say that I agree with Deb, Jenny, and Lauren.

I am continually amazed by the hoards of women who opt for breast 'augmentation'. One of these extremely average (and overweight) women died just a few weeks ago around here from her 'cosmetic' procedures. When I was much younger I believed that only performers and otherwise good looking women opted for these things but millions of ordinary women have bags of fluid in their breasts... imagine that!! And what does that say about all the husbands and boyfriends that don't mind the unnatural look and feel of their loved ones. Let us not forget Sylvester Stallone and the boob jobs he gave to all his girlfriends. Plenty of these same guys have wet dreams about AJ.

This is the society we live in. So when one of the most beautiful women today comes out and tells the world she has had her "assets" removed (regardless of the expensive reconstruction surgery most of us couldn't afford... complicated multiple step operations in her case, it matters.
I am very impressed with her.

I’m fortunate in that I live in Australia, where the gene test is free for someone with a family history which suggests a genetic link. As I said in my own blog yesterday, I had already had a double mastectomy when I discovered that I was carrying the BRCA2 gene fault. I then had my ovaries removed, as the fault also brings a higher risk of ovarian cancer. I have private health insurance but I’m pretty sure, if I didn’t, Medicare would have covered that too.

I do admire Angelina Jolie for speaking out; it’s not her fault that such treatment is so expensive in the US and her story highlights the inequities in the system. I also think it highlights the need for continuing investment in research. At the moment, while her decision means she can reassure her children that they are less likely to lose her (even a double mastectomy is not an absolute guarantee) her biological children have a 50 per cent chance of having inherited the gene fault.

My daughter was 14 when I discovered that was the case for her. My aunt died at 22 from breast cancer so I felt compelled to tell my daughter when she turned 18, legally old enough to be tested. What happened next is her information but any girl in this situation could find herself considering losing her breasts and, more devastating still, her ovaries, when she’s still in her teens.

The genetic links we know about may only cause a very small percentage of cancers but research isn’t discreet. Any progress in this area is bound to spill over into treatment or prevention of more common types of cancer. For good or ill, celebrities do have a serious influence and their talking about their health issues can open the door to greater understanding and acceptance. It could even help to drive home the fact that Medicare is good thing.

It's a message of hope to women everywhere: your breasts are not you, they are not your beauty, they are not your sexuality. You can lose both of them and be no less than you were.

This isn't the only place I'm hearing criticism of Angelina Jolie for having the money and "privilege" to be able to afford genetic testing. IMO the anger towards her is entirely misplaced.Jolie did acknowledge the problem of expense, and said she hopes more women can get tested. More significantly, by going public she is opening a dialog, starting a conversation, which might lead eventually to more access to testing for everyone.
I am 67 and am living on a pathetic amount of money from Social Security. I've been poor most of my life. I get angry at rich people a lot--but I have a broad political perspective. And I really don't think Angelina Jolie did anything wrong or anything to hurt me and other poor women. Quite the opposite. So she can afford the best medical care--when you have money, that's what you do! Leave the woman alone. She's going through hard stuff, and doing what she can for others.

My thoughts? Well, I think there's a lot of judgment going on here--which isn't like TGB or its readers in my experience. Yes, what Angelina Jolie did is financially out of reach for a lot of people (likely including me but, at 76, who cares about breast reconstruction if you've got cancer?). From what I understand, she and Brad Pitt give extremely generously of their time and resources to worthy causes and people in need throughout the world.

My mother died of breast cancer, and I don't know if I have the gene or not. I've tried to live a reasonably healthy life and have gotten a mammogram faithfully every 1-2 years since I turned 40. I'm guessing that, if I have the gene, it probably would have shown up by now.

I sincerely hope I never get BC because I have no desire to live the last two years of my life in as much misery as my mother did. Radical surgery, followed by two years of swinging between hope and despair, pain, serious lymphedema, dreadful side effects from poisonous chemotherapy drugs--and despite it all--death. I understand that treatments have improved since the mid-1970s, but I will never go through what she did.

Having been through genetic testing and found to be BRCA2 positive a year ago, I admit that the cost of the test was partly responsible for my hesitation and procrastination. What convinced me to take the test was when I met a woman with stage 4 ovarian cancer who had survived 25 years after breast cancer. I agree that AJ is to be thanked for speaking up. She is using her bully pulpit to help give women something to think about. It is a topic of concern among families like hers and mine. Not everyone will act, but if one life is saved as a result, it's worth it. Not stressed as highly in the story is that ovarian cancer is impossible to screen for, and preventative/prophylactic surgical removal is necessary to reduce the risk. If I hadn't had a prophylactic hysterectomy, the stage 1 fallopian cancer pathologists discovered would have continued to grow and spread in my abdomen.

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