RE: Angelina Jolie had a "preventative double mastectomy" NY Times (Full Version)

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LafayetteLady -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 6:11:38 AM)


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ORIGINAL: sexyred1


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ORIGINAL: tj444


quote:

ORIGINAL: LafayetteLady
While I whole heartedly agree that men should think this way, when it comes to Brad Pitt, you can't help but look at the women he has been with. While none of them are *just* there boides, I'm sure (seeing as how I don't know them), all of them have hit the "most beautiful" list for their physical appearance at least once. And Jolie would still be considered beautiful without her breasts. I would be more impressed if he stayed with and gave that support if the person were to become really disfigured to the point of not being able to make that list anymore, say like what happed to Ebert with his thyroid surgery. When he supports a woman who loses have her face and sticks around, I will be impressed.

sure but she is no longer "perfect".. and some of those other rich, famous dudes would have dropped her like a rock for just thinking of doing the surgery.. Imo if she was with someone like.. say... George Clooney, he would have been outta there in a shot.. yeah, I think George is one of the shallow dudes.. I am sure he isnt the only one either.. Being rich, famous & in Hollywood it is hard enough to keep a marriage together, so few last as it is.. Not to mention its one thing doing the surgery and another thing making it public.. I wonder how many men (rich or not) said to themselves that no way would they have stayed with her like Pitt has.. but again, who needs the douches anyway..


Actually, she is stil perfect, in fact more so since she cared enough for her family to do this. She is having her ovaries removed soon as well.

Neither of you know how Brad Pitt feels or can make assumptions on what famous people would do if their partners were to do the same thing for the same reasons.

Instead of bashing a brave woman who made a tough decision and her partner who clearly loves her, his kids and who are both very philanthropic, you should be applauding them.

Cancer and medical decisions are no laughing matter, I can tell you first hand. And anyone with a supportive partner, famous or not, is lucky.


Well, I clearly said that she was still considered beautiful. No one is "perfect," and I didn't say *I* considered her beautiful because I have never liked her. But that is just my personal opinion.

As for applauding them? Sorry, she made a personal decision and I am sincerely glad that she did what she thought was right for her. I'm also sincerely glad that Pitt is so supportive. I don't necessarily believe it should be a public thing. It was a private decision between a husband and wife, and in my opinion should have stayed that way. I just have a feeling she was worried that it was going to get reported in the tabloids and decided to come out about it first. The sad thing about that is that going public was taken out of her hands. And no one is going to announce they had the scoop before she made the announcement.

So while I realize you think I am "bashing" her, I don't think I am. You are quite right, cancer and the medical decisions that it involves are no laughing matter. I have first hand knowledge as well. And yes, famous or not, having a supportive partner is a wonderful thing.

So while cancer is not simply mutually, but widely agreed that it is no laughing matter, in my opinion, it also shouldn't be something for public scrutiny. Which, no matter what side of the fence we all fall on, we are doing. Me and you. Because it isn't our business to "applaud" her for making private decisions about her life. Or to criticize them.




samboct -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 6:49:03 AM)

From my perspective- the real issue here is whether science backs up Angelina Jolie's choice. I've spoken with researchers- generally Ph.Ds-not MDs- who are not happy with the notion of radical mastectomies. Angelika posted a link to a paper published back in 2004, but the folks in the breast cancer research community would probably disagree with the idea that radical mastectomies are successful.

There are a bunch of issues with breast cancer diagnosis and treatment today. First- the notion that finding cancer earlier will lead to better outcomes- well, that's been a flop. That's why the newest guidelines suggest mammograms later in life and more spread apart. Yes, we're finding more cancerous lesions and precancerous lesions. But cutting them out doesn't seem to do much in terms of survival rates.

Second- check out Atossa Genetics which is working on the idea of using NAF- nipple aspirate fluid as a diagnostic. This company is based on the hypothesis that most breast cancer occurs in the ducts and by treating the cancer in the specific duct, you will have better outcomes than radical mastectomies. (IIRC, there are 7 ducts per breast.)

Third- the state of cancer diagnostics is atrocious. It's clear that some tumor cells provide a measure of protection. How can this be? Well, 90% of the time- what kills you is not the primary cancer, but the metastases. This is probably why the radical mastectomies don't really do a lot- the metastases from tumors in the ducts can travel to other parts of the body. The primary tumor can often perk along for years- not doing too much to you. But since there's evolutionary pressure on cancer cells- some primary tumors SUPPRESS the growth of metastases. (There was a wonderful series of articles in Science a couple of years ago which gave a review of what we know about cancer today- lots of progress since I worked in the field some two dozen years ago.) So if you cut out the primary tumor- then the metastases take off and kill you. However, some primary tumors evolve and become more aggressive- and then they send out colonizing cells which cause metastases. Since tumors are genetically heterogenous- the same tumor can be doing both. Hey- nobody ever said this stuff was simple.

Fourth- there's a correlation with age here that seems to be getting ignored. A friend of mine who's over 50 had the genetic tests and showed up positive for BRCA1 (might have been two). Because she's watching her mom die of breast cancer now- she wants to have the double radical mastectomy. I'm livid at her damn doc for giving her the test in the first place with inadequate counseling. Basically, she's past the age where the tests really mean much- if she's survived past 50, her likelihood of getting aggressive breast cancer based on those genes is dropping. Of course, she could get the disease on some other basis, but I suspect that her odds of contracting the disease are not all that bad compared to the rest of the population.


Sam



crazyml -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 6:58:14 AM)

With the best will in the world... the balance of evidence is that there are certain situations where it makes sense to have a radical mastectomy.

I confess. that since you're a stranger on the internet, you probably haven't spoken with that many researchers. If you have then, I'm sorry for disbelieving you, but you certainly haven't spoken to a representative number of them.

The thing that really irritates me about your post, though. Is that there's a sort of implied presumption that AJ just said "Oh fuck yeah! Chop my tits off" without bothering to look for alternatives, seek second opinions, etc.

I mean... you cannot possibly believe that AJ didn't do a spot of googling on this topic before having her breasts cut off?

Seriously?

For fuck's sake.




samboct -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 7:22:20 AM)

Crazy ML

Umm- I've given talks on the topic of cancer diagnostics and have spoken to guys like Piotr Grodzinski numerous times (he's head of the NCI) at the meetings I attend. As an FYI- one of the reasons people go to meetings is because some stuff ISN'T being published- it's still being discussed. The issue of Science which goes through what I think is state of the art (well, close to it) was published on March 25, 2011. May I make a suggestion that you try reading before throwing stones? However, I will warn you or anyone else, this stuff is dense and not easy to follow even with a science background- it's written for researchers in the field.

A bit more accessible- here's an interview with S. Quay- who's CEO of Atossa Genetics. I've heard his road show where he pointed out explicitly that radical mastectomies were unnecessary. http://www.news-medical.net/news/20130222/Breast-cancer-tests-an-interview-with-Dr-Steven-Quay-CEO-of-Atossa-Genetics.aspx

Google generally works great- but occasionally you have to tell it where to look.

In terms of Angelina Jolie's actions- I'm assuming that she talked to her docs and did get a second opinion. She got what is probably the standard of care in medicine today. But doc's rarely keep up with cutting edge research- they tend to do what they learned in med school.

My bet- within a decade- double radical mastectomies will no longer be standard treatment. I'll put my money where my mouth is. Will you?


Sam



crazyml -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 7:38:48 AM)

Umm... I did say that if you weren't fibbing then I'm sorry.

Can I be clear though on what you're claiming.

Is it your claim that a majority of researchers believe that there is no call for double mastectomies? Yes or no will do.

Do you really believe your claim that "But doc's rarely keep up with cutting edge research- they tend to do what they learned in med school. "

Because this is horseshit. Surely you're aware of CPD? Surely you're aware that the leading consultants publish regularly?

Umm.. unless you also hang with time tavellers your bet is pretty fucking silly.

Let's be clear on a couple of things now...

You're not claiming that double mastectomy is "standard treatment" now, are you? Because, as you'll know from all your talkin and stuffs that it's not a standard treatment. There is a very narrow set of circumstances in which it's indicated.

So if you're saying that in a decade "double mastectomies" will never be the right choice - I hope you're right.

Of course diagnosis will improve, of course less invasive treatments will emerge. But that's in the fucking future.

AJ had to make a choice given the best information that was available to science today. And I will bet $1000 that she won;t have consulted one of your docs that rarely keeps up with research, I'll bet she spoke to someone rather well versed in the area.

I'm sorry if I seem snitty.

Actually, no I'm not... Your original post and your reply were really irritating.




samboct -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 8:16:15 AM)

To answer your questions-

Researchers in breast cancer- I suspect that most would agree that there is little/no need for double radical mastectomies- they don't work well. However, these are typically not the docs doing the surgery.

Most docs at best try and keep up with developments in their field and many don't. Yet, the first people that are going to be involved here are likely to be GPs. You ask GPs whether or not some tumors can play a protective role against metastases and I guarantee you'll get a blank look 95% of the time. I haven't spoken with many oncologists on this one- so I don't know what their answer will be. But the oncologists I have spoken with do tend to use surgery as the first line of defense.

In terms of diagnostics- that's not the future- there's a great deal going on now. Atossa Genetics is just one company at this- there are others.

Yes, I know I'm advocating what is a minority opinion at this point. Nevertheless, given the lousy track record of success of the typical therapies, it seems to me that doing something different is called for or is at least worth looking into.

You're making the assumption that Angelina Jolie did her homework well- I'm not. If she's watching a family member die, she's likely in a spot where she's not thinking clearly. For some women, the fear of the disease makes the surgery worthwhile. That she happens to be a celebrity means that there's a lot of focus on her health choices- but it doesn't mean that they're good ones. She's an actress- not a scientist.

Sam




thursdays -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 8:26:57 AM)

[argh]



crazyml -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 8:40:24 AM)

- Now posted from my forum account.

quote:

ORIGINAL: samboct
Yes, I know I'm advocating what is a minority opinion at this point.


Bingo.
quote:


Nevertheless, given the lousy track record of success of the typical therapies, it seems to me that doing something different is called for or is at least worth looking into.


No shit. And there's a ton of money flowing into all that "looking into" stuff. But AJ had to make her decision months ago - in the past.

quote:


You're making the assumption that Angelina Jolie did her homework well- I'm not. If she's watching a family member die, she's likely in a spot where she's not thinking clearly. For some women, the fear of the disease makes the surgery worthwhile. That she happens to be a celebrity means that there's a lot of focus on her health choices- but it doesn't mean that they're good ones. She's an actress- not a scientist.

Sam




Here's were we really disagree. On the balance of probablities - I think that it's fair to assume that a person would do some checking up before having their tits cut off.

I think it's fair to assume that she won't have taken her GP's word for it.

I think that AJ can thank her stars that while merely an "actress" she can afford to hire a bunch of Scientists.



kalikshama -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 9:48:38 AM)

Hey Sam,

Thanks for your posts; they were quite interesting.

I agree that this is quite likely:

quote:

You're making the assumption that Angelina Jolie did her homework well- I'm not. If she's watching a family member die, she's likely in a spot where she's not thinking clearly. For some women, the fear of the disease makes the surgery worthwhile. That she happens to be a celebrity means that there's a lot of focus on her health choices- but it doesn't mean that they're good ones. She's an actress- not a scientist.




tj444 -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 11:56:53 AM)

quote:

ORIGINAL: sexyred1
Actually, she is stil perfect, in fact more so since she cared enough for her family to do this. She is having her ovaries removed soon as well.

Neither of you know how Brad Pitt feels or can make assumptions on what famous people would do if their partners were to do the same thing for the same reasons.

Instead of bashing a brave woman who made a tough decision and her partner who clearly loves her, his kids and who are both very philanthropic, you should be applauding them.

Cancer and medical decisions are no laughing matter, I can tell you first hand. And anyone with a supportive partner, famous or not, is lucky.

I was not bashing her.. geeze.. the "perfect" I referred to is how certain douche dudes would see her.. oddly enough, those same douches would cheer and even pay for a "flat" girl to get huge fake boobs.. but they dont see what Angellina did as basically the same thing (implants are implants), just for Angelina, potentially life-saving.. I guess I dont have a good opinion of certain types of men.. lol

I do applaud both her and Pitt, and her decision to go public.. that was quite brave in today's judgmental world.. I dont think she went public to stave off the tabloids tho, I think she did it cuz she wanted to help other women who face this difficult decision.. My Godmother (who is no longer alive) had a double mastectomy, btw..



tj444 -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 12:25:03 PM)


quote:

ORIGINAL: LafayetteLady
You could be right, but I disagree for a couple of reasons. I don't think Clooney is that shallow. Yes, he is a playboy, but he seems to always date those less famous than him, but still celebrity, which makes for a difficult relationship in Hollywood.

There is also the publicity factor. Brad Pitt's popularity rating is pretty high (as is Clooney's). That would plummet for anyone who dumped her, and that would not be beneficial to them. I'm not saying that is what is making Pitt stay, since in other interviews (before this happened) he talks about how much she means to him. But he certainly would lose his popularity almost 100% if he dumped her, which also means he would be unable to get any work, because no one would want to see his movies (I currently don't care to see his movies anyway).

I think there are 2 big differences between Clooney and Pitt.. and that is the length of time they have had with the women in their lives & kids.. yes, Clooney is a playboy so you really dont expect the women to last all that long with him.. and he has also never had kids with any of them.. but Pitt has been with Angelina for a long time and they have quite a few children.. that puts a very different slant on things to me.. If Pitt did split with her, I dont think a drop in Pitt's rating would be cuz she has a strong rating, I think it would be cuz he would be breaking up their family.. (I think both of their ratings would drop).. People still want families to stay together, the couple to grow old together, still in love with each other and buck the trend, especially for Hollywood.. I hope they are indeed such a couple..



VideoAdminRho -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 1:32:05 PM)

I have removed a fairly large number of posts for being too far off topic, for making the poster the subject and for personal attacks.

Please, let's try to stick to the subject and be civil.



TallullahHk -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 6:13:45 PM)

AJ is far more than an actress. She's a highly respected humanitarian who works with organizations at the diplomat level. She hardly strikes me as a women who doesn't make well informed decisions.

She didn't watch one family member die from breast cancer. Her maternal grandmother died at the age of 45; her mother had breast cancer and died from ovarian cancer at the age of 56; her maternal aunt had the same BRAC1 gene as AJ and died of breast cancer at the age of 61. With those odd it amazes me that anyone is questioning her choice.

With testing positive for BRAC1 and given an 87% chance of developing breast cancer and a 50% chance of developing ovarian cancer. I have no doubt that she made the best decision for HER and HER family. And I have no doubt that she consulted the best geneticists and oncologists she could find. Nor do I have an doubt that she did extensive research on her own.

Bottom line, whether you agree with the research or not, she made a PERSONAL decision that she felt was best for HER and HER FAMILY.



sexyred1 -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 6:26:55 PM)


quote:

ORIGINAL: kalikshama

Hey Sam,

Thanks for your posts; they were quite interesting.

I agree that this is quite likely:

quote:

You're making the assumption that Angelina Jolie did her homework well- I'm not. If she's watching a family member die, she's likely in a spot where she's not thinking clearly. For some women, the fear of the disease makes the surgery worthwhile. That she happens to be a celebrity means that there's a lot of focus on her health choices- but it doesn't mean that they're good ones. She's an actress- not a scientist.




Her mother died a while ago, so I am sure she was thinking quite clearly when getting opinions from various doctors and getting genetically tested.

While I fully agree with LafayetteLady that we seem to be applauding AJ coming out about something that should remain private, let's be real here: she is super famous and it would have come out somehow. She took the proactive approach to openly discuss this in a classy way; her NY Times article was very helpful and may help women, even one woman who can relate.

So that is why I applaud her and Brad. Who I doubt needs any help in the popularity department, so his supportive attitude is likely due to his love for her, not out of any career worry. [8|]

I find it intolerable that some posters are questioning the validity of her choice. NO woman on the planet would ever get a double mastectomy with reconstruction out of some cavalier idea without researching it to death.




dcnovice -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 6:39:13 PM)

quote:

While I fully agree with LafayetteLady that we seem to be applauding AJ coming out about something that should remain private, let's be real here: she is super famous and it would have come out somehow. She took the proactive approach to openly discuss this in a classy way; her NY Times article was very helpful and may help women, even one woman who can relate.

Agreed.

And I wonder if it truly "should remain private," to be honest. I'm battling cancers (plural) right now, and I don't see it as anything to hide.



littlewonder -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 6:40:57 PM)

I kinda like that she came out with it. I don't think she did it purely for selfish reasons but to be of help to others who are suffering from this in their family. She tends to do that not only with breast cancer but with many other issues in the world that are close to her heart.

When my dad died of COPD, I decided to do some volunteer work with the issue because I didn't want to see others suffering and dying from the same thing. It was horrible watching my dad go through it.

I had chronic and genetic depression. I am always going out of my way to talk about it and enlighten others about it because again, I want to be able to show the world that it doesn't have to be a stigma. Life CAN and does go on even if you have it. You can live a normal life. I didn't come out with it for selfish reasons because I have it. I came out with it because I got tired of hearing others calling others crazy and every other term that is just downright wrong. I wanted others to know that there is help available and even give them options they can look into and not just medication alone.

So no, I don't think she did this for herself but because it was a cause near and dear and close to her heart.



dcnovice -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 7:39:14 PM)

quote:

I had chronic and genetic depression. I am always going out of my way to talk about it and enlighten others about it because again, I want to be able to show the world that it doesn't have to be a stigma. Life CAN and does go on even if you have it. You can live a normal life. I didn't come out with it for selfish reasons because I have it. I came out with it because I got tired of hearing others calling others crazy and every other term that is just downright wrong. I wanted others to know that there is help available and even give them options they can look into and not just medication alone.

Amen and thanks and God bless from a fellow depression survivor.

Have you read William Styron's Darkness Visible?



littlewonder -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 7:49:56 PM)

No. I've never read it but I will check it out. Thanks for the suggestion.



dcnovice -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/29/2013 7:54:33 PM)

It's the book I always want to give people and say, "Here. This is what I'm talking about."



samboct -> RE: Angelina Jolie had a "preventative double mastectomy" NY Times (5/31/2013 3:16:31 AM)

Now I'm getting puzzled by where the 87% chance cited came from. According to this NCI fact sheet found here: http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA women who carry the BRCA1 gene have about a 5x greater risk of developing breast cancer than the rest of the population. Furthermore, the NCI is noting that double radical mastectomy does not remove the cancer risk and does not discuss whether it reduces risk at all- but instead suggests use of a drug- tamoxifen, as a prophylaxis. This recommendation is much more in line with the researchers I've spoken with. Furthermore, there are other behavior modifications which also reduce risk such as exercise and weight reduction, both of which in Angelina's Jolie's case, are likely to already be in compliance.

In short, although there is an assumption that she could afford the best of care, I am questioning the reasons for her decision. I suspect that there are a number of other folks in the research community who are similarly surprised.

Sam



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