We’ve long known that the BRCA1 and BRCA2 gene mutations commonly found in Ashkenazic Jewish women are linked to higher rates of breast and ovarian cancer. A new report published online in the Journal of Clinical Oncology provides more details about ovarian cancer risk.
The report notes that women who have the BRCA1 or BRCA2 mutation and have their ovaries removed (oophorectomy) have an 80% reduced risk of developing ovarian, fallopian tube or peritoneal cancer. They also see their chances of dying before age 70 reduced by 77%. The best results were achieved by women with the BRCA1 mutation who preventively underwent an oophorectomy before age 35.
Summarizing the results of the study, CNN.com published an article with the maddening headline, “Study: Women with BRCA1 mutations should remove ovaries by 35.”
The study doesn’t actually say that, though the study’s lead author (a man) is quoted saying, “To me, waiting to have oophorectomy until after 35 is too much of a chance to take…These data are so striking that we believe prophylactic oophorectomy by age 35 should become a universal standard for women with BRCA1 mutations.”
What he doesn’t mention is the problems with the procedure. Oophorectomies before age 35 effectively put hormone levels in the prepubescent range, not to mention the procedure lowers libido and affects quality of life. And of course, an oophorectomy usually means the woman is sterilized, unless she elects to freeze some of her eggs (assuming she can afford to do so).
I don’t mention any of this to belittle the dramatic results of this study. It’s clear that there’s a serious advantage to undergoing an ooph (as the surgeries are commonly known) for women who have the BRCA1 mutation, and that the surgery is most effective at preventing cancer when it’s done early. Still, it’s wrong for CNN or the study to tell women what they “should” do with their bodies.
The pro-choice movement is based on the idea that a woman should be able to make her own decisions about when she wants to have children. At rallies and marches for reproductive rights, women hold signs that say, “My Body, My Choice.” That choice shouldn’t be limited to access to abortion.
Women with the BRCA1 and BRCA2 mutation deserve all of the same choices that are given to everyone else. Of course, the government doesn’t legislate breast and ovarian cancer surgery in the same way it legislates abortion. But the social pressure adds up. Neither CNN’s headline writers, nor the authors of this study can tell these women what they “should” do. That decision is up to the women and their doctors.
I can’t help seeing CNN’s article as part of the social push women receive to have children as young as possible. Endless articles and “experts” on TV news shows tell women everywhere to start making babies early, or risk suffering from infertility as they head into their mid thirties. Never mind that much of the data used to make this claim has been thoroughly debunked, people still love to tell women that once they turn 35 the chances of getting pregnant are shriveled and tiny (including my own gynecologist, who told me I should “hurry up” and get pregnant before I turn 35. I’m currently 29).
In short, it is easy for doctors being quoted in articles, and “experts” on cable news panels to tell women exactly when they should get pregnant. But this decision, just like the decision of whether or not to have disfiguring surgery like an elective mastectomy, or sterilizing surgery like an ooph, should be made by a woman, her partner and her doctor.
Women with the BRCA1 and BRCA2 mutation should be given access to information about this and many other studies. They should have a chance to ask their doctor questions. (A good one is, “What would you tell me to do if I was your daughter?”) They should consult with their partners if they have them, and think about their own plans for the future. And then they should do whatever they want. Their bodies, their choices.
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