How far should our hishtadlus go?

amother

Tue, May 14 2013, 6:46 am

I read this morning that Angelina Jolie got a double mastectomy to reduce the risk of breast cancer. She says (quoted from a video of her talking) "Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy.I wanted to come out with this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don't need to fear they will lose me to breast cancer."
It just got me thinking... Is she crazy for doing this? I understand that there are no guarantees, God runs the world. But, how far should our hishtadlus go to prevent illness?

Liba

Tue, May 14 2013, 6:52 am

If one has the brca gene and a strong family history it is actually pretty normal hishtadlus. 87% chance is quite high. They were almost likely going now or later, why not get rid of them now, before chemo and radiation are needed as well?

Breasts are all nice and good, but life is really awesome.

Breast cancer chv"sh isn't a walk in the park.

Isramom8

Tue, May 14 2013, 7:06 am

Might be better to reduce our risk with a healthy diet, exercise, breastfeeding our babies, not smoking, etc. But if she is convinced that she has an 87% chance after meeting with a genetic counselor, it's not a crazy choice.

I can't really judge since I know that I don't have the (known) breast cancer genes.

amother

Tue, May 14 2013, 7:34 am

BRCA runs in my husband's family. Some siblings and cousins have tested positive for it, and some made this decision while others decided not to but rather be extra vigilant about any changes they notice. To each their own. If you've ever encountered breast cancer up close, you wouldn't blame someone who has reason to believe they're next for taking such extreme measures.

Isramom- when the gene is involved, the factors you mentioned are pretty much useless. They might lower your chances by 5%, which is nothing when you're facing odds of more than 80%.

Isramom8

Tue, May 14 2013, 8:15 am

Isramom- when the gene is involved, the factors you mentioned are pretty much useless. They might lower your chances by 5%, which is nothing when you're facing odds of more than 80%.

I hear that. But might lifestyle choices delay the onset of breast cancer to an older age when a woman would die of "something" anyway?

freidasima

Tue, May 14 2013, 8:39 am

Not from what they have proven. If one is 40 and has five year old kids one might want to live to actually see them graduate from elementary school, not to speak of high school. And if the price is taking off one's breasts? it's not like it is an organ that we need for anything other than nursing.

Interesting to think whether people's "problem" with what she did or the concept of pre-empting such a disease comes from fear of surgery per se, which is understandable, there are always risks, or because it is a breast...with all that goes with that concept psychologically. Let's say it would be some other organ that we didn't need for anything, that we could easily live without, and without the psycho babble connected to it, would people protest so much?

If medical odds are such that it helps to get them off, get them off and now. Better earlier than later. Same goes BTW for ovaries but one needs them to have children and therefore it's a harder call. AND do all the other things to make one healthier, but truthfully it helps by 5% as written earlier and it has been proven that genetics are the basis of most of what happens to us healthwise unfortunately.

granolamom

Tue, May 14 2013, 8:44 am

one's hishtadlus is highly personal. I think that no one can judge another's. for one woman, hishtadlus is doing the minimum surgery and tons of 'natural' work. for another woman, it would be a double mastectomy.
I believe that the hishtadlus here would be to learn about the disease, choose reputable health care practitioners, consult with others, make the choice that sits well in one's soul and daven. a double mastectomy does not guarantee a long life either. all in G-ds hands, statistics notwithstanding.

Clarissa

Tue, May 14 2013, 9:16 am

Isramom8 wrote:

Even older people don't want to die if they don't have to. My aunt was diagnosed with breast cancer at 75. Was treated and survived, thank God. This was about 13 years ago, and she's enjoyed 13 years with her wonderful husband, children and grandchildren. And nieces, of course. There's no good time for a devastating disease. If I knew I had the gene, I'd absolutely get a mastectomy (my sister had breast cancer) and have my ovaries taken out.

PinkFridge

Tue, May 14 2013, 9:54 am

When I was tested I decided that if positive I could see getting the plumbing out but not a prophylactic mastectomy. After all, breast cancer is more easily detected and treatable and all that. But the type one is at risk for is, I've heard, much more aggressive. I really can't fault anyone for deciding to make that decision, and honestly I'm not sure what I would have done had push come to shove.

sarahd

Tue, May 14 2013, 10:32 am

PinkFridge wrote:

I really can't fault anyone for deciding to make that decision

I find this an interesting choice of language. Why would it occur to anyone to "fault" Jolie for this? I think she is rather to be admired for making this difficult choice for the sake of her family (and herself, of course.)

Isramom8

Tue, May 14 2013, 10:40 am

DrMom wrote:

I don't understand why anyone would question what she did. What, is anyone here seriously suggesting that she made a poor choice?

The issue of not wanting to part with breasts aside (and bear in mind that means goodbye to the kind of s-exual enjoyment a woman might be accustomed to), there is a school of thought that questions the premise that chopping off body parts is what will keep us healthy.

Not trusting nature all that much, I'd probably do it. But still.

PinkFridge

Tue, May 14 2013, 10:47 am

sarahd wrote:

PinkFridge wrote:

I really can't fault anyone for deciding to make that decision

Good point. Erev yom tov may not be the best time for me ;-)

amother

Tue, May 14 2013, 10:51 am

OP here, I wasnt referring to this procedure per se.. I think this just opens a bigger question of how many preventative measures we should be taking. There are all sorts of procedures that reduce risk of cancer (all types), which are usually pretty invasive. and then there's the stay away from radiation/sun/certain foods/deodorant etc mindframe. whats our obligation and what's beyond that?

Frumdoc

Tue, May 14 2013, 11:24 am

I used to know an amazing woman who died in her mid 20s, without husband or kids, from brca related ovarian cancer. Her 2 sisters, mother, aunts and grandmother had all died at ages less than 40, from brca breast or ovarian cancer. At the shiva, her father was inconsolable, having lost every female relative he loved to the same cancer. It was terrible.

If it was me, I'd whip the lot out, breasts, ovaries. Living without that shadow over your head must be a whole new life full of sunshine. I completely admire Anjelina Jolie for being a huge star and s-symbol, and coming out publicly about removing two of the things that she is famous for LOL

amother

Tue, May 14 2013, 11:30 am

amother wrote:

There is a big difference between taking care of ourselves to try to prevent cancer, and having a high genetic risk factor. Eighty-five percent chance??? That means you would be meant to rely on a miracle, basically.

So are we allowed to rely on miracles?

I had a frum friend diagnosed with breast cancer and she insisted on relying on a Miracle to heal her instead of taking medical treatment. She wanted to save her breasts because without them she was certain she'd never get a shidduch or nurse a baby. But she didn't live long enough to do either.

What some people don't take into consideration, is that medical advances are also from G-d. They are a miracle! True they can be painful, but the alternative can be, too.

DrMom

Tue, May 14 2013, 11:39 am

Isramom8 wrote:

DrMom wrote:

I don't understand why anyone would question what she did. What, is anyone here seriously suggesting that she made a poor choice?

I don't know of *any* school of thought that advocates *arbitrarily* "chopping off body parts." You are misrepresenting the situation entirely. Angelina Jolie has a genetic marker and family history that predicts a 87% chance of developing breast cancer -- an often fatal disease. Her preventative surgery was not done randomly.

imamiri

Tue, May 14 2013, 12:09 pm

PinkFridge wrote:

Treatable, but still can metastasize, come back or treatment may cause complications to other organs. Breast cancer awareness has done a great service by making women aware they need to be the first line of detection but also a disservice by making people think breast cancer is not a big deal. It's still deadly.

marina

Tue, May 14 2013, 1:03 pm

amother wrote:

There is a big difference between taking care of ourselves to try to prevent cancer, and having a high genetic risk factor. Eighty-five percent chance??? That means you would be meant to rely on a miracle, basically.

So are we allowed to rely on miracles?

I had a frum friend diagnosed with breast cancer and she insisted on relying on a Miracle to heal her instead of taking medical treatment. She wanted to save her breasts because without them she was certain she'd never get a shidduch or nurse a baby. But she didn't live long enough to do either.
What some people don't take into consideration, is that medical advances are also from G-d. They are a miracle! True they can be painful, but the alternative can be, too.

Where were the rabbis or teachers? Did anyone try to convince her otherwise? That is a horrible story.