Archive for May, 2013

Celebrities, Cancer and Genetics

Tuesday, May 28th, 2013

It is interesting that it takes a celebrity, in this case the actress Angelina Jolie, to increase our awareness about a disease that kills millions around the world every year. The statistics is clear: one in three women will develop a breast neoplasm during their lifetime. Yes, I am talking about cancer, in this case, breast cancer. Angelina brought to the spotlight last week what nobody wants to talk about, or discuss, or think. The cover of TIME magazine on May 27 showed to the world how some decisions are bitter in our lives, especially when our loved ones suffered and died without knowing more about it (see more on TIME Magazine “The Angelina Effect“). Angelina was able to open a discussion around the world about breast cancer prevention (see the NYTimes article “My Medical Choice”). Breast Cancer is a disease that was once a malady of the “old”, but with more awareness it is clear that it can affect anybody at any age – you just need a defective gene. Genetics is key in some cases, especially when the disease runs in the family. Cancer is classified as “The Emperor of all Maladies” in the Biography of Cancer written by Siddhartha Mukherjee. This disease is as old as humans and the story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. Angelina was able to expose herself in a way never seen in a Hollywood Movie that she had a main role. She was able to show the world how genetics is becoming part of our daily lives, something that not even a scientist working to find a cure for cancer is able to do. Science tells us the history of the genes involved in hereditary breast cancer: BRCA1 and BRCA2 were identified in the 1990s, more than 20 years ago (for more information see the review article “The Genetics of Familial Breast Cancer“). Interestingly, methods to diagnose the likelihood of a person with mutations in BRCA1 and BRCA2 getting cancer were covered by patents owned or controlled by a company called Myriad Genetics. Myriad’s business model of exclusively offering the diagnostic test led from Myriad being a startup in 1994 to being a publicly traded company with 1,200 employees and about $500M in annual revenue in 2012. It also led to several controversies over high prices and the inability to get second opinions from other diagnostic labs, which in turn culminated in landmark lawsuits and big discussions about gene patenting (see more in the article from The GuardianAngelina Jolie’s cancer decision highlights row over genetic technology”). This is a discussion that is around for a while, since the Human Genome was sequenced in 2001. Importantly, the health care providers do not cover some of the genetic tests already available in cases like Angelina’s, since the tests are very expensive. So, how everybody with a family history for defective genetics will be tested? And how many celebrities like Angelina will take to make general people more aware of the revolution in preventive medicine that just started? I think that Angelina’s choice was the best decision, since her mother died at age 56 and her aunt just died recently of the same malady. This fuzz about Angelina’s choice was a good thing, since it is educating people about genetics, cancer and the decisions we have to make based on our family history. This could even change the scope of genetic testing for breast cancer genes, who knows? Unfortunately, somebody famous has to take the center stage to start a discussion that will probably affect every human being during his or her lifetime. Society will gain a lot with more awareness about this deadly disease. Thanks Angelina, that was a good choice for you and for all of us! (Image Source: TIME Magazine).

This Blog Post is dedicated to my brave mom Angela Falconi