The Angelina effect

  • The Washington Post
  • Monday, March 30, 2015 1:59pm
  • Life

Angelina Jolie, mother of six, whipped the Internet into a frenzy last week after announcing her decision to have her ovaries removed in an elective surgery meant to prevent cancer.

“I feel feminine, and grounded in the choices I am making for myself and my family,” the actress wrote in an op-ed for The New York Times. “I know my children will never have to say, ‘Mom died of ovarian cancer.’ ”

Jolie’s mother died at age 56 after a decade-long battle with breast cancer. Last week Jolie underwent a laparoscopic bilateral salpingo-oophorectomy to remove her ovaries and fallopian tubes.

After Jolie’s piece published Tuesday, “Angelina Jolie Pitt” quickly began trending internationally on Twitter. Her essay, urging readers to “take control and tackle head-on any health issue,” climbed the Times’ “Most Emailed” list.

Doctors say the buzz will likely drive more women to consider genetic testing and, perhaps, elective surgeries that research shows can drastically reduce the risk of cancer. Researchers have dubbed this phenomenon “the Angelina Jolie effect.”

After undergoing genetic testing, Jolie, 39, discovered she carries a gene mutation that gives her an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. She also lost her grandmother and aunt to cancer. Two years ago, in an op-ed, Jolie shared her choice to have a double mastectomy.

“A Nobel laureate could give the same message, and it might reach only a handful of people,” said David Fishman, director of the Mount Sinai Ovarian Cancer Risk Assessment Program in New York City. “Angelina is using her celebrity in a heroic way, and she’s going to reach millions of people worldwide.”

Fishman estimates interest in genetic testing at Mount Sinai Hospital, one of New York’s largest medical centers, has nearly doubled since 2013.

“Since then, every, single patient in my program has brought up Angelina Jolie,” said Fishman, whose program treats more than 2,000 women annually. “It takes a lot of courage for someone to be willing to share their private health care with the world. Her courage pushed a deeply sensitive issue into the spotlight.”

A study published last year in Breast Cancer Research uncovered a similar burst in popularity overseas: Referrals to breast cancer clinics more than doubled in the United Kingdom after Jolie wrote about her first procedure.

Researchers, who collected data from 21 major clinics, saw referrals increase 250 percent — peaking at 4,847 in summer 2013, compared to the previous year’s June and July numbers, which capped at 1,981. “All participating centres were conscious of a more significant increase in women attending referring to the Angelina Jolie story and further, noted women seen in the past seeking updated advice on testing and risk-reducing surgery,” study authors wrote.

Ovarian cancer is the fifth-leading cause of cancer death in U.S. women, according to the Centers for Disease Control. The American Cancer Society estimates about 21,290 women will develop ovarian cancer this year, and roughly 14,180 will die from the disease.

Widely called “the silent killer,” it is hard to catch early without regular ultrasounds. Ovarian cancer is often detected at an advanced phase, where the five-year survival rate falls below 30 percent, according to research from Arizona State University.

A woman’s risk of developing breast or ovarian cancer increases significantly if she inherits a harmful mutation in what geneticists call the BRCA1 gene or the BRCA2 gene. (Men can also carry the mutations — and the heightened risks for breast cancer.)

Genetic tests — which cost between $300 and $3,500, depending on the insurance plan — can detect these early warning signs and better guide a patient’s future health-care decisions, Fishman said. About 200 of Mount Sinai’s patients annually decide to have elective surgeries, like Jolie, to decrease their cancer risk. Those operations are often covered by insurance.

Jolie’s choice sends a message to at-risk women who may be concerned about losing their sexual identity: Arguably the most glamorous woman of our time opted to remove certain body parts in an effort to evade deadly cancers — and that doesn’t make her any less of a woman.

“I called my husband (Brad Pitt) in France, who was on a plane within hours. The beautiful thing about such moments in life is that there is so much clarity. You know what you live for and what matters,” Jolie writes in her essay.

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