Friday, 27 March 2015

Welcome to the 'surgical menopause in your 30s' club, Angie

In May 2013 I wrote a post about Angelina Jolie having a prophylactic (preventative) double mastectomy to reduce her risk of developing breast cancer, followed by reconstructive surgery (implants) nine weeks later. And it recently emerged that last week (March 2015) she underwent a prophylactic bilateral salpingo-oophorectomy - removal of both ovaries and Fallopian tubes, to reduce her risk of developing ovarian cancer.

Through a blood test prior to all these surgeries, it had been determined that she had inherited a mutation in the BRCA1 gene, which gives her an estimated 87% increased risk of developing breast cancer, and a 50% increased risk of developing ovarian cancer. She has already lost her mother, grandmother, and aunt to this insidious disease.

What this means is that she, like me, is now in full-blown surgical menopause, necessitating the need for immediate and ongoing hormone replacement therapy. The difference between our procedures was that hers was a much less invasive laparoscopy (minor keyhole surgery), while mine was a three-hour-long laparotomy (major abdominal surgery which, along with the removal of both ovaries and Fallopian tubes, also entailed the complicated removal of massive cystic teratoma which had mushroomed and taken up residence in between all the organs in my abdominal cavity).

Besides the fact that we are so similar in age (she is 10 months younger than me), and we now share a similar endocrinological journey ahead, Angie's story reminds me of yet another issue very close to my heart: The grave injustice of adoptees who are prohibited by law from accessing personal records that pertain to their genetic identities.

While I was lucky enough to be born and adopted in South Africa, a country that allows an adoptee to search for their biological parents once they turn 18 - with their adoptive parents' written permission, or 21 - without their parents' permission, this is not the case for millions of North Americans who are forced to live under an archaic system of permanently sealed birth records. This has given rise to organisations like Bastard Nation, who are vocal campaigners for the right of all adoptees - not just those in certain States - to access on demand of their unaltered original birth certificates (OBCs), at age of majority, without condition, and without qualification.

If what Dr Jason Knight of the Cleveland Clinic says about "Family history [being] the most essential tool that is used by physicians to determine who should have testing," and "the most important thing that a person can do is know their family's cancer history," then let's hope that stories like Angie's, and my own upcoming adoption memoir, will help organisations like Bastard Nation in their lobbying efforts for nationwide access to OBCs.