Reflections on Angelina Jolie Pitt’s Health Choices

May 4, 2015 Updated: April 23, 2016

Before your read on, please be forewarned that what follows is longer than my usual posts…hoping that you’ll read on nevertheless, and find it interesting and helpful.

This past March, Angelina Jolie Pitt wrote in The New York Times about her health choices. Here’s the link to her piece: http://www.nytimes.com/2015/03/24/opinion/angelina-jolie-pitt-diary-of-a-surgery.html.

First, a little background
Jolie Pitt, via advances in modern genetic technology, was found to have the “breast cancer gene,” as per mainstream lingo. In actuality, there isn’t a breast cancer gene. Rather, Mrs. Jolie Pitt carries a mutation in a gene that, according to conventional medical thinking, appears to be associated with an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer.

Two years ago, armed with this information, she wrote about her decision to have a bilateral preventive mastectomy: http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html.

Her recent piece, in case you don’t or haven’t read it, details her decision to have a “bilateral salpingo-oophorectomy,” aka the removal of both her ovaries and fallopian tubes.

My reflections on Jolie Pitt’s choices and her writings
First, kudos to Jolie Pitt for making her personal journey public, for the credo that knowledge is power, and for the reminder that individual health choices must be just that: individual. These are central themes of her piece.

However, I must confess that I was deeply disappointed by the overall message that Jolie Pitt conveys, and the potency of this message, given her level of celebrity.

Here’s why, and then some
Jolie Pitt speaks of her fears: fears of illness, fears of premature death.

Indeed, fear runs rampart in the world of medicine. This fear is both the product and an inevitable disease of our Western medical cosmology.

As a physician, my training imbued me with the implicit beliefs that illness is bad and death is worse. Holding these beliefs, we do a tremendous disservice to both our patients and ourselves. And in this disservice, we can literally make and keep our patients sick.
 
Why this is so
Emotions can affect our health and our healing, our illness and our dying.

While this notion is not widely accepted by conventional Western medical thinking, the links between emotions and health are firmly rooted in the ancient wisdom of healing traditions worldwide. And, in fact, modern science now chimes in accord.

On some of these chimes of modern science
The investigative tools of numerous biomedical disciplines clearly demonstrate the causal relationship between emotions and health: the effects of emotions on gene expression, on disease risk and progression, as well as the toward health effects of palliating anxiety and fear1,2,3….Just to name a few.

A little more on the science of it all
The dogma of conventional biomedical genetics has held that genes are fixed determinants of whatever they code for. In other words, if you have the gene, you’ll get the disease.

However, developments in the field of functional genomics (sometimes referred to as “epigenetics”), have proven to the contrary. Many factors have been shown to influence whether or not what a gene codes for comes to pass; amongst these are our thoughts and emotions.4,5 It also bears mention that the effects of thoughts and emotions on the immune system and states of inflammation have been firmly established by scientists exploring these links.6,7

All of this gives us pause to ask: is it the gene that’s causing disease, or is our “dis”-ease causing disease? Might it be that the fear of illness and dying is causing illness and dying?  

Indeed, one must answer a resolute yes, given these chimes of modern science. Yes, our fear may be making us sick; it may even be killing us.

More questions to ponder
So, why don’t we find more of these ideas applied throughout medicine, in clinical practice?  

Unfortunately, many in my profession suffer from nearsightedness and limited peripheral vision. We don’t read the journals of specialties other than our own, nor do we read those of other scientific disciplines. Thus, cross-pollination of information and practices, across disciplines, so that they can find fertile soil for propagation, is rare.

What is needed
If we were to expand our paradigm to one that accommodates thoughts and emotions as participating factors, we’d be able to reap the benefits of this sea change that is occurring in the scientific arena, and to promote therapeutic approaches that utilize this knowledge. Such approaches enable emotional healing, and thus, can address those fears that may be felt about illness, dying and death.

We might then fear less and be fearless, in the face of these inevitable facts of life: of illness, dying and death. And we might also find that our fearlessness directly impacts our health. We might live better, and we might die better.

I’ll be writing more on approaches to emotional healing in posts to come.

Finally, back to Angelina Jolie Pitt, and some concluding thoughts regarding her choices and her writings
Undeniably, knowledge is power. Yet we must be circumspect as to the completeness and correctness of this knowledge.

As always, I welcome your comments.

References
1Powell ND, Tarr AJ, Sheridan JF. Psychosocial stress and inflammation in cancer. Brain Behav Immun. 2013 Mar;30 Suppl:S41-7.

2Loizzo JJ, Peterson JC, Charlson ME, Wolf EJ, Altemus M, Briggs WM, Vahdat LT, Caputo TA. The effect of a contemplative self-healing program on quality of life in women with breast and gynecologic cancers. Altern Ther Health Med. 2010 May-Jun;16(3):30-7.

3Spiegel D. Mind matters in cancer survival. Psychooncology. 2012 Jun;21(6):588-93.

4Lutgendorf SK, DeGeest K, Sung CY, Arevalo JM, Penedo F, Lucci J 3rd, Goodheart M, Lubaroff D, Farley DM, Sood AK, Cole SW. Depression, social support, and beta-adrenergic transcription control in human ovarian cancer. Brain Behav Immun. 2009 Feb;23(2):176-83.

5Volden PA, Conzen SD. The influence of glucocorticoid signaling on tumor progression. Brain Behav Immun. 2013 Mar;30 Suppl:S26-31

6Powell ND.

7Spiegel D.