There have been a lot of news stories about Anjelina Jolie and her decision to have a double mastectomy after certain tests told her that she had an 87% chance of developing breast cancer. Her family history was rich with cancer as she had lost her own mother to the disease. Jolie made decisions to be tested and to take the most radical precautions so her 6 children wouldn't have to deal with the same loss of their mother as she did.
When I first heard this store break I instantly thought about what wealth can buy someone. I began to consider what I would do if faced with the same path. There is no history of cancer in my family, so my thoughts about this was purely from an outsiders perspective. From what I understand, and this is a very basic understanding, Jolie was able to have a test that determined that she had the genes or the set of genes that almost always resulted in breast cancer. Was that type of testing available to anyone who is scared of developing cancer? The answer- yes! The testing is available to anyone; anyone with the means to pay for it. The cost of this type of genetic testing ranges from several hundred dollars to several thousand dollars, and most likely is not covered by most health insurance plans. The double mastectomy that followed this genetic testing for Jolie could have cost up to $100,000- maybe more. And I can't think of an insurance plan that would cover that type of surgery.
Jolie is lucky to have resources at her disposal that most of us can only dream about. When she was faced with her very likely future of cancer, she didn't have to crunch numbers and see how she would make it work. She simply had the preventative surgery. She has the luxury of healing in a self imposed sanctuary likely with little thought as to who would help take care of her 6 children while she recovered. She would not have to weigh her options picking work over cancer treatments. I am sad to think that these freedoms are only available to a select elite few.
I fall into the category that most people fall into. I am employed and have a perfectly adequate healthcare plan through my employer. In fact, since I work for a cancer care management firm, I might have just a few more resources at my disposal than does the general public. But the fact remains, it is unlikely I have the same option that Jolie had when she learned of her genetic testing results. Most of us have to wait to be diagnosed with cancer before we can seek treatment, and even then the limits of cancer remedies is shocking if you are on a budget.
I have been thinking about this after I watched an HBO documentary about 2 years ago called The Education of Dee Dee Ricks. This gritty and no holds barred look at one wealthy woman's battle with breast cancer. During her treatment, Dee Dee realized that even she was struggling with her finances, despite the fact that she had been extremely successful in Manhattan's financial district. She was shocked when she began to look deeper into cancer and it's effects on the patients. Dee Dee is single, with two young children at home and she was grateful to have friends who supported and loved her all around her so that she could concentrate on taking the best care of herself so she could beat this disease. She had chemo, and eventually had a mastectomy. Like Jolie, she had a breast implant to rebuild her breast after her treatments. During this time in her life, she became committed to helping those without her resources but who still had to deal with the fallout of a cancer diagnosis. She met up with a woman who was a patient at a cancer center named after Ralph Lauren. the head doctor at this center is committed to helping cancer patients navigate their way through their treatment. Most of these people are impoverished and have very limited access to the necessary treatments. In fact, most of these women will die, purely because of their lack of resources.
There are an astounding amount of people who have lost their jobs since the financial crash in 2008. 5 years later it seems that we may be crawling out of the hole, and people are beginning to work again. But a lot of these people are starting over again, at the bottom, often for much less money than they made 10 years ago and sometimes with limited or no healthcare. To these people, a cancer diagnosis is a death sentence. These people don't have access to the genetic testing, they don't have the option for preventative treatment, and often they don't have the resources for early diagnosis, aggressive and sometimes experimental treatments, alternative healing. These people, if diagnosed and with a treatment plan, often have to continue working or their rent is not paid.
I was thinking about all of this when the Anjelina Jolie story broke. I was amazed at the bravery and courage that Jolie had to undertake such a radical prevention of cancer in her life. But at the same time, I was so sad because more often than not, the financial limitations of most people prevent them from being able to be so aggressive in preventative measures. I thought about how devastating the diagnosis of cancer would be to someone with average means, someone who would have to weigh the financial implications of such a diagnosis. I realized that treatments at our centers were down, and it wasn't because fewer people have cancer, it is because fewer people are seeking treatment. Fewer people have healthcare coverage that make survival even a possibility.
I feel sad because in a country where we hold our values of freedom so close to our vests, in a country that encourages us to seek our destiny to the fullest, that people still die of cancer. I understand the reality of cancer is that some people will die, but I cannot and will not resolve that people will die of cancer because they can't afford screening or treatment. I find it deplorable that we live in a society where the wealthy will survive diseases that the rest of us may not.
One of my favorite movies is Braveheart (pre-Mel Gibson anti-Semite go crazy period). There is a scene when the king of England is speaking to his roundtable and says something to the effect of if they cannot drive the Scots out of their resistance, they will breed them out. Is that what we have here, the poor being bred out because we cannot afford treatments nor do we have access to pre-screening, preventative testing and the most aggressive and successful cancer remedies that the rich will survive while the poor will be bred out?
