Actress Angelina Jolie arrives at the 84th Annual Academy Awards held at the Hollywood & Highland Center on February 26, 2012 in Hollywood, California. Photo © Getty Images/Jason Merritt

Angelina Jolie still misses her mother, who died at age 56 of hereditary ovarian cancer. The two women share the mutated BRCA1 gene that gives rise to ovarian and breast cancer. Today, the actress revealed that she has undergone a prophylactic double mastectomy at age 37, with a view to avoiding breast cancer and surviving to a good old age for her children. Women who choose elective mastectomies - before any sign of cancer appears - are called "previvors."

Jolie started the process to remove her breasts about 3 months ago on February 2. She wanted to spare herself the loss of both nipples but wanted to be sure that cancer was not lurking there. After some testing, she went ahead with the mastectomies and had immediate reconstruction via breast implants.

Jolie wrote of her reasons: "My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman."

Jolie and actor Brad Pitt have been engaged for some time and have 6 children. Pitt has been supportive of Jolie and stayed with her during each of the surgeries required to complete her mastectomy and reconstruction. She notes that this changes family relationships, saying in her editorial, "I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition."

It is uncertain as to whether or not Jolie will start on chemoprevention by taking Tamoxifen or other hormone-lowering drugs. But it is certain that she is forever changed by this decision.

Angelina Jolie could have kept this news under wraps for quite some time, but decided to share it. "I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options. Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of."

Patient Empowerment asks:  What Can The Rest of Us Learn from Angelina Jolie's Double Mastectomy?

One Leg Circle Photo © Marguerite Ogle

Hitting The Gym Boosts Estrogen Metabolism, Lowers Breast Cancer Risk

Here is yet another great reason to get fit - it helps your body process estrogen more efficiently - and that reduces the risk of estrogen-sensitive breast cancer. You've been hearing for years that exercise is good for muscle tone, weight reduction, strength and flexibility, and heart health. Exercise also aids in recovery from cancer, but now we know that it can help prevent or delay the onset of breast cancer.

A new clinical study was done with 400 premenopausal women, split into groups of 200 each. One group was sedentary and the other group followed a regular exercise schedule. The exercise group spent 30 minutes of aerobic exercise 5 times a week over a period of 16 weeks. These women used some standard gym equipment such as elliptical and stair climber machines and treadmills. Urine samples from both groups were taken before the study started as well as at the end of the 16 week period.

Researchers found that the exercise group had higher levels of estrogen metabolites - these are the substances that break down estrogen and lower your risk for breast cancer. The group that didn't exercise had lower levels of these metabolites, so their systems were not able to process natural estrogen as well as the active group.

The study was led by Dr. Mindy Kurzer of the University of Minnesota in Saint Paul and published May 7 in the journal Cancer Epidemiology, Biomarkers & Prevention.

Mammogram Skin Marker Photo © Pam Stephan

I keep current on my annual mammogram, and I usually ask questions when anything about the process intrigues me. This time, the technician stuck this orange skin marker on me, right where a prominent mole is located. I knew it wasn't a prize for good behavior - so I asked what it was and how it helped me. She had a collection of these stickers - different colors, shapes, and sizes. Each patient might need one, none, or several, to clarify certain features that could appear on her mammogram.

The little orange sticker went home with me, and I did some research on it. Turns out these help your radiologist decide whether or not a blip on your film is a bad guy or a good guy. And that makes life easier on you, because that means fewer of those phone calls from the technician saying, "We saw something on your mammogram and need you to come back for more." Hate those callbacks, don't you? I do!

Mammogram skin markers work in your favor, reducing errors and improving communication between you, the technician, and your radiologist. They put a tag on things like moles and scars - well known territory - so you don't have to have repeated imaging done. That adds up to fewer mammo squeezes and clearer results.

Expired Prescription Pills Photo © Karl D. Stephan

During my treatments for breast cancer, I took pills. Lots of pills, all shapes and colors, all for different issues. After a while, when I would take Pill #1 - it would cause a side effect - and then I'd need Pill #2 to chase off the side effect from Pill #1. This often seemed pointless, but because I wanted to survive, I just kept refilling those prescription and taking those pills. I had a stockpile of prescription pills and a spreadsheet for my medication schedule. Finally when treatment was over, I was afraid to throw away the remaining pills because they felt like a security blanket. The pills had become my weapons against recurrence, and I didn't really want to part with them. Like many patients, I took estrogen-lowering drugs for 5 years after primary treatment, and then kept the extra pills in the back of my medicine cabinet. Finally, on National Prescription Drug Take-Back Day, an initiative of the Drug Enforcement Agency (DEA), I gathered up all my hoarded pills and took them to a nearby Sheriff's Office.

At a National Take-Back Day, volunteers accept packages of prescription medicines that are brought in by people like me and you. Most pills will be received, although an Epi-Pen and an old bottle of Mercurochrome that I had were rejected. The pills will be put into a bag for medical waste, and all the packaging will go into the trash. DEA agents will collect the bags of medicines - they took in 244 tons in 2012 - and these will be incinerated in special kilns that do not release fumes into the air.

Although none of my drugs would give you a thrill if you tried them, one reason the DEA collects these is to prevent drug abuse. Many young people get their recreational drugs right out of the family medicine chest, and can become addicted. Prescriptions are abused more than street drugs like cocaine, hallucinogens, and heroin in total. One other reason to properly dispose of drugs is to keep them out of the water supply. Flushing drugs may seem to be a safe disposal method, but when too much of those wind up in your tap water, you've got a problem.

If you didn't make it to your local Drug Take-Back event this year, and you still have drugs to dispose of, talk with your pharmacist or doctor. They can help you find the right place to take those pills.

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