From a breast cancer husband's perspective

The news that Angelina Jolie has had a double mastectomy to reduce her chances of breast cancer is everywhere.The general reaction is: good for her. Jolie learned that she carried the BRCA1 gene, which dramatically increases a woman's chance of developing breast cancer as well as ovarian cancer, a disease that claimed her mother's life. And so Jolie made a decision that she said reduced her risk of the disease from 87 percent to less than five percent.After her mastectomy, she had reconstructive surgery, which can create beautiful artificial breasts. But nerves are cut in the surgery, notes breast oncologist Marisa Weiss. "In general, women can expect to lose sensation in that area. It's a sacrifice of an erogenous zone."So it isn't easy to say goodbye to the real thing. I remember when my wife was diagnosed with bilateral breast cancer--a tumor in each of her "girls." We went to various surgeons to hear their treatment plans. One doc recommended a double mastectomy. Marsha, who always thought she would be the kind of woman who would say, "Off with my breasts" if it would save her life, was deeply upset. She didn't want to lose her breasts. She loved having her breasts. I said to her what I truly felt: "It doesn't matter to me. I'll love you with or without your breasts."She turned to me and said, "How would you feel if they were going to cut off your penis."Yikes!I tried not to take it personally. But I did come to understand that this was a tough and personal decision, and that no one can tell the patient what to do. My job was to listen and, as one woman told me, "follow her lead." In the end, Marsha opted for lumpectomies plus radiation. She did not have the breast cancer gene, so her survival odds were not compromised by deciding against a double mastectomy.No matter what decision a woman makes, it helps to have a caregiver in her corner. Jolie has said that Brad Pitt is "loving and supportive," which is exactly the way it should be. But some men might not know exactly what to say or do – what can I say, guys are sometimes a bit clueless.I interviewed many husbands and wives for a book I wrote called Breast Cancer Husband, so I can offer suggestions. One husband told his wife: "Your scar is beautiful, because it means you are going to live." Another husband said: "I don't care what you're missing. That's not what you're about for me. I'm not counting how many of what you have. I just like being with you." Then there was the woman who asked her husband if he missed her breast. "It's the last question I would have expected," he said. "I had to reflect, but it didn't take long. I just told her the truth." Yes, he did miss her breast. And that made his wife feel better, because she missed it, too.Marc Silver, an editor at National Geographic, is the author of Breast Cancer Husband: How to Help Your Wife (and Yourself) Through Diagnosis, Treatment, and Beyond. His wife, Marsha, diagnosed with bilateral breast cancer in 2001, is today in good health. With his daughter, Maya, Marc co-authored the book My Parent Has Cancer and It Really Sucks: Real-Life Advice from Real-Life Teens.