Ever since the news of Angelina Jolie’s double mastectomy, there has been a general raising of awareness of the risks for cancer, but more importantly the role that genetic screening can play in cancer prevention. Ms. Jolie was tested for the genetic fault, discovered it, and made the choice of treatments which she was comfortable with. It could not have been an easy decision for her, any surgery is a risk with an average of 1 death per 50,000 surgeries. With 14 million plastic surgeries performed last year, that is just under 300 deaths in the US alone. Thanks to her screening for the gene, her risk for developing breast cancer has plummeted dramatically, and by testing early, she was given the largest range of options for treatment. She opted for the more radical of treatment options, but the options were there.

The genes involved in breast cancer were first identified in 1990, and ever since then, millions of women have been exploring their options to avoid cancer. There are two genes tested for, named appropriately BRCA1 and BRCA2 (BReast CAncer). The genes are also associated with other forms of cancer such as ovarian, which recently took the life of Pierce Brosnan’s daughter, Cassandra. But this risk does not just impact women, it also effects their families, as Cassandra left behind two children and a husband.

Facing this, the options available can seem daunting. Going from cancer.gov, there are multiple options:

Surveillance – frequent cancer screenings. This does not prevent cancer, but through close monitoring, through transvaginal ultrasounds, mammograms, blood tests, and MRI’s, the hope is to catch any cancers which do develop very early.

Chemical Prevention – The use of drugs to reduce the chance of developing cancer. Birth control pills have been shown to reduce ovarian cancers, and there are studied underway looking at anti-cancer medications such as tamoxifen and raloxifene for possible use for those with the BRCA genes.

Risk Avoidance – A proper diet, being active, and hormone treatments have been shown to have benefits in avoiding various cancers. Research only shows limited benefit of this, but if paired with other treatments may prove beneficial.

Surgery – By removing the at-risk tissue, the chance of cancer drops dramatically. This can be removal of the ovaries, a hysterectomy, or mastectomy, or even all of the above. By being proactive, and performing this surgery before cancer forms, it gives the maximum opportunity for reconstruction.

There is no perfect solution, and every option brings with it risks. Women with family histories of cancer, such as Cassandra (her mother died of ovarian cancer in 1991) and Angelina (her mother died of ovarian cancer in 2007), are recommended to undergo testing. Thanks to the Genetic Information Nondiscrimination Act (GINA) of 2008 it is illegal to discriminate against someone for the results of a genetic test. It becomes a tool in every persons arsenal of health. Now with Obamacare, the cost for getting this test is now fully covered, and with the Supreme Court’s decision on gene patenting, the cost will continue to plummet.

Without Obamacare to force them to make the step, it is highly unlikely that insurance companies would have stepped up on their own. Corporations are, by nature, averse to change. Genetic testing for conditions such as breast cancer is still in its infancy, and most companies are reluctant to embrace it. The new regulations set forth by this president has made such testing required coverage. This in turn is changing the healthcare cost curve, and even right-wing publishers such as Forbes is admitting that the slowdown in the rise of healthcare costs is due to Obamacare’s new regulations. By the heavy focus on screenings and testing, studies have found that screenings resulted in significant cost savings. With the coverage of such screenings now required, and the cost benefits obvious, many insurance companies have begun encouraging such testing due to the overall reduction in healthcare costs.

There are those, however, who would seek to destroy this. From religious zealots who wish to determine the appropriate medical options for their employees to politicians aiming to repeal the law, those who would step up and tell the American people, “You do not deserve to live” are still out there. Even though Obamacare saves lives every day, these people are in effect begging for the right to murder them. It is not about any moral or religious choice, it is about the power over life or death itself.

The decision to get tested and, if found positive, what steps to take is among the most difficult any woman can face. They will need the support of their family and friends, with a lot of understanding.

This is me and my wife 11 years ago last January. A month ago, after her families history of cancer, she was tested and found positive for the BRCA2 gene. These are the decisions she is facing right now, and I see how difficult it has been for her. If it were not for Obamacare and the court’s decision, we could not have afforded this testing to have been done.

For those who fear knowing, remember, a test result does not end your life. You have the gene before ever having the test done. Instead it gives you information to arm yourself and to face the future. If you have these concerns about your health and the BRCA gene, talk to your doctor.