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Starting Point with Soledad O'Brien

Angelina Jolie's Double Mastectomy Sparks Discussion of Breast Cancer; What Women (And Men) Should Know; Disney Sexing Up "Brave" Heroine?; Prince Harry's Jersey Shore Tour

Aired May 14, 2013 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

(COMMERCIAL BREAK)

JOHN BERMAN, CNN ANCHOR: Welcome back to STARTING POINT, everyone. I'm John Berman.

CHRISTINE ROMANS, CNN ANCHOR: And I'm Christine Romans. New this morning: the stunning revelation by Angelina Jolie, one of Hollywood's biggest stars, that she had a preventive double mastectomy because she carries a gene that dramatically increases her risk for breast and ovarian cancers, a mutation of that gene does. She talks about the entire process in a candid new op-ed.

BERMAN: She sure does. Jolie's openness will potentially help millions of women who are no doubt talking about this this morning. But there are a lot of questions, especially who should get screened.

Senior medical correspondent Elizabeth Cohen joins us now from Atlanta to talk more about this cancer gene and tell us more about the test that Angelina Jolie says she took.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Right, the test is called a BRCA test. BRCA is breast cancer gene. If you have a mutation of this gene, you could be or you are at a much higher risk for getting breast cancer than other women.

So let's look at a little section of her piece in "The New York Times" because she lays it out so beautifully. Angelina Jolie writes, "I carry a faulty gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer. 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."

So in Angelina Jolie's case, she decided to get tested because her mother died at a pretty young age of ovarian cancer. She was diagnosed in her 40s, and I guess what went through her head was, gee, was that just a fluke that my mother got ovarian cancer so young or is there a bad gene in my family? And she decided to set out and find out the answer.

ROMANS: And Elizabeth, she said she wanted to write because of this. She said, "I wanted to write this to tell other women that the decision to have a mastectomy was not easy, but it is one I am very happy I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent."

Elizabeth, is the procedure she underwent a sure way to significantly decrease the risk of developing breast cancer?

COHEN: You know what, Christine, it's not 100 percent. And the reason why is they do have to leave some breast tissue; it's impossible to remove all of it. So that is why she still has some risk, but it's under 5 percent. But I can see why she thinks it's worth it. I mean, to go from 87 percent chance of getting breast cancer to under 5 percent is dramatic.

Now I want to talk a little bit about her ovaries and the reason for that is is that, in these circumstances, genetic counselors will often tell women, "You've got a faulty BRCA gene. If you're young and you still want to have children, go have your children, but we recommend that you get your ovaries removed by the time you are 40." That's what a genetic counselor told me this morning.

Now, Angelina Jolie did say she started with her breasts and it's unclear whether she's planning on having her ovaries removed as well.

ROMANS: And Dr. Otis Brawley, we spoke to him earlier, whose life's work is prevention of cancer, he said that the recommendation in a case like this is that the ovaries are removed.

BERMAN: One of the things that happened obviously when this news broke overnight is that so many people started having these discussions, started talking about this openly and publicly. And one of the people we have been talking about this with is our dear friend and colleague. Zoraida Sambolin is here with us right now.

ZORAIDA SAMBOLIN, CNN ANCHOR: You know, it actually -- I think it was a blessing that this happened because I was trying to figure, as you know, John, how would I tell our viewers that I would tell our viewers that I'm going to be gone for a while. I was diagnosed with breast cancer about three weeks ago and I have too chosen to have a double mastectomy. Very different reason than Angelina Jolie.

And I am going to document my journey because it's an intensely personal decision what you decide to do about your health care, but at the end of the day, and Elizabeth will confirm this, a woman has a lot of options and choices nowadays and they can really weigh in on what the best decision is for them.

Angelina Jolie inspired me today on so many levels. She talked about something that I really struggled with because, you know, I have two beautiful kids and I talk about all the time. And, you know, as women and as mothers, there they are -- Nicola and Sophia -- you want to live for them. I would do anything for them. I would cut off any appendage for my children.

But my femininity really was something I struggled with here as well and I felt bad struggling with that. And yet today Angelina addressed that very issue -- a woman's femininity, and it's OK to talk about that, that this is something that, you know, is a part of you that you're about to lose. And I've chosen reconstruction also, Elizabeth, and that really is a daunting process also, right?

COHEN: You know, I don't know if I want to use the word daunting because I watched -- I watched a woman go through reconstruction, and it's not easy. I wouldn't use the word easy. But think many women do it and they're very happy with it once it's done and over.

And I think that's so important because, Zoraida, I still think that some women think, when they talk about double mastectomy, they think they're going to have nothing. And there's so many different ways to do reconstructive surgery these days. It has come so far since the early days. And I think the fact that you're talking about this, and that you came -- you went public today -- is so important, because it shows here you are, this wonderful, smart woman, making empowered choices and thinking through what you want to do. You don't have to have a double mastectomy with a breast cancer diagnosis in all cases, but it's a choice many women make. And they go on to have reconstruction and then their lives move forward.

SAMBOLIN: I have -

COHEN: So I think it's wonderful that you've done this.

SAMBOLIN: I have chosen the reconstruction and I'm working with a wonderful plastic surgeon who has walked me through the entire process. And the reason I use daunting is because it's a major decision that you're making and it's major surgery that you're having as well.

And there are some really wonderful success stories out there. I had this wonderful man who has walked me through what his worst-case scenario, what his best case scenario, another thing that Angelina Jolie talked about, which, you know -- I don't know. How do you talk about saving a woman's nipple, right? Yet she had the presence of mind to have that conversation. That is my fiance that you are looking right there, who was the first person I called when I was diagnosed and has been just a remarkable support for me.

But those things, when you talk about your sexuality, and those kinds of conversations, can you save your nipple? Can it at least look like a breast when it's all said and done? Those are tough conversations to have, and making that decision and you do -- the insurance company pays for the reconstruction. I was amazed at the women that I talked to that had no idea that the insurance company would pay for that.

In Angelina Jolie's case, that genetic test, the BRCA test, is something that all insurance companies don't pay for. They like to see a nice, strong history of genetics in the family before they decide that they're going to pay for that $3,000 test. So I'm hoping as we're talking about this, Elizabeth, and as Angelina Jolie is talking about this, that at the end of the day that more women can have the option of that genetic testing.

COHEN: Right. It really is tough. I mean, if you don't have insurance, if your insurance won't pay for the whole thing. It's so expensive. I mean, I've talked to women who have a family history of breast cancer and, you know, mother, sister, aunt, multiple people -- but can't get the test because they can't afford it. And what they end up doing is they go to the company and makes it and they ask for financial help.

It's interesting that right now the Supreme Court is looking at this case, because one of the reasons why it's expensive, experts say, is because only one company is --

SAMBOLIN: It's a monopoly.

COHEN: Exactly, they have a monopoly. So what happens with a monopoly? The prices are high. So the Supreme Court is looking at whether it's OK to have a monopoly on a test like this and the decision will come out in the next couple of months.

So that price may come down in the future. But there is help out there. And I've met women who just said, forget it, I just couldn't afford it. And luckily, genetic counselors, doctors, came forward and said there's this foundation, there's that foundation, and set them up with funding.

BERMAN: Can I ask you guys both one question because, as Zoraida knows all too well, I'm new to all this. There's so much I don't know about this whole situation. But Angelina writes this op-ed overnight. It sounds like she'll be out again in public acting soon. What's the length of the process she's going through and generally it takes to get through this?

SAMBOLIN: Do you want to weigh in on that? I think I know, but you've experienced it because you went through it with someone.

COHEN: Right. I think it depends partly on what kind of reconstruction you get. So you can get reconstruction a couple of different ways. They can use implants, which is what Angelina Jolie is doing,. Usually they're saline. You can take fat off a woman's hips and make breasts out of that fat or you can also take fat from her stomach and make breasts out of that.

It depends. But it also depends how quickly you go from the mastectomy to the reconstruction. But it can be a matter of months, and it sounds like that's what it is in her case, is a matter of months.

SAMBOLIN: Yes, she mentioned that she started with the expanders, which is exactly what I'm going to do. So as you go in and you have everything removed, you have mastectomy, they put in the expanders and it's basically -- it looks like a saline implant. And what they do is they slowly but surely fill it up because your body has got to adjust to that. And so that's a process that you go through.

Typically by three months, you should feel pretty whole. It's about three total surgeries that you're going to have at the end of the day. But the big one, the first one, is really the most complicated one. After that, you're pretty much smooth sailing.

ROMANS: Elizabeth, can I just ask one question, or make one point maybe for you to weigh in on a little bit? Breast self-exams and mammograms starting at what age? I mean, we're talking about detecting cancer or even before cancer, in these two cases we're talking about this morning -- maybe this is a good time to remind women to make sure we're really on the lookout, without a $3,000 BRCA gene test, really on the lookout for signs of breast cancer.

COHEN: Right, and this is something every woman should do, so I'm glad you mentioned that. So this breast cancer genetic test, you know, doctors only recommend it when you have a family history of breast or ovarian cancer. But all of us need to be doing mammograms and breast self-exams, monthly breast self-exams.

Now, the mammograms, you remember Christine, you and I talked a lot about this at the time, very - you know, there was this big controversy. At what age should women start -- 40, 50, yearly, every other year, whatever? And really the bottom line is is that most major organizations are recommending starting at age 40 and doing it every year.

You get radiation, you know, nobody wants radiation, but, you know, these organizations have said the little bit of radiation you get is worth the information that you get from the test.

SAMBOLIN: Can I say one other thing? Because, you know, I've had a history of what's called fibrocystic breast tissue for a very long time, and I do want to share this because it's very dense breast tissue and they've had a really hard time kind of figuring out what is wrong with me.

But I have been religious about getting my mammograms and so, at the end of the day, one of my diagnosis on my left side is a very early breast cancer. And I believe it's because of that, because I did not mess around. I went when I was supposed to go, and I followed it diligently. Because, at the end of the day, that makes you empowered also.

And I can't let you leave, Elizabeth, without empowering other women out there -- and men actually, because I've had a couple of guys here who have a history of breast cancer in their families. There's one guy, the entire family of women have had breast cancer and those did not choose a double mastectomy have died.

And so, you know, very powerful stories this morning and I want folks to know we are a resource for them, that there's just so much information for folks to be empowered. So can you tell them about that?

COHEN: Right, if you go to CNNhealth.com, that's the CNN health unit's Web site, and you can see all of the wonderful information we have there with links to all sorts of stories, including ones that I've written about how to be an empowered patient when you get a diagnosis of breast cancer.

And I'm sure, Zoraida, you found this also. There's lots of options out there. You don't get a breast cancer diagnosis and you immediately do A, B, and C. There are choices and different women are going to make different choices. Just know the choices you have and if it means going for a second opinion, go for that second opinion. But rarely is it just one thing that you have to do. Know what your options are and make smart choices.

SAMBOLIN: I absolutely agree with that. I had three opinions and, at the end of the day, they allowed me to make my choice. And so I think that's very important to surround yourself by amazing women. So I thank you, Elizabeth Choen, and your entire team. Ronnie Selid (ph), she's been amazing. Thank you.

COHEN: Ronnie's (ph) amazing, that is true.

BERMAN: Support is such a key thing here and Zoraida needs to know, and obviously does know, that we are all behind you 100 percent.

SAMBOLIN: I want to be that too at the end of the day.

BERMAN: And you are supporting all of us, and you're really leading us through this whole process. So thank you for that.

SAMBOLIN: Any time.

BERMAN: We'll be back in just a moment.

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(BEGIN VIDEO CLIP)

MERIDA: I am Merida first born descendant of Clan Dunbroch. And I'll be shooting for my own hand.

UNIDENTIFIED FEMALE: What are you doing?

(END VIDEO CLIP)

BERMAN: Merida who was supposed to be a different kind of Princess and this morning, a new controversy, swirling around this popular Disney Pixar movie, the movie is "Brave". And the film star Merida was hailed as an empowering Disney princess and really a role model for young girls.

ROMANS: But the spunky heroine has undergone an extreme makeover now appearing thinner and more glamorous. The transformation has left many fans angry and outrage over this makeover has gone viral. With an online petition garnering more than 120,000 signatures.

One of those signatures belongs to the creator and director of "Brave". Oscar winner Brenda Chapman and she joins us now. Good morning.

BRENDA CHAPMAN, WRITER & DIRECTOR, "BRAVE": Good morning.

ROMANS: You know, you won an academy award for co-directing this film. You know this character. You really know this character.

CHAPMAN: Yes.

ROMANS: And you know the main character was inspired by your own daughter. So it's also pretty personal to you. What do you feel --

(CROSSTALK)

CHAPMAN: Yes it is.

ROMANS: -- when you see this new version of this princess who to all of us was supposed to be the anti-princess?

CHAPMAN: I'm a bit appalled actually. I -- I just couldn't believe it when I saw it. It -- it is so not Merida, that it -- that it was kind of shocking to see what they did to her.

BERMAN: So what's going on here do you think? Is Disney just trying to cash in by kind of sexing up this princess?

CHAPMAN: Well I think they've taken -- they've gone through the whole Disney princess line and I think they're just doing standard procedure which in this case was I think a bad choice because Merida is not standard procedure. She's not one of the regular princesses and -- and she was created to be not one of those princesses.

ROMANS: And we're showing the line up right there and you can see her in the middle kind of with a saucy pose I would say, and a lower neckline and a slimmer waist and she looks older. And you know one of --

(CROSSTALK)

CHAPMAN: Yes.

ROMANS: -- one of her characteristics, Brenda, was that -- sort of a resistance to conventional beauty. She appears in the same kind of dress that her character kind of detested. Right?

CHAPMAN: Exactly. Exactly I mean Merida wouldn't be caught dead looking like that. And I think that's what's angering everyone is that they've -- they've totally lost sight of the character in this new design.

BERMAN: Just let me read -- let me read the statement that Disney released. They said "Merida exemplifies what it means to be a Disney princess through being brave, passionate and confident and she remains the same strong and determined Merida from the movie whose inner qualities have inspired moms and daughters around the world." I'm not sure you agree with that statement, do you?

CHAPMAN: Not at all. I mean if they'd left her looking the way she looked, I would be great. But you know I understand with the toys that they have to -- you know that they don't want to put in a lot more money creating a new body for the doll, so yes she has a Barbie like quality with the dolls.

But this is a drawing what they put out there that's going to be on tons of merchandise. And it doesn't cost that much money to put a little effort into a drawing that portrays the character as who the character is as opposed to this sort of grotesque, you know, sexist sort of depiction of her.

ROMANS: I mean maybe some people will look at it and say she just looks a little older, she looks a little more in line with the other, with the other you know -- I'm playing devil's advocate here -- that a little more in line with some of the other princesses.

Is there anything that you can do, any other actions like a lawsuit? Do you have any standing on merchandising claims, is there anything that you -- that you can do aside from putting your name on the petition?

CHAPMAN: Not really. I mean, I -- unlike live action directors and writers, I don't get a residual check. I'm not whining all the way to the bank as I've been accused of doing. But what -- because there is no check. But really there is nothing I can do but speak out. I have no rights to that character anymore, other than my heart, you know what's in my heart and why, you know, she was inspired by my daughter and by real teenage girls.

BERMAN: Let's leave on a positive note then. What is in your heart? What is the message that you want young kids around the country to take from Merida?

CHAPMAN: That for young girls you don't need a romantic relationship to be complete but that you should be an individual and strive to do what love to do and be who you are and accept who you are. That is Merida's spirit and that's what I was hoping to put forward with -- with this character.

ROMANS: Brenda Chapman it's so nice to meet you. Thanks for coming by this morning.

BERMAN: We appreciate it.

CHAPMAN: Thank you.

ROMANS: Ahead on STARTING POINT, the no shenanigans tour, no shenanigans Prince Harry is teaming up today with New Jersey Governor Chris Christie, what we can expect next. You're watching STARTING POINT.

(COMMERCIAL BREAK)

ROMANS: It's a good Tuesday morning and welcome back.

Prince Harry's latest stop in his current U.S. tour is Seaside Heights, New Jersey an area hit hard by Hurricane Sandy back in October.

BERMAN: So what is on the agenda for today? Poppy Harlow tracking Harry's stop on the Jersey shore.

POPPY HARLOW, CNNMONEY.COM: Good morning John and Christine. Well this is day six of a whirlwind U.S. tour for Prince Harry. He began with time spent in Washington, D.C. He visited the White House. He visited Arlington National Cemetery. And then he moved on to Colorado, where he helped out with the warrior games for wounded veterans, something very close to Prince Harry's heart.

And now he is in Seaside Heights, New Jersey, he will be here shortly, taking a tour with Governor Christie of some of the areas hardest hit by Sandy. He's going to tour a town right by here to see some of the worst of the devastation. We're told that's what the Prince wanted to see. Also he will tour the Boardwalk here in Seaside Heights which just reopened for business.

A lot of business owners here are very excited that he's coming. We are told by someone close to the Prince on the U.S. tour that Governor Christie is very happy that he is putting the rebuilding effort of New Jersey back in the spotlight in terms of the media.

I want you to take a listen to one of the business owners we've talked to this morning.

(BEGIN VIDEO CLIP)

CHARLEY DRAPER, OWNER ADRENALINE PIERCING AND TATTOO: I think it shows people across the country that this town was hit relatively hard, considering what happened. And his presence alone should bring people into the town, should generate interest and in turn generate more business. It's exactly what this town needs.

(END VIDEO CLIP)

HARLOW: And just hours after Prince Harry departs, they are going to start to disassemble that damaged roller coaster that is iconic, an iconic part of this town. They're going to remove it as part of the whole rebuilding process. And as far as Prince Harry, the rest of his day he's going to head in to New York City where he is going to go to an event with Prime Minister David Cameron, promoting British trade relations.

And then he's going to go up to Harlem where he is going to be attending a baseball event for underprivileged youth. And then he will end his evening with a big fund-raiser for a number of his foundations -- guys.

BERMAN: Our thanks to Poppy Harlow.

You know we are hearing before that Prince Harry is very much overshadowing the British Prime Minister David Cameron on this trip. I guess that is no surprise.

STARTING POINT is back in a moment.

(COMMERCIAL BREAK)

ROMANS: Welcome back to STARTING POINT.

BERMAN: Welcome back, everyone. We now have -- we're talking about the man who helped save three women from years of captivity. He is now the subject of a unique tribute in ink.

Steven Mulholland of Cleveland got this new tattoo of Charles Ramsey on his leg. Local tattoo artist Rodney Rose admires Ramsey's straight talking style and did the work for free. Nice work as a tribute to his local hero.

ROMANS: That's cool. That's it for STARTING POINT. I'm Christine Romans.

BERMAN: And I'm John Berman. "CNN NEWSROOM" with Carol Costello begins right now.