Actor writes in detail about her decision to have operation to prevent cancer that killed her mother
Angelina Jolie has revealed she has had her ovaries and fallopian tubes removed to prevent her from developing ovarian cancer, the illness that killed her mother at the age of 56.
“My doctors indicated I should have preventive surgery about a decade before the earliest onset of cancer in my female relatives,” Jolie wrote in the New York Times. “My mother’s ovarian cancer was diagnosed when she was 49. I’m 39.”
Two years ago, Jolie had a double mastectomy because she had inherited the faulty BRCA1 gene, which placed her at high risk of developing breast cancer, and also gave her an elevated lifetime risk of developing ovarian cancer.
At the time she flagged that she may undergo more surgery, but she wrote in the Times that she still believed she had some time before going down that route.
“Then two weeks ago I got a call from my doctor with blood-test results,” Jolie wrote. Her doctor told Jolie the test she had every year to monitor for ovarian cancer had revealed a number of elevated inflammatory markers, which together could be a sign of early cancer, and to see her surgeon immediately.
“That same day I went to see the surgeon, who had treated my mother,” she wrote. “I last saw her the day my mother passed away, and she teared up when she saw me: ‘You look just like her.’ I broke down. But we smiled at each other and agreed we were there to deal with any problem, so ‘let’s get on with it’.
“Nothing in the examination or ultrasound was concerning. I was relieved that if it was cancer, it was most likely in the early stages. If it was somewhere else in my body, I would know in five days. I passed those five days in a haze, attending my children’s soccer game, and working to stay calm and focused.”
While her PET/CT scan looked clear, and the tumour test was negative, there was still a chance of early stage cancer, she said.“I still had the option of removing my ovaries and fallopian tubes and I chose to do it,” Jolie wrote.
“Regardless of the hormone replacements I’m taking, I am now in menopause. I will not be able to have any more children, and I expect some physical changes. But I feel at ease with whatever will come, not because I am strong but because this is a part of life. It is nothing to be feared.”
Early detection and treatment of ovarian cancer is rare because it is a cancer that can quickly dislodge from the fallopian tube or ovary surface and spread, making it much harder to treat and highly fatal.
In Jolie’s case, surgery revealed a small benign tumour on one ovary, but no signs of cancer in any of the tissues. Unlike ovarian cancer, a single case of breast cancer in a family does not mean other family members are at higher risk, nor does carrying the BRCA1 gene automatically mean the treatment, called a salphingo-oophorectomy, is right for everyone.
“In my case, the eastern and western doctors I met agreed that surgery to remove my tubes and ovaries was the best option, because on top of the BRCA gene, three women in my family have died from cancer,” Jolie wrote.
“It is not possible to remove all risk, and the fact is I remain prone to cancer. I will look for natural ways to strengthen my immune system. I feel feminine, and grounded in the choices I am making for myself and my family. I know my children will never have to say, ‘Mom died of ovarian cancer’.”
Jolie said she had written about her experience to help raise cancer and testing awareness, and to highlight that there were multiple factors to consider before undergoing surgery.
But not anyone can be tested for the mutation. Families that carry a mutation of the BRCA1 gene have their own unique mutation of it. It means that in order for doctors to have tested for the mutated gene in Jolie, one of her relatives must have been tested for the mutation after already being diagnosed with cancer, so that doctors knew what specific BRCA1 mutation to look for in her relatives.
In 2013, actor Pierce Brosnan’s daughter, Charlotte, died from ovarian cancer. But because the test for the mutated gene did not exist when her mother died from the same cancer in 1991, doctors would not have been able to test her to find out which mutation she carried and therefore, test other family members for it.
This article was written by Melissa Davey, for theguardian.com on Tuesday 24th March 2015 07.19 Europe/Londonguardian.co.uk © Guardian News and Media Limited 2010