In May 2013, Angelina Jolie had a well publicised double mastectomy to minimise the risk of developing breast cancer. And now she has revealed that she has also had her ovaries and fallopian tube removed to prevent the possibility of ovarian cancer.
The 39-year-old hollywood star published a lengthy opinion piece, titled ‘Angelina Jolie Pitt: Diary Of A Surgery’ in the New York Times on Monday, explaining her decision. The mutation in the BRCA1 gene gave her an estimated 87 percent risk of breast cancer and 50 per cent risk of ovarian cancer. She had lost her mother and grandmother to ovarian cancer and her aunt to breast cancer.
According to Jolie, she had been planning to undergo surgery to remove her ovaries and fallopian tubes for a while, However a call from her doctor two weeks ago made the procedure more urgent.
Writing in the New York Times magazine, Jolie said,” ‘Your CA-125 is normal,’ the doctor said. I breathed a sigh of relief. That test measures the amount of the protein CA-125 in the blood and is used to monitor ovarian cancer. I have it every year because of my family history.” ”But that wasn’t all. He went on. ‘There are a number of inflammatory markers that are elevated, and taken together they could be a sign of early cancer.’ I took a pause. ‘CA-125 has a 50 to 75 percent chance of missing ovarian cancer at early stages,’ he said.”
“He wanted me to see the surgeon immediately to check my ovaries. I went through what I imagine thousands of other women have felt. I told myself to stay calm, to be strong,,” she wrote.
She underwent a laparoscopic bilateral salpingo-oophorectomy and said she took this heart-wrenching decision so she “could see her grandchildren grow up”.
She noted that she chose to keep her uterus because there is no history of uterine cancer in her family. “Regardless of the hormone replacements I’m taking, I am now in menopause,” she writes. “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.” She points out that surgery has not eliminated her natural predisposition for cancer, but it has taken at least one type of the deadly disease out of the equation.
She finally notes, “I know my children will never have to say, ‘Mom died of ovarian cancer’,”
Angelina jolie has shown a lot of courage to share her private health care with the world and push a deeply sensitive issue into the spotlight. Interest in genetic testing and referrals to breast cancer clinics have more than doubled after she wrote about her 1st procedure.
BRCA genes, what you need to know
1. BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA and, therefore, play a role in ensuring the stability of the DNA. When either of these genes is mutated, or altered, such that its protein product is not made or does not function correctly, DNA damage may not be repaired properly. As a result, cells are more likely to develop cancer.
2. A BRCA1 or BRCA2 mutation can be inherited from a person’s mother or father. Each child of a parent who carries a mutation in one of these genes has a 50 percent chance of inheriting the mutation.
3. 55 to 65 percent of women who inherit a BRCA1 mutation and around 45 percent of women who inherit a BRCA2 mutation will develop breast cancer by age 70 years.
4. 39 percent of women who inherit a harmful BRCA1 mutation and 11 to 17 percent of women who inherit a harmful BRCA2 mutation will develop ovarian cancer by age 70 years
5. Men with BRCA2 mutations, and to a lesser extent BRCA1 mutations, are also at increased risk of breast cancer.
6. Because harmful BRCA1 and BRCA2 gene mutations are relatively rare in the general population, genetic testing of individuals who do not have cancer should be performed only when the person’s family history suggests the possible presence of a mutation in BRCA1 or BRCA2 such as Breast cancer diagnosed before age 50 years, both breast and ovarian cancers or cases of male breast cancer
7. A positive test result indicates that a person has inherited a known harmful mutation in BRCA1 or BRCA2 and, therefore, has an increased risk of developing certain cancers. However, a positive test result cannot tell whether an individual will actually develop cancer or when. Many women who inherit a harmful BRCA1 or BRCA2 mutation will never develop breast or ovarian cancer.
8. Several options are available for managing cancer risk in individuals who have a known BRCA1 or BRCA2 mutation. These include enhanced screening, prophylactic (risk-reducing) surgery, and chemoprevention.
