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She said she had the surgery last week as she carries a gene that gave her a 50% risk of developing ovarian cancer. This surgery is coming two years after she had a double mastectomy to prevent breast cancer. Read what she wrote in her New York Times article after the cut...
Angelina Jolie Pitt: Diary of a Surgery (as first published on New York Times)
I
wanted other women at risk to know about the options. I promised to
follow up with any information that could be useful, including about my
next preventive surgery, the removal of my ovaries and fallopian tubes.
I
had been planning this for some time. It is a less complex surgery than
the mastectomy, but its effects are more severe. It puts a woman into
forced menopause. So I was readying myself physically and emotionally,
discussing options with doctors, researching alternative medicine, and
mapping my hormones for estrogen or progesterone replacement. But I felt
I still had months to make the date.
Then
two weeks ago I got a call from my doctor with blood-test results.
“Your CA-125 is normal,” he 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, and that I had no reason to think I
wouldn’t live to see my children grow up and to meet my grandchildren.
I
called my husband in France, who was on a plane within hours. The
beautiful thing about such moments in life is that there is so much
clarity. You know what you live for and what matters. It is polarizing,
and it is peaceful.
That
same day I went to see the surgeon, who had treated my mother. 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.
The
day of the results came. The PET/CT scan looked clear, and the tumor
test was negative. I was full of happiness, although the radioactive
tracer meant I couldn’t hug my children. There was still a chance of
early stage cancer, but that was minor compared with a full-blown tumor.
To my relief, I still had the option of removing my ovaries and
fallopian tubes and I chose to do it.
I
did not do this solely because I carry the BRCA1 gene mutation, and I
want other women to hear this. A positive BRCA test does not mean a leap
to surgery. I have spoken to many doctors, surgeons and naturopaths.
There are other options. Some women take birth control
pills or rely on alternative medicines combined with frequent checks.
There is more than one way to deal with any health issue. The most
important thing is to learn about the options and choose what is right
for you personally.
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. My doctors
indicated I should have preventive surgery about a decade before the
earliest onset of cancer in my female relatives. My mother’s ovarian
cancer was diagnosed when she was 49. I’m 39.
Last
week, I had the procedure: a laparoscopic bilateral
salpingo-oophorectomy. There was a small benign tumor on one ovary, but
no signs of cancer in any of the tissues.
I
have a little clear patch that contains bio-identical estrogen. A
progesterone IUD was inserted in my uterus. It will help me maintain a
hormonal balance, but more important it will help prevent uterine
cancer. I chose to keep my uterus because cancer in that location is not
part of my family history.
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.”
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.
I
feel deeply for women for whom this moment comes very early in life,
before they have had their children. Their situation is far harder than
mine. I inquired and found out that there are options for women to
remove their fallopian tubes but keep their ovaries, and so retain the
ability to bear children and not go into menopause. I hope they can be
aware of that.
It
is not easy to make these decisions. But it is possible to take control
and tackle head-on any health issue. You can seek advice, learn about
the options and make choices that are right for you. Knowledge is power.
Angelina Jolie Pitt is a filmmaker and a U.N. envoy.
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