Angelina Jolie: Why I chose surgery again

Hollywood star Angelina Jolie has had her ovaries and fallopian tubes removed as a preventative measure against cancer.

Angelina Jolie: Why I chose surgery again

Writing in the New York Times yesterday, Jolie said she had the surgery last week as she carries the ‘faulty’ BRCA1 gene that gave her a 50% risk of developing ovarian cancer.

Two years ago, Jolie, whose mother died of ovarian cancer in 2007, had a double mastectomy.

“It is not easy to make these decisions,” she said. “But it is possible to take control and tackle head-on any health issue.”

Jolie, who is married to actor Brad Pitt, with whom she has six children, three of whom are adopted, chose to have her ovaries and fallopian tubes removed after a check-up two weeks ago.

In the newspaper article, entitled ‘Angelina Jolie Pitt: Diary of a Surgery’, she said a blood test revealed “a number” of elevated inflammatory markers that could be a sign of early cancer, and was advised to see a doctor immediately.

“I went through what I imagine thousands of other women have felt,” she wrote. “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 polarising, and it is peaceful.”

Read More: Angelina Jolie has ovaries removed

Further tests revealed Jolie was free of a tumour, but nonetheless decided to have her ovaries removed after consulting doctors. Her mother, grandmother, and aunt all died of the disease.

“My doctors indicated I should have preventive surgery about a decade before the onset of cancer in my female relatives,” wrote Jolie.

“My mother’s ovarian cancer was diagnosed when she was 49. I’m 39.” Her mother, actress and producer Marcheline Bertrand, died of the disease at the age of 56.

“That same day, I went to see the surgeon, who had treated my mother,” Jolie 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’.”

Jolie said doctors agreed that surgery to remove her fallopian tubes and ovaries was the best option because, on top of the BRCA gene, three women in their family had died from cancer.

Writing about the procedure, she explained: “It is a less complex surgery than the mastectomy, but its effects are more severe. It puts a woman into forced menopause.”

Jolie, who won an Oscar in 2000 for her supporting role in Girl, Interrupted and who is also a film director and UN ambassador for refugees, is now undergoing hormone replacement therapy.

“Regardless of the hormone replacements I’m taking, I am now in menopause,” she said.

“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.”

Jolie is not alone in influencing health behaviour around the world.

Attendance for cervical cancer screening rose both in Britain and Ireland in 2008 and 2009 when the reality TV celebrity Jade Goody was diagnosed with cervical cancer and died.

Jolie said she felt deeply for women for whom such a decision comes very early in life, before they have had a chance to have children.

“Their situation is far harder than mine,” she wrote. “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.

“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.’”

Hollywood star is shining example, say Irish experts

Angelina Jolie’s decision to have her ovaries and fallopian tubes removed to lessen her chances of developing ovarian cancer has been hailed as courageous by one of Ireland’s leading health experts.

“This woman has had a huge impact in the way people view their rights towards appropriate cancer treatment,” Janice Walshe, consultant medical oncologist at St Vincent’s University Hospital in Dublin, said yesterday.

The Hollywood star underwent the preventative surgery last week - two years after having a double mastectomy.

The actress carries a mutation in the BRCA1 gene which means she had a 50% chance of developing ovarian cancer, which killed her mother, Marcheline Bertrand, in 2007.

“It is a brave decision,” said Dr Walshe. “She had a close family history of cancer and that meant she had a large lifetime risk of developing it herself.”

Jolie sparked a doubling in referrals for genetic breast cancer tests in Ireland and Britain in 2013, in what doctors dubbed the ‘Angelina effect’.

“She has increased our consultation times in clinics twofold, with people coming in and asking questions that they would not have done before,” Dr Walshe said, adding that she hoped it would make women become more aware of the symptoms of ovarian cancer.

More than half of women with ovarian cancer die within five years of diagnosis and those who are not diagnosed until a more advanced stage have a poorer survival rate.

The main reason it is such a big killer is because it is hard to detect in the early stages. The main symptoms are swelling in the abdomen, weight gain, bloating or irritable bowel-like symptoms.

“Where the issue of screening comes in, it is important to detect it early,” Dr Walshe added.

“The problem is that screening for ovarian cancer is very difficult. We use a blood screening marker and ultrasound and, although they are not very good at detecting early cancer, they are the best we have.”

Naomi Fitzgibbon, cancer information services manager with the Irish Cancer Society, pointed out that although hereditary cancer - which occurs when a faulty gene is passed on from either parent - greatly increases the chance that cancer will develop, people can carry such genes and not develop cancer.

“Experts believe that between 5%-10% of ovarian cancers are caused by changes that have been passed on in certain genes,” she said.

Aishling Deegan, senior communications officer with the ICS, added: “Of course the decision that Angelina has taken requires a lot of courage but it also takes a lot of courage not to do it.

“It’s clear that Angelina has put a lot of thought and consideration into this and is in the fortunate position of having significant resources at her disposal to help her in this process.”

In Britain, the chief executive of Target Ovarian Cancer, Annwen Jones, said: “Angelina Jolie’s decision to tell her story is very brave, and she plays a vital role in raising awareness of ovarian cancer and the BRCA gene mutation, which significantly increases the risk of ovarian cancer.

If you are concerned about ovarian, breast or any cancer call the Irish Cancer Society’s National Cancer Helpline on Freefone 1800 200 700 and speak to a specialist cancer nurse.

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