Writing in The New York Times yesterday, the 39-year-old explains that two years ago a blood test revealed that she carried a mutation in the BRCA1 gene, which gave her an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer.
Having lost her mother, grandmother and aunt to cancer, the mother of six made the choice to have a preventive double mastectomy.
Jolie Pitt wrote about this choice at the time as she wanted other women at risk to know about the options. She also promised to follow up with any information that could be useful, including about her next preventive surgery, namely the removal of her ovaries and fallopian tubes.
She writes:
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.
Jolie Pitt went to see the surgeon the same day for the necessary tests, but had to wait five days for the results.
The PET/CT scan came back clear, and the tumour test was negative.
She explains that while there was still a chance of early stage cancer, that was minor compared with a full-blown tumour.
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.
Last week Jolie Pitt underwent a laparoscopic bilateral salpingo-oophorectomy which revealed a small benign tumor on one ovary, but no signs of cancer in any of the tissues.
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.