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Angelina Jolie says she has had her ovaries removed to prevent cancer. The actor, director and activist had her breasts removed two years ago.
Here are five things to know about the choices Jolie made:
She has a high genetic risk of cancer
Jolie has known for years she has a much higher-than-usual risk of breast and ovarian cancer because of genetic mutations she inherited. She has a particularly harmful mutation of the BRCA1 gene. Mutations in this gene give women a 65 percent lifetime risk for breast cancer and a 39 percent lifetime risk of ovarian cancer. Jolie says her particular set of mutations gives her an 87 percent risk. Jolie's mother had breast cancer and died of ovarian cancer, and her maternal grandmother also had ovarian cancer.
Less than two weeks after Jolie revealed she'd had a double mastectomy, her aunt, Debbie Martin, died at age 61 from breast cancer.
Surgery may have lowered her risk
A study last year showed that people with certain BRCA1 mutations can cut their risk by as much as 80 percent if they get their ovaries removed by age 35.
The researchers said ovary removal should become standard for anyone with so-called BRCA1 mutations.
There’s no good screening test for ovarian cancer
Jolie had a blood test for a compound called CA-125. It’s produced by ovarian tumors and is a good way to check to see how well treatment for ovarian cancer is working. It’s not such a good test for finding ovarian cancer in the first place, however.
Ovarian cancer symptoms can be maddeningly vague: bloating and discomfort, mostly. There is no good screening test yet.
Ovarian cancer is the deadliest women’s cancer
Ovarian cancer kills 15,000 women a year in the United States. Only 46 percent of women diagnosed with ovarian cancer survive for five years or longer. That’s mostly because the disease usually is detected late, after it has started to spread.
Treatment for ovarian cancer is harsh
Usually, the first approach is surgery to remove the ovaries and surrounding affected tissue. That can mean parts of the colon and bladder, as well as the uterus, depending on how far the cancer has spread. Chemotherapy is also almost always given, usually the so-called platinum-based drugs such as cisplatin or carboplatin, plus a taxane drug such as paclitaxel. Women may receive the drugs intravenously and also infused into the abdominal cavity.
Side-effects include hair loss, nerve damage, nausea, hearing damage and kidney damage. Radiation therapy is also common and it can damage nearby organs and tissues, causing incontinence, rash, upset stomach and pain.