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Angelina Jolie ovary removal was prudent, expert says

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Posted at 9:31 PM, Mar 24, 2015
and last updated 2015-03-25 16:39:09-04

Actress Angelina Jolie, 39, had both of her breasts removed in 2013 because of a high risk of developing breast cancer. On Tuesday, Jolie announced that she recently had her ovaries and fallopian tubes removed.

“It is not easy to make these decisions. But it is possible to take control and tackle head-on any health issue,” Jolie wrote in a New York Times op-ed.

Each year, about 20,000 American women are diagnosed with — and 14,000 die from — ovarian cancer, according to the Centers for Disease Control and Prevention. It’s the deadliest cancer of the female reproductive system.

Jolie said she decided to have her ovaries removed after a blood test scare suggested she might be in the early stage of cancer.

“It's good that Angelina came forth with this because it has started a dialogue on this topic,” said Sanaz Memarzadeh, a gynecologic oncologist at Ronald Reagan UCLA Medical Center. “It’s important to talk about ovarian cancer, to research this area, to come up with early detection tests.”

About 75 percent of women with ovarian cancer are diagnosed as late stage. Unlike pap smears and routine mammography, there is no routine detection test for ovarian cancer. The symptoms can begin suddenly.

“Most women say they were fine until ‘a month ago' and then all of a sudden they find they had abdominal bloating and discomfort.” Memarzadeh said. “The symptoms get worse and worse until someone says they should do an ultrasound or CAT scan. Then it’s found that the disease has already spread.”

Because ovarian cancer is often detected late, only about 30 to 40 percent of women with ovarian cancer survive another five years — despite radical surgery.

“We can’t catch these cancers early,” Memarzadeh said. “If we had a better way of detecting earlier, fewer women would need this radical operation.”

Jolie, like 1 in 400 women, has a gene called BRCA that increases the risk of several types of cancer including breast, ovarian and cervical cancers. Several members of Jolie’s family have died of cancer.

Removal of ovaries and fallopian tubes can reduce breast cancer risk by up to 50 percent and ovarian cancer by up to 90 percent, according to the Mayo Clinic.

For high risk patients like Jolie, Memarzadeh said surgical removal is recommended.

Surgery to remove the ovaries is fairly straightforward and low risk in the right hands, Memarzadeh said. But the loss of reproductive hormone production results in early menopause. That increases the risk of:

  • Osteoporosis

  • Hot flashes

  • Sexual problems

  • Cognitive changes

  • Increased heart disease risk

It’s also still possible to develop cancer, though much less likely. Women with a family history of cancer can have a genetic test to see if they have the BRCA mutation.

Because there is no simple and reliable way to screen for ovarian cancer, it’s important to look for warning signs:

  • Vaginal bleeding or discharge that is not normal

  • Pain in the pelvic or abdominal area

  • Back pain

  • Bloating

  • Feeling full quickly while eating

  • A change in your bathroom habits


Gavin Stern is a national digital producer with the Scripps National Desk.