The Medical Opinion On Angelina Jolie's Surgeries

Some commentators have criticized the actress’s proactive surgical approach to cancer prevention—but what are local doctors saying? And do at-risk women have other options?

You’ve seen her on the stage, screen, in the tabloids, and in The New York Times. Yep, Angelina Jolie has written another article for the Times. Last week she published her article “Angelina Jolie Pitt: Diary of a Surgery”. The article mentions Jolie’s controversial decision to undergo a preemptive double mastectomy in 2013, but focuses on a more recent surgery. That’s right, Jolie didn’t stop there: she revealed that to further lower her risk of developing cancer, her ovaries and fallopian tubes were surgically removed.     

Jolie’s proactive surgeries—which have left her unable to have more children and will trigger premature menopause—are not without critics. But the 39-year-old (more on her age later and why it’s relevant) actress, wife, and mother has a family history of cancer; she lost her mother, grandmother, and aunt to the disease. Jolie also carries the mutant gene BRCA1 (her aunt also carried this gene) that puts her at higher risk for some cancers. Jolie’s article is an open-ended discussion about preemptive surgeries and the options women have.

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Doctor Yukio Sonoda

And there are options. In the past, we spoke with gynecologic oncologist Yukio Sonoda, MD, FACOG, FACS, from Memorial Sloan Kettering Cancer Center about fertility-sparing surgery for women with cervical cancer. When we spoke with him about Jolie and her article he said, “I thought it was a very courageous act to share something so personal. Such actions by a well-known public figure will dramatically increase public awareness about this problem.”

Because of her age, Jolie is considered “in the window” of when such a procedure can be performed. In regards to such preemptive surgeries Sonoda says, “In the right situation—such as for Ms. Jolie—I am all for it. I have seen patients with advanced BRCA-associated ovarian cancer and also those patents who had waited to have their prophylactic surgery and ultimately developed cancer. I always wonder if these situations could have been avoided had they done something earlier.”

Sonoda also mentioned that removal of the fallopian tubes and ovaries could achieve an 80-90% ovarian cancer risk reduction. According to Sonoda there are no other methods of prevention as effective as this. Although the use of oral contraceptives is associated with a reduction in ovarian cancer risk, it is not nearly the same as removing the tubes and ovaries.

It is important to discuss all of your options with your doctor and it is also encouraged that patients speak with a genetics counselor who is familiar with the risks associated with BRCA genes.

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