Angelina Jolie never ceases to amaze me, not by the choices that she makes, but rather how she uses them to inform women on health issues. Her latest decision to undergo bilateral salpingo-oophorectomy, or removal of the ovaries and fallopian tubes— and to share that with the New York Times— is one that should be applauded, and one that I really admire.
For years, we have known that due to genetic markers, Jolie was at risk not only of developing breast cancer, for which she already had a preventative double mastectomy, but that the BRCA1 gene mutation is also associated with ovarian cancer. The difference as far as the detection rates for breast cancer versus ovarian cancers is quite significant— and primarily, it has to do with the fact that the ovaries are small structures the size of walnuts that are deeply embedded inside the body, in the pelvis, so using imaging to detect changes in size is difficult. This is why early detection rates for ovarian cancer are very limited. The only time doctors are able to detect signs of the disease is in patients like Jolie, where there are known risk factors, and they can then implement a prophylactic plan for monitoring the disease.
Due to the fact that her mother, grandmother and aunt all died of women’s cancers, I am sure she was closely following her blood tests, especially the test for CA 125. This protein is a marker for inflammatory cells that is used as an adjunct along with ultrasounds and CAT scans to monitor the progression of ovarian cancer. So when her doctors saw a change in those levels, as Jolie states in her column, she decided to move forward with the procedure.
The treatment of ovarian cancer, if caught late in the game, is limited because it consists of surgery, or chemotherapy and radiation. However, if it’s caught early, ovarian cancer has a very good chance of being treated effectively over a long period of time. While Jolie’s doctors only found a benign tumor on one of her ovaries and no signs of cancer in her tissues, she writes in her column that she is still at risk for cancer because she kept her uterus, though uterine cancer does not run in her family.
The key continues to be developing better tests for early diagnosis and creating screening tools that women can use in the future. At least in the case of Jolie, her shared story could become the inspiration that we need for more research and more involvement from doctors, scientists and activists for whom the cause also hits close to home.