PAM BELLUCK2015 03 May 26Safin Hamed/Agence France-Presse - Getty ImagesAngelina JolieCancer experts said on Tuesday, actor, filmmaker Angel
PAM BELLUCK2015 03 May 26
Safin Hamed/Agence France-Presse - Getty Images
Cancer experts said on Tuesday, actor, filmmaker Angelina Julie Peter (Angelina Jolie Pitt) last week selected removal of the ovaries and fallopian tubes is a wise decision, because she who carry mutations in the BRCA1 gene, which greatly increases the risk of ovarian cancer, the cancer is difficult to detect, usually late incurable stage can be found.
They also said that Julie Peter so frankly about their choice, will encourage similar women to weigh their options. Among white women in the United States, BRCA mutations account for 5%-10% of breast cancer cases, and ovarian cancer accounts for 10%-15%. It is not clear how often this mutation is common in other races and ethnicities.
"With BRCA1, strongly suggest that BRCA2 gene mutation carriers at the age of 40 to take preventive measures, the ovaries and fallopian tubes," University of Pennsylvania (University of Pennsylvania) Bhathal Research Center (Basser Research Center) executive director Susan Domczek (SusanDomchek) said. "There is no effective way to detect ovarian cancer, there are many women with advanced ovarian cancer died of the disease." The center specializes in BRCA variation. The 39 year old Julie Peter wrote in "New York Times" for writing opinion article, removal of the ovaries and fallopian tubes was unexpected, but the cancer worries prompted her decision as soon as possible the "treatment of laparoscopic tubal bilateral oophorectomy". Her mother, aunt and grandmother died of cancer.
She wrote, "let me know, I can still decide to go to the excision of ovary and fallopian tube, and my decision is to do surgery."
Two years ago, she wrote her breasts removed, because BRCA1 increased her risk of developing breast cancer, which triggered a discussion about women breast cancer with high incidence of what should be done in the world. It was also the BRCA1 mutation that prompted her to undergo surgery last week.
Several doctors said that for women in similar circumstances, they usually recommend the removal of the ovaries before the removal of the breast, but the price is that women who do this kind of surgery will be early menopause, no longer have children. However, the removal of the ovaries significantly reduces the risk of breast cancer in women. Compared with ovarian cancer, breast cancer is usually easier to detect and treat.
"We are very insistent on ovariectomy," Dom Cheik said. "We will mastectomy as an option to talk."
Experts said that some of the details mentioned by Julie Peter may not apply to all women carrying such a mutation, may be different doctors have different views. For example, Julie Peter wrote, doctors advised her to undergo surgery at least 10 years earlier than her mother's first diagnosed age -- the age of 49. But the doctors said that the actual experience shows that 35 to 40 years old is more suitable for the age, the ideal state is at birth, cancer risk increased dramatically before.
Julie Peter also said she received an annual CA-125 protein test to monitor whether there are signs of ovarian cancer. She said her doctor said the test would have missed a lot of cancer. Some experts say they no longer carry out such tests because there are too many cancers and there is no evidence that they can improve survival rates.
Memorial Sloan - Caitlin Cancer Center (Memorial Sloan Kettering Cancer Center) director of clinical genetics service Kenneth Offut (Kenneth Offit) said, "basically, no such test data support, we recommend surgery."
He also said, "in the end, she did a good job. She made the right decision, and underwent ovarian surgery in the time window."
Julie Peter's decision not to remove the uterus is in line with expert advice. The Mayo Clinic (Mayo Clinic) of the Department of Obstetrics and Gynecology oncologist Jamie Bakkum and Dr. mace (Dr. Jamie Bakkum-Gamez) said, "there is no research shows that there is a mutation in the BRCA gene have the risk of uterine cancer."
Jamie Bakkum - with Dr. mace and other experts agreed to her decision to take hormone replacement therapy: an estrogen and progesterone IUD patch to reduce menopausal symptoms caused by surgery.
Julie Peter has six children, of whom three are adopted. She wrote that she knew the decision would be "more difficult" for women who still wanted to be pregnant, and that she knew they could choose to "remove the fallopian tubes, but keep the ovaries."". Experts warned that the removal of fallopian tubes can effectively prevent ovarian cancer, the evidence is still not enough.
Krance, 35, also had a BRCA2 gene mutation, and she underwent bilateral mastectomy two years ago, and said she was considering whether to remove the fallopian tube before removing the ovaries, according to Sheila Krans, Shira.
"The doctor will give you a lot of options, but no one will tell you what to do," said Krans. She lives in New York Waliketari, with two young children. "When children grow up, they can't be with them. This is the worst thing, and I'll try my best to avoid it."
62 year old Esser Zelensk (Ethel Zelenske) is a BRCA1 carrier, living in Baltimore. In 2007, she removed her fallopian tubes and ovaries. A few years later, she was diagnosed with peritoneal cancer. This happens every year in about 0.5% women who have had their ovaries removed, Offut said. He was treated, but two years ago, peritoneal cancer recurred.
"My doctor told me that I will always need to be treated," said Ms. zalun smolensk. Like many other women, she welcomed Julie Peter's public disclosure. "I really like the idea that knowledge is power, because I've always said that."