March 24, 2015

"Regardless of the hormone replacements I’m taking, I am now in menopause," writes Angelina Jolie, who is 39...

... about her laparoscopic bilateral salpingo-oophorectomy.
Two years ago I wrote about my choice to have a preventive double mastectomy.... [This was] a less complex surgery than the mastectomy, but its effects are more severe. It puts a woman into forced menopause. So I was readying myself physically and emotionally, discussing options with doctors, researching alternative medicine....

I will not be able to have any more children.... But I feel at ease with whatever will come, not because I am strong but because this is a part of life. It is nothing to be feared.... [I]t is possible to take control and tackle head-on any health issue....
ADDED: I don't know how seriously Ms. Jolie took alternative medicine, but I think it's good that she mentioned it here the way she did. She researched it. That's all she said. That throws out a line to the many people who think, when they find themselves in similar circumstances, I want to try the "natural"/alternative approach. It's tempting to many people, including many intelligent people, notably Steve Jobs. I could name individuals in my family — people I know were intelligent and who had access to science-based medicine — who took the alternative route and missed the opportunity to address deadly medical problems at the right time. It is extremely valuable for a celebrity as big and well-loved as Ms. Jolie to call people back from that precipice with the gentle words "discussing options with doctors, researching alternative medicine" followed by the decision to have dramatically life-changing surgery. That's a memorable lesson with a stamp of celebrity authority that's really useful to the vast numbers of people who don't automatically realize that they ought to be rational and go with science.

42 comments:

madAsHell said...

I don't know all her health issues, but she might have a problem between her ears.

madAsHell said...

Hmmm....she was 39 again this year.

Hagar said...

When you have scalpel, all problems can be cured by surgery.

You have to be careful - and very sceptical - when talking to doctors.

Rae said...

Other than thie she's seemed to be fairly level headed, particularly for a Hollywood celebrity. Perhaps she just has a flair for the dramatic.

MadisonMan said...

It's her life, but this strikes me as trying a little too hard to stave off death. The deaths of her aunt, Mom and grandmother surely had a huge impact on her.

Laslo Spatula said...

What do you cut off if the fear is of brain tumors?

I am Laslo.

Ann Althouse said...

"I don't know all her health issues, but she might have a problem between her ears."

Could you possibly explain why? Because in my view, you are the one who seems stupid here.

campy said...

TMI

Bob Boyd said...

"What do you cut off if the fear is of brain tumors?"

Trigger finger.

Laslo Spatula said...

Was she convinced by doctors to do it, or was no one able to convince her not to do it?

Chicken or the eggs.

I am Laslo.

Karen of Texas said...

I wonder how Ronald Reagan felt about conventional medical science and care? His cancer didn't kill him - but I wonder if his after surgery life and lifespan would have been different if he'd gone with the gold standard of mainstream conventional US cancer care instead of that pesky alternative German stuff.

Anonymous said...

The research by competent authorities on "alternative" (NewSpeak for charlatan cons in healthcare) medicine shall be ignored and only the personal research efforts of an actress who played a video game character shall be considered valid.

Pfah.

MayBee said...

You are so right, Althouse.

I am amazed at the number of people in my Facebook feeds who warn their friends off "western medicine" when they announce they have cancer, or MS, or what have you.

Social media and society in general is a good place to get your weird ideas praised and confirmed. Everybody knows this clinic in Mexico with coffee enemas, or can tell you for a fact that all your health issues can be controlled via a fresh diet.

Karen of Texas said...

I wonder if she's going the BHRT route - the "alternative" - or if she's going with the standard horse pee?

gerry said...

Good heavens, the hostility towards Jolie is amazing! She has proof of a genetic predisposition to sexual-organ-related cancers, ovarian cancer is particularly nasty and difficult to diagnose early enough to prevent metastasis and death, and she has the financial means to obtain prophylactic surgery. Why is that bad?

Michael McNeil said...

The problem with alternative systems is weeding out error. While any traditional system of medicine likely includes efficacious treatments and medicines, no doubt due to the brilliance of individual healers in the past who noticed particular correlation(s) which were true, it is inevitable that lots of garbage “knowledge” will enter into the system (any system) as well. Only the West has developed science as a reliable method for separating out the wheat from the chaff, by testing theories and purported treatments for efficacy against the World — and lacking that critical check, traditional medicines are uniformly utterly untrustworthy.

traditionalguy said...

How do you argue with her. She wants to have herself "fixed." And that is her decision to make.

Anglina, we hardly knew ya.

sane_voter said...

There are two issues that may point to a prophylactic ovary removal. 1) genetic pre-disposition to ovarian cancer, and 2) prevention of estrogen-driven recurrence of estrogen-positive breast cancer.

As mentioned in the article, Jolie has the BRCA1 gene mutation that gives her a 40-60% chance of ovarian cancer and up to a 90% chance of breast cancer, so she falls in group 1.

I think this is a reasonable decision. She already has had her children so no need for her eggs, and I assume she wants to be there for them in the long term.

Karen of Texas said...

I have no problem with her deciding this was the best course of action for her. It's her body, she can do what she wants.

Oh. Wait. Huh. Does that open a death door? A baby door? Maybe an illegal legal drug door? (I'm looking at you, Mary Jane.)

But seriously, I have no problem with her decision. As pointed out by sane_voter, she had input that she used to decide what the best course of action was for her. Given her odds, especially with the ovarian cancer, she had a right to decide that course of action.

Michael K said...

"if he'd gone with the gold standard of mainstream conventional US cancer care instead of that pesky alternative German stuff."

What does that mean ?

I've done a number of subcutaneous mastectomies for prophylaxis when the biopsy's suspicious, or in one case where the woman had had several biopsies and had worrisome activity in the previous biopsies.

She was right.

The ovarian thing is out of my area but sounds reasonable.

Michael McNeil said...

Within a decade she'll be able to grow herself new ovaries if she wants, or within just a couple years make new eggs for herself (without ovaries) via the new stem cell technique, then have a surrogate carry the child to term.

Amy said...

As someone who has had similar surgeries to Ms Jolie (however, after a breast cancer diagnosis, not prophylactic), I read a different take into her quote.
I see her as saying she researched the alternative medical approach to help mitigate the affects of being thrust into menopause, not as an alternative to the surgery.
There are various supplements and herbs that are phytoestrogens which can help replace some of the hormones lost with the removal of your ovaries. You cannot take BHRT if you are BRCA+ so that is not an option.
I will not comment on her choice to have both surgeries, as it is a very personal one. I know BRCA+ women who have had prophylactic surgery, and others who have not but developed cancer, and some who have not yet developed cancer but are living with the risk. All these approaches are reasonable. You cannot imagine what you would do if you found that information about yourself.
But I find nothing extreme or eccentric in anything she said, either about the surgeries, her research or her approaches to it.
I only wish her a long, healthy, cancer free life.

Birches said...

With her family's health history and her own history that has an effect on her chances for ovarian cancer, I don't see it as a wrong choice.

Women have had hysterectomies for much less.

Paul said...

I am the outlier who refused chemotherapy for my Non Hodgkin's Lymphoma and relied on "alternative" methods after the removal of my tumors surgically. I am going on 19 years cancer free and my doctor admitted this year that chemotherapy would have killed me as I have Hep C, which while in my case is asymptomatic, would have have been a different story after chemo.

Alex said...

Wow, such hostility from the men here.

JAORE said...

I suspect that when she says research she means really checking on reports, looking at the sample method and discussing with professionals.

For many (most?) it means a five minute Google search.

Once written, twice... said...

This might be a dumb question, but does this mean her sex life is done?

rhhardin said...

I don't see the problem.

And, as they say for hysterectomies, they take out the nursery but not the playpen.

NotWhoIUsedtoBe said...

I found nothing wrong with this piece at all. She could have stayed in denial and most likely died of cancer. My sense is most people do that.

madAsHell said...

Because in my view, you are the one who seems stupid here.

Stupid is a bit harsh.

I just don't believe that you can avoid cancer by removing the parts that potentially could produce cancer.

I also can't believe there is a physician that would go along with this.

Therefore, she must be brow-beating someone with a medical license to pursue this course....cuz I'm pretty sure this isn't covered by malpractice insurance.

My daughter is an epidemiologist. When Angie had her boobs removed, there was a huge spike in requests for similar surgery.

Furthermore, why does she need to announce such foolishness to the world? It won't affect her ability to act.

So it must be that she is bat-shit crazy, AND irresponsible.

khesanh0802 said...

Why doesn't she remove all her body parts. That will certainly prevent ALL cancers, but not be fun. What a wack job!

Crunchy Frog said...

As mentioned in the article, Jolie has the BRCA1 gene mutation that gives her a 40-60% chance of ovarian cancer and up to a 90% chance of breast cancer, so she falls in group 1.

My wife developed estrogen-positive breast cancer at age 35. By the time it was discovered, it had already spread to her lymph nodes.

After surgery and a year of radiation, chemo, and drugs to throw her into early menopause, we thought she was in the clear. We were wrong. Within 18 months it returned with a vengeance, this time in her bones. I lost her just after her 38th birthday.

I cannot fault Angelina Jolie for her choice, however radical it may be. I'm not 100% convinced it will solve the problem, though.

n.n said...
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n.n said...

Medical practice and popular culture have become notably proactive, which explains the deprecation of The Hippocratic Oath, most notably in order to normalize elective abortion. A breast, a clump of cells with no independent future, and a human life, a clump of cells with a future if its mother chooses it in a lottery.

n.n said...

It's notable how bitterly we cling to life once we survive one-child, pro-choice, etc. planning. The significance of this policy is made all the more stark in light of the sacrifices we make after birth to delay our mortality.

Known Unknown said...

The only downside is that while tumors are site-related, the drivers of those cancers are genomic in nature, and could potentially show up somewhere else.

Birches said...

This might be a dumb question, but does this mean her sex life is done?

It will change. I've heard from some women who've had hysterectomies young that their sex drive was completely erased afterwards. I don't think it affects everyone the same though. Hormone replacement can probably help, but it has side effects too, I think.

The only downside is that while tumors are site-related, the drivers of those cancers are genomic in nature, and could potentially show up somewhere else.

I think you might be right, but we're going on what little knowledge we have right now. The fact is, chemo is an awfully barbaric solution to cancer, but we still do it because we haven't found anything that works better.

CatherineM said...

At about 1:40 in the news report below, the reporter talks about her family history, her having the gene, and having prophylactic surgery. Guess what folks, they found pre-invasive cancer that would not have found with out the surgery. Due to how hard it is to catch Ovarian cancer early, the surgery saved her life.

http://7online.com/entertainment/angelina-jolie-underwent-surgery-to-have-ovaries-removed/570838/

I am really surprised at the smart ass comments and remarks that Jolie is crazy. Even if all of you arm chair oncologists think the cancer is just going to "pop up" somewhere else, chances are it will be easier to find than in dense breast tissue and certainly the ovaries. Let's say you are right, then considering how detailed and open she has been to educate about BRCA, then I am sure you will read one day about what a mistake it was and feel very smug. Meanwhile, she will have contributed to the knowledge of what to do if you carry BRCA.

It doesn't read like (did any of you read what she said?) she went into any of this carelessly.

I am also surprised at the juvenile comment about her "removing the nursery, but leaving the playground." Wow.

CatherineM said...

Re alternative medicine here is ICBS on the Oprah's and Bill Maher's of the world:

http://icbseverywhere.com/blog/first-years-archives/bill-maher-is-clearly-skinning-the-cat-in-a-unique-fashion-and-telling-some-whopping-lies/

Paul said...

"Re alternative medicine here is ICBS on the Oprah's and Bill Maher's of the world:

http://icbseverywhere.com/blog/first-years-archives/bill-maher-is-clearly-skinning-the-cat-in-a-unique-fashion-and-telling-some-whopping-lies/"

I don't necessarily disagree with you but again bypassing Western treatment for my lymphoma and following an alternative path saved my life. The cancer never returned and the chemo would have killed me.

Anonymous said...
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Diana said...

Actually, the Op-Ed is written by Angelina Jolie Pitt.