News headlines called attention to Angelina Jolie Pitt's choice to have her ovaries and fallopian tubes removed. Her decision was fueled by knowing her family's health history.
Your Local Health | Written by BJ Towe
Jolie Pitt’s grandmother, aunt, and mother all were victims of cancer. For that reason, several years ago she got a simple blood test, which showed she had a specific mutation in the BRCA1 gene. This gave her an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. Her first preemptive measure was to have a double mastectomy in 2013. The second was to have her ovaries removed along with her fallopian tubes, which now are believed to be where the cancer originates.
Steven Elg, M.D., a Gynecologic Oncologist with The Iowa Clinic, says physicians may order genetic testing when certain factors are present, such as having a first-degree relative (parent, sibling, child) who had cancer, the age at which that relative was diagnosed, and having a previous cancer yourself.
“While screenings are available to help catch certain cancers — breast, uterine, and colon cancer, for example — there’s no screening test for ovarian cancer. It typically is discovered at a very late stage and, consequently, there are few survivors,” says Elg. “If we can identify certain genetic mutations in the BRCA1 or BRCA2 gene, we can take preventive steps to prevent the cancer from forming in these patients.”
Jolie Pitt’s surgeries were one way to reduce her cancer risk. But in her March 24, 2015 op-ed piece appearing in the New York Times, she wrote: “I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery … There are other options … The most important thing is to learn about the options and choose what is right for you personally.”
According to the Centers for Disease Control (CDC) and Prevention, it is often recommended that women who have significant risk factors, which include a mutation in the BRCA1 or BRCA2 gene, have their ovaries and fallopian tubes removed to reduce their risk of cancer.
If, however, patients are still in their childbearing years, Elg typically first recommends going on birth control pills, which decreases the risk of ovarian cancer by about 50 percent. “Those patients can discontinue taking the pills when they desire to become pregnant and resume taking them after delivery,” he says.