Jolie: my children will never have to say 'mom died of ovarian cancer'
Two years after her double mastectomy, actress Angelina Jolie has revealed she has had her ovaries and fallopian tubes removed to avoid the risk of ovarian cancer.
The glamorous wife of actor Brad Pitt and the mother of six children said in an op-ed column in 'The New York Times' that she had the surgery last week after blood tests showed what could have been early signs of the disease that killed her mother at the age of 56.
Jolie (39), who carries a mutation in the BRCA1 gene that increases her risk for breast and ovarian cancer, said she went public with her decision so women would know about options available to them.
"I went through what I imagine thousands of other women have felt. I told myself to stay calm, to be strong, and that I had no reason to think I wouldn't live to see my children grow up and to meet my grandchildren," she said.
"The most important thing is to learn about the options and choose what is right for you personally. I know my children will never have to say, 'Mom died of ovarian cancer'."
Irish doctors pointed out that having a faulty BRCA1 or BRCA2 gene was not common but they raised the carrier's risk of developing cancer.
Dr David Gallagher, a medical oncologist and cancer genetics consultant in St James's Hospital and the Mater Private Hospital in Dublin, said less than 1pc of the population had these faulty genes.
When the actress announced she had her breasts removed, doctors worldwide saw the 'Angelina effect', he said. "They saw an increased demand for genetic services. That fell off a little bit but it picked up again quickly because both doctor and patient awareness has increased. Her bravery has done a lot of good."
Most women in Ireland in the past opted for regular screening and surveillance, rather than removal of their breasts as a preventative measure, if they had the mutation. But there are signs that may be changing and more are opting for surgery. However, we have no figures on how many are having the surgeries.
"The big difference between ovarian cancer and breast cancer for women who carry these genes is that screening works for breast cancer. But it does not work for ovarian cancer. They have to have their ovaries removed. That removes fertility and brings on early menopause.
"The timing of doing that is a difficult issue. Once they are at a stage they can consider it, they have their ovaries and fallopian tubes removed," Dr Gallagher said.
The risk of ovarian cancer for BRCA1 starts earlier than for BRCA2, he said. It can mean the difference between surgery in the late 30s or early 40s.
He pointed out men who have these kinds of genes are also at higher risk of breast or prostate cancer.
People should be alert to the possibility they may be carriers if they have a strong family history of breast cancer, ovarian cancer and prostate cancer.
They should also seek advice from their GP if there is history of family getting cancer at a young age or bilateral breast cancers.
It is important to point out that if people are diagnosed as carriers, there is no inevitability they will develop cancer.
The waiting list for a genetic test can be around 14 months in the public system and patients face an eight-week wait before they get a result.
The cost of testing for the genes privately is around €1,400.
MUTATED GENES RAISE RISKS
Angelina Jolie has a mutation in the BRCA1 gene which raises her risk of breast and ovarian cancer.
Women who have a 'faulty' BRCA1 or BRCA2 gene have a 50pc-85pc lifetime risk of developing breast cancer. This compares with the average lifetime risk of 12pc.
Women with either 'faulty' gene also have a 10pc-40pc lifetime risk of ovarian cancer.
They may opt for risk-reducing surgery, removing their breasts and ovaries.
Anyone who is worried should contact their GP, who will assess their risk and decide if they should go for a blood test to find out if they are carriers.
Men can also have the mutated gene, putting them at risk of breast and prostate cancer.
Breast cancer is the second most common cancer in women - after skin cancer - and affects about 3,000 women in Ireland each year. Only about 5pc-10pc are due to genetics.
Irish Cancer Society helpline: 1850 60 60 60