Two years ago, when Angelina Jolie Pitt went public with her decision to have a double mastectomy after her doctors informed her she had "an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer," she vowed she would continue the dialogue about her "medical choice." On Tuesday, she did just that.
In a New York Times "Diary of a Surgery," the actress, director and humanitarian now reveals that last week, she underwent a laparoscopic bilateral salpingo-oophorectomy. It was a procedure she'd long assumed she would have, but wound up moving more quickly on after some elevated inflammatory markers set off warning bells. She writes that all of her tests and procedures, nerve wracking as they were, ultimately revealed nothing more than a small benign tumor on one ovary, but that she is nonetheless relieved that as a woman who carries the BRCA1 gene mutation, one who lost her mother, grandmother and aunt to breast cancer, she has done what she could so that "I know my children will never have to say, 'Mom died of ovarian cancer.'"
For me, Jolie Pitt's was an eerie story to read on this particular Tuesday morning. It's been exactly six months to the day since my best friend, a mother of two, died of ovarian cancer. Unlike Jolie, she had no family history to warn her, no gene test that would have tipped her off. Instead, like far too many women with this particularly insidious, vicious and difficult to diagnose disease, she was just having some stomach problems. What followed were four years of multiple surgeries, six different kinds of chemo and one clinical trial. What followed was a front row view of what a miserable, ruthless killer ovarian cancer is.
I believe if she'd had the option in her thirties, like Jolie has, my friend would have made same choices she did. Yet Jolie Pitt's aggressive approach – both in her initial mastectomy and her recent oophorectomy – is not for everyone. The actress makes clear that "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 is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally." And that's a hugely important distinction. We need to make healthcare choices as informed individuals, living within a healthcare system that profits well from women's terror of cancer. Last year, after a Journal of Clinical Oncology report on the BRCA1 gene showed the effectiveness of prophylactic oophorectomy in reducing cancer risk, a slew of headlines swiftly and bluntly urged "women with cancer gene should remove ovaries."
What Jolie Pitt's forthright account of her experience can achieve, thankfully, isn't more fuel for the rather flippant and wildly inaccurate assumption that early detection is a foolproof dodge for the worst forms of female cancers. It's instead a chance for a candid dialogue about women's health, and where our priorities ought to be in regard to it. Jolie Pitt is one of the few public figures ever – and certainly a great rarity among sex symbols – to pronounce, "I am now in menopause. I will not be able to have any more children, and I expect some physical changes." She has, with a single sentence, now shut down the entire tabloid industry that revolves around scrutinizing her abdomen for signs of a baby bump. And with that she has validated, for millions of others watching her and reading her, that a woman's worth is not tied to her baby making apparatus. She is more than her breasts or her womb. As my friend Deborah Copaken wrote in her own recent elegy, "Losing you, my darling uterus, did not make me any less of a woman." While she won't eradicate cancer by sharing her voice and experience, Jolie Pitt is educating readers about the reality of hard choices and sometimes difficult consequences. And she's making those choices less lonely for other women facing cancer's cruel odds.