Is Preventative Surgery the Answer?

With Angelina Jolie in the news again after bravely under going preventative surgery, lots of people are confused about whether traumatic surgery for something that has not happened is the right choice. The BBC wrote a great article that gives a good insight into what makes people make that choice.

While most women in the UK have a one in 54 chance of developing ovarian cancer in their lifetime, for those who inherit faulty genes, like Angelina Jolie, the risk increases to one in two. If women know they have BRCA gene mutations, they can choose to take action before cancer develops.

But weighing the risk of cancer that might never grow against the very real trauma of surgery to remove healthy tissue as a preventive measure is an incredibly difficult conundrum, as Angelina Jolie explains.

“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,” she says in her diary in the New York Times.

“In my case, the Eastern and Western doctors I met agreed that surgery to remove my tubes and ovaries was the best option, because on top of the BRCA gene, three women in my family have died from cancer.”

In the UK, around one in every 500 people will carry a BRCA mutation. Generally, experts only recommend screening if a person has a strong family history of breast or ovarian cancer.

For example:

  • One first degree relative (mum, dad, sibling) and one second degree relative (aunt, uncle, grandparent) diagnosed before the age of 50
    Two first degree relatives diagnosed before the age of 50
    Three or more first or second degree relatives diagnosed at any age

Does surgery remove any risk of cancer?

Surgery does not completely guarantee that cancer will not develop – it is impossible to remove all of the at-risk tissue. And there are side effects to consider – taking out the ovaries removes a woman’s fertility and puts her into the menopause, for example.

Faulty BRCA genes are responsible for around 5% of all breast cancer cases and 10% of ovarian cancers, meaning the rest are caused by other factors.

Although Jolie says surgery was the right choice for her, she says it may not be for others faced with the same dilemma.

“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.”

Some people may opt instead for enhanced screening – frequent check-ups to make sure no cancer is growing. Doctors may also prescribe drugs like tamoxifen to reduce the risk of cancer developing.

As Jolie says: “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.”

This article was taken in part from

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All content on this website is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. Always consult your own GP if you’re in any way concerned about your health.

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