For some time now, Angelina Jolie has been planning additional surgery to further reduce her risk of cancer. The 39-year-old, who in 2013 had a double mastectomy, elected to have preventative surgery after tests revealed she had an "87 percent risk of breast cancer and a 50 percent risk of ovarian cancer" due to an inherited (and notorious) gene mutation known as BRCA1. Jolie's mother, grandmother, and aunt have all died early from cancer.

"There is no longevity on my mother's side of the family," Jolie said in a 2007 interview. "My grandmother also died young (age 45), so my mother always thought it could happen to her."

In a new op-ed piece for the New York Times, the actress revealed that she decided to have her ovaries and fallopian tubes removed after routine blood tests revealed possible early signs of cancer. Jolie writes that the test, called a CA-125, measures the amount of protein in the blood and is useful for monitoring ovarian cancer. While the results were normal, her doctor did find elevated inflammatory markers that taken together might indicate the start of the disease. 

She writes: “CA-125 has a 50 to 75 percent chance of missing ovarian cancer at early stages,” he said. "He wanted me to see the surgeon immediately to check my ovaries."

Further scans and a tumor test all came back clear, but with a window to remove her ovaries and fallopian tubes still open, Jolie decided to take it.  

"I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this," she writes. "A positive BRCA test does not mean a leap to surgery. I have spoken to many doctors, surgeons and naturopaths. There are other options. Some women take birth control pills or rely on alternative medicines combined with frequent checks. 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."

Jolie said both the Eastern and Western doctors she sought advice from advised preventative surgery as her best weapon — not only because of the presence of the BRCA1 gene, but also because of its aggressive nature within her family. The surgery complete, she now finds herself in menopause. 

"I will not be able to have any more children, and I expect some physical changes," she writes. "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."

In closing, she again urged women to explore all the options available to them. "It is not easy to make these decisions. But it is possible to take control and tackle head-on any health issue. You can seek advice, learn about the options and make choices that are right for you. Knowledge is power."

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