Angelina Jolie Pitt has revealed her decision to have her ovaries and fallopian tubes removed after early signs of cancer were detected.
The actress and mother wrote openly about her experience in the New York Times, in the hope that her experiences will help to educate other women at risk from cancer about the options available to them.
The 39-year-old, who underwent a double mastectomy two years ago, now faces early menopause as well as not being able to have children.
But why exactly did she make the decision and what does surgery entail?
Writing for the New York Times, Jolie Pitt described how two years ago a simple blood test revealed that she carried a mutation in the BRCA1 gene.
"It gave me an estimated 87% risk of breast cancer and a 50% risk of ovarian cancer," she added. "I lost my mother, grandmother and aunt to cancer."
Jolie Pitt added that the second preventative measure against cancer, to have her ovaries and fallopian tubes removed, had been on the cards for a while.
"I had been planning this for some time. It is a less complex surgery than the mastectomy, but its effects are more severe. It puts a woman into forced menopause," she wrote.
"I was readying myself physically and emotionally, discussing options with doctors, researching alternative medicine, and mapping my hormones for estrogen or progesterone replacement."
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While this might seem like a drastic action to some, it is evident that Jolie Pitt simply didn't want to take the risk. Her mother died aged 49 - just ten years older than Angelina is now.
The surgery itself, is a quick process which can take as little as a day to recover from. Speaking to HuffPost UK Lifestyle, Deborah Bruce, consultant gynaecologist at London Bridge Hospital says that it would usually involve "a laparoscopic (keyhole) procedure to remove the ovaries and Fallopian tubes".
"It can also be performed by an open procedure but this would involve more risks to the patient and a longer recovery period," she adds.
Recovery time for such a procedure can vary, says Bruce: "After a laparoscopy, which is usually a day case procedure, recovery should be quicker and easier than an open procedure which would involve an overnight stay of two to three nights.
"After a laparoscopy, most women are back to full activities within 4-6 weeks, compared to a laparotomy which can take up to three months."
There are side effects to the surgery, says Bruce, which includes inducing a surgical menopause which would be associated with all the complications of a natural menopause: hot flushes, night sweats, increased risk of osteoporosis/ cardiovascular disease and uro-genital issues such as vaginal dryness.
Bruce adds that unfortunately menopausal symptoms are usually more "severe" following a surgical menopause.
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Forced menopause aside, there are many women who have applauded Jolie Pitt's decision. Charity, Ovarian Cancer Action, also lends its support to the actress.
“We applaud Angelina's decision and are anticipating another wave of the ‘Angelina Effect’, which saw a dramatic increase in the number of women referred for genetic testing after she announced that she'd undergone a double mastectomy in 2013," said Katherine Taylor, acting chief executive of Ovarian Cancer Action.
“While all women in the UK have a one in 54 chance of developing ovarian cancer, for those with a mutation in their BRAC1/2 genes, like Angelina, the risk increases to one in two."
BRCA1 and BRCA2 are genes that prevent cells from growing and dividing too rapidly.
Everyone carries BRAC1 and BRCA2 genes in their DNA, however having a mutation in either of these genes can increase a woman’s risk of both breast and ovarian cancer and a man’s risk of developing prostate cancer.
Those who test positive for a BRCA1/2 mutation are more likely to develop ovarian cancer. With a BRCA1 mutation, women have a 40-60% chance of going on to develop ovarian cancer and with a BRCA2 mutation, they have a 10-30% chance.
"If women know they have BRCA gene mutations, they can choose to take action before cancer develops, much like Angelina has," said Taylor.
"Her bravery to announce this news publicly could save lives.”
As for Jolie Pitt, she believes that she's definitely made the right decision: "I feel feminine and grounded in the choices I am making for myself and my family," the actress wrote.
"I know my children will never have to say, 'Mom died of ovarian cancer'."