Hollywood megastar Angelina Jolie announced Tuesday that she has had her ovaries and fallopian tubes removed over fears of a hereditary form of cancer, following her double mastectomy two years ago.
The actress, who has lost her mother, grandmother and aunt to the disease, said she had the procedure last week after results from a blood test raised fears that she may be in the early stages of cancer.
Jolie's publicizing of her double mastectomy pushed the issue into the spotlight, sparking a debate about the pros and cons of the procedure as a preventative measure.
Tuesday's announcement could do the same for ovarian cancer, which is the deadliest cancer of the female reproductive system, according to the American Cancer Society.
Although tests showed she was not in fact in the early stages of cancer, Jolie said she chose to go ahead with the surgery because of her family history and because she carries a gene mutation that had given her a 50 percent risk of developing ovarian cancer, the same mutation that put her at 87 percent risk of developing breast cancer.
"I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this," Jolie wrote in an op-ed piece in The New York Times, the same way she announced her double mastectomy two years ago.
"A positive BRCA test does not mean a leap to surgery," said Jolie, who is married to fellow Hollywood heavyweight Brad Pitt with whom she has six children.
Her doctors said that she should have the preventive surgery about a decade before the earliest onset of cancer in her female relatives.
"My mother's ovarian cancer was diagnosed when she was 49. I'm 39."
Jolie said that she had been preparing for the possibility of ovary removal ever since her double mastectomy, but thought she had plenty of time to plan the procedure.
But two weeks ago, she said, she got a call from a doctor who said her blood test results had "a number of inflammatory markers that are elevated, and taken together they could be a sign of early cancer."
She was told to see a surgeon immediately.
"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," Jolie wrote.
"I called my husband in France, who was on a plane within hours. The beautiful thing about such moments in life is that there is so much clarity. You know what you live for and what matters. It is polarizing, and it is peaceful."
She went to see a surgeon, the same one who had treated her mother and whom she last saw on the day that her mother died.
The examination and ultrasound were regular, so she waited for five days, saying she tried to stay calm and focused as she attended her children's soccer game and went about her daily life. Then scan results came back clean.
"To my relief, I still had the option of removing my ovaries and fallopian tubes and I chose to do it," she said.
The surgery has put the mother of six into menopause.
"I will not be able to have any more children, and I expect some physical changes. 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.
"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."
Ovarian cancer often runs in families and is one of the deadliest forms of cancer because there are often no symptoms in the early stages.
Hollywood star and Bond actor Pierce Brosnan lost his first wife Cassandra Harris in 1991 and his daughter Charlotte in 2013 to the disease. Harris's mother also died of ovarian cancer.