Patients already using new experimental blood tests to detect cancer, Washington Post reports

Some patients may be using blood tests to detect cancer that haven't been cleared by the FDA.

A story by Marlene Simons in today's editions of The Washington Post reports that Galleri, a new multi-cancer detection test, is but one of 20 tests in various stages of development that analyze substances in the blood that might indicate cancer. 

Those tests, the article says, "may be especially useful finding 'silent' cancers — such as pancreatic or ovarian cancer — which often don't cause symptoms until the disease is advanced and more difficult to treat."

On the flip side, Simons' piece indicates, "while these findings are promising, experts warned of drawbacks. So far, there's no evidence that finding cancer via a blood test translates to longer survival and fewer deaths, or even a cure, experts said."

Dr. Lori Minasian

The WashPost story also quotes Dr. Lori Minasian, deputy director of the National Cancer Institute's division of cancer prevention, as warning that "people want to believe there is one test that can pick up all the different kinds of cancers, and if it's negative, they can go on their way. But it's not that simple.

Several experts, the piece continues, "pointed out that multi-cancer detection tests don't find every cancer at its earliest stage, in part because certain cancers spread quickly."

These tests, which aren't covered by Medicare or other insurance, have yet to be cleared by the Food and Drug Administration for final approval — but are available as "lab-based" tests under federal guidelines that "permit their use in certain settings."

Caveats include many unanswered questions, the story says, "such as whether use of the tests should be based on age, risk factors, or family history." Along with the notion of how frequently people should take the blood tests, the remaining issues make it almost certain that they "probably are several years away from widespread use."

More information on research into various diseases can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

All-time tennis great Chris Evert gets second cancer diagnosis, takes a break from ESPN

Chris Evert, one of the tennis world's greatest woman stars, just received a cancer diagnosis — her second.

The 68-year-old International Tennis Hall-of-Famer, according to a story by Glynn A. Hill in yesterday's editions of The Washington Post, is temporarily stepping down from her position as ESPN analyst and will miss the network's coverage of the Australian Open next month.

Chris Evert

Her public announcement, the article says, "came 11 months after Evert declared she was free of ovarian cancer, which she had discovered in January 2022."

The 18-time Gram Slam singles champion, who intends to return to ESPN for its coverage of the rest of the Grand Slam season, is undergoing chemotherapy following another robotic surgery to remove the malignant cells.

Her statement, made through the network, said, "Since I was first diagnosed with cancer…I've been very open about my experience. I wanted to give all of you an update. My cancer is back. While this is a diagnosis I never wanted to hear, I once again feel fortunate that it ws caught early."

She added that she encourages "everyone to know [their] family history and advocate for [themselves]. Early detection saves lives. Be thankful for your health this holiday season." 

Evert, one of the most accomplished players in tennis history, "was ranked first or second in the world from 1975 to 1986 and she became the first player of any gender to win 1,000 singles matches" Hill's story notes.

Evert's first diagnosis was made after a preventive hysterectomy, after which she underwent six cycles of chemo. That helped her bond with her friend, ex-rival Martina Navratilova, who at roughly the same time was diagnosed with early-stage throat and breast cancers. In March of this year, Navratilova declared she was cancer-free.

To learn more about recurring disease, check out Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Next big advance may be new cancer vaccines that could treat cancers in a variety of organs

Research may be turning a corner, with many scientists predicting new cancer vaccines that would work within five years on breast, lung, ovarian, skin, and pancreatic cancers.

According to a recent Associated Press story by Carla K. Johnson, "these aren't traditional vaccines that prevent disease, but shots to shrink tumors and stop cancer from coming back." 

Dr. James L. Gulley

The article quotes Dr. James L. Gulley, who helps lead the Center for Cancer Research at the National Cancer Institute that developed immune therapies, including cancer treatment vaccines. He says, "We're getting something to work. Now we need to get it to work better."

Cancer vaccines, like other immunotherapies, boost the immune system to find and kill cancer cells. For a vaccine to work, the piece quotes Dr. Nora Disis of UW Medicine's Cancer Vaccine Institute in Seattle as saying, it needs to teach the immune system's T cells to recognize cancer as dangerous. "If you saw an activated T cell, it almost has feet. You can see it crawling through a blood vessel to get out into the tissues," she said.

Dr. Steve Lipkin, a medical geneticist at New York's Weill Cornell Medicine, also is quoted: "Vaccines are probably the next big thing. We're dedicating our lives to that."

More information about vaccines can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Uterine cancer, and its deaths, increasing — particularly among Blacks, Hispanics and Asians

Uterine cancer is on the rise, especially among black women.

That's the conclusion of a study reported by Toni Caryn Rabin in editions of The New York Times a while back.

According to the story, "cancer of the uterus, also called endometrial cancer, is increasing so rapidly that it is expected to displace colorectal cancer by 2040 as the third most common cancer among women, and the fourth-leading cause of women’s cancer deaths."

The study, published in JAMA Oncology, showed that the "mortality rate has been increasing by almost 2 percent a year overall, with even sharper spikes among Asian, Hispanic and Black women," Rabin's article notes.

Uterine cancer, she continues, "was long believed to be less common among Black women. But newer studies have confirmed that it is not only more likely to strike Black women, but also more likely to be deadly."

According to a report from an expert panel convened by the American college of Obstetricians and Gynecologists, "Black women die of uterine cancer at twice the rate of White women," the story asserts.

One of the major problems blocking early detection is that "few women are aware that a change in menstrual bleeding, before or after menopause, is one of the main warning signs, along with pelvic pain and painful urination and intercourse," the article says.

Dr. Shannon Westin

Dr. Shannon Westin, a gynecologic oncologist at the university of Texas MD Anderson Cancer Center in Houston, is reported as saying that "when she first started caring for women with uterine cancer, there were about 39,000 new cases a year. Now, there are more than 65,000 — and she has been in practice only 15 years."

Those figures, she indicates, present "a clear indicator we should be ringing the alarm bells."

Dr. Carol Brown, a gynecologic oncologist, senior vice president and chief health equity officer at Memorial Sloan Kettering Cancer Center in New York, calls the surge in cases an epidemic. 

"The striking statistic is that right now…the number of women who will lose their lives to endometrial cancer in the U.S. is almost the same as those who will die of ovarian cancer, which is unbelievable to those of us in practice for the last 30 years," she's quoted as saying.

More information on studies with surprising results can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers. 

National study finds frequent use of hair straighteners may pose risk for uterine cancer

Can frequent use of hair straighteners pose a small risk for uterine cancer?

According to a story by Roni Caryn Rabin in today's editions of The New York Times, the answer is yes. 

Rabin's article says the risk is higher than for women who have never used the products.

The study, which was published yesterday in The Journal of the National Cancer Institute, followed nearly 34,000 U.S. women for more than a decade.

Hair straightener use has previously been tied in studies to a higher risk of ovarian and breast cancer.

"While the increased risk [for uterine cancer] was found among women from all racial and ethnic backgrounds," the story continues, "Black women might be disproportionately affected: Sixty percent of participants who reported using hair straighteners self-identified as Black women, according to the study."

A March report from an expert panel indicated that over all Black women die of uterine cancer at twice the rate that White women do.

Frequent use is defined as more than four times in the previous year, and includes "any personal use, whether women applied products themselves or had the straighteners applied by others."

Alexandra White, PhD

Alexandra White, PhD head of the environmental and cancer epidemiology group of the National Institute of Environmental Health Sciences (HIEHS) and the study's lead author, is quoted as saying that "there is a lot of pressure on women, especially Black women, to have straight hair. It's not an easy decision to not do this."

Researchers have cautioned that the study's findings need to be confirmed by other studies.

The uterine cancer study, Rabin's piece says, shows that some chemicals found in straighteners — such as parabens, bisphenol A, metals, and formaldehyde — could week "play a role in the increased" risk.

Uterine cancer, the story maintains, "is increasing rapidly. The number of cases diagnosed each year has rises to 65,950 this year from 39,000 just 15 years ago." 

When detected early, overall survival rates are high.

More information about risk factors, including those for minority groups, can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Unnoticed breast cancer gene found to be almost as perilous as better known ones such as BRCA

Mutations of PALB2 can raise a woman's risk of breast cancer nearly as much as better known mutations like BRCA. 

According to a recent story by Susan Berger in The New York Times, doctors "are increasingly recomending that anyone who was tested before 2014 go through genetic testing again" — to look for the PALB2 gene, which also raises a patient"s chances of contracting ovarian and pancreatic cancer.

Dr. Peter Hulick

The Times article quotes Dr. Peter Hulick, medical director of the Mark R. Neaman Center for Personalized Medicine at NorthShore University HealthSystem in Evanston, Ill., as saying that "raising awareness with physicians and patients is critical, otherwise patients are getting an incomplete genetic assessment." 

Earlier this year, the American College of Medical Genetics and Gonomics advised that "women with PALB2 mutations be surveilled similarly to patients with BRCA mutations, and that, depending on family history, mastectomies could be an option to reduce the risk in some patients," Berger's piece reports. 

The Times article further notes that guidelines from the National Comprehensive Cancert Network, as well as the genetics organization,"suggest women with the PALB2 mutation should have breast MRIs and mammograms, alternating every six months." The guidance was based on peer-reviewed evidence by a global team of experts in cancer genetics.

Hulick also said, according to the story, that "the risk of developing breast cancer was 40 to 60 percent greater among women with the PALB2 mutation, similar to the risk from BRCA." 

More informatiom about the BRCA1 and BRCA2 mutations can be found in "Rollercoaster: How a man can survive his partner's breast cancer," VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Inaccurate DNA test plagued woman for more than a decade after double mastectomy

A Missouri woman's years of mental anguish stemmed from a DNA testing mistake.

According to Maureen Boesen's online story in the HuffPost, she "made major decisions — like having a double mastectomy — based on a false positive. I was robbed of the chance to breastfeed my babies, and it broke my heart."

The Kansas City mother of three's recent guest article contends she "just couldn't get past the fact that my inaccurate test result meant I had been carrying around a devastatingly unnecessary burden for more than a decade."

Because she and her two sisters have an extensive family history of cancer (ovarian and breast), Boesen not only opted for the preventive bilateral mastectomy at age 23 but was planning to have a complete hysterectomy by the age of 35. A second DNA test, with its negative result, quashed that idea — especially after a third test also showed she didn't have the dangerous BRAC1 gene mutation that would mean a 75% lifetime risk of getting breast cancer and a 50% chance of contracting ovarian cancer.

What was surprising, Boesen reported, was that the new results "were even more shocking and overwhelming than finding out I was positive. I was feeling so many emotions — confusion, sadness, anger, anxiety, depression, relief — all at once."

More information about false positives, BRCA1 and BRCA2 mutations, and other prophylactic surgeries can be found in ˆRollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Actress pushes women's mental, physical health

Angelina Jolie promoting care for breast cancer patients, especially through loved ones, docs, research

More and more, Academy Award-winning actress Angelina Jolie is becoming known for her work outside Tinseltown.

Such as promoting caregiving for breast cancer patients — not only in regard to the care of loved ones but other aspects pertaining to "mental and emotional health, and physical safety."

Angelina Jolie

In a piece she wrote for a recent edition of Time magazine, Jolie, who's gained even more fame as a special envoy of the U.N. High Commissioner for Refugees, explains that "care is not just about medical treatments. It's also about the safety, dignity and support afforded to women, whether they're battling cancer or trying to manage other stressful situations."

Far too often, her column indicates, "they're not given nearly enough."

Jolie had a prophylactic double mastectomy in 2013 — plus surgery two years afterward to remove her ovaries and fallopian tubes — because she'd learned through a genetic test that she carried a mutation of the BRCA1 gene, which sharply increased her chances of developing breast and ovarian cancer.

The surgeries reduced but didn't eliminate those chances. With the operations, she writes, she had an estimated risk of 87 percent of getting breast cancer, 50 percent of ovarian.

Without the mutation, women typically have a 13 percent risk of breast cancer.

But Jolie, a contributing editor of Time, insists that without proper care, a female patient can fall apart not only because of risks of disease like cancer but "because of other pressures in her life that receive no attention at all…her family situation, her safety and whether she is carrying stress that is undermining her health and making her days much more difficult."

It should not take "someone getting sick to realize that faring for them and not harming them is necessary," she insists.

The now 44-year-old Jolie, who'd lost both mother and grandmother to breast cancer before their late 50s, adds that although there's been rapid progress in technology and science since her surgeries that can help "more people survive in the future and [be] able to live better lives during their illness," there's still "no reliable screening test for ovarian or prostate cancer…and no effective treatment for the most aggressive forms of breast cancer, known as triple negative cancers."

The actress, daughter of actor Jon Voight, while maintaining that care and support of loved ones is the most important factor in women's ability to cope with cancer and to face even the possibility of the disease, cites other related problems that plague modern females — post-traumatic stress disorder, for example, "anxiety, psychological distress, sexual violence and domestic violence."

And then, she writes, there's "poor mental health" stemming from "discrimination, overwork, poverty, malnutrition, low social status and unremitting responsibility for the care of others."

Care for patients is an integral part of "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

'Gaping hole' is found in U.S. health system

N.Y. Times article exposes major economic hardships that some cancer caregivers are facing

America's health system is badly flawed because it's making caregivers of patients with cancer and other diseases work much too hard to negotiate it — especially economically.

Aaron E. Carroll

That's the basic conclusion of a recent The New York Times article by Aaron E. Carroll, a professor at Indiana University School of Medicine.

In the piece, Carroll says his friend, international fraternity CEO Jim Fleischer's story about a rare cancer taught him about the problem in our health system.

Despite his friend having "great insurance" and "enough money" and getting "excellent care," he discovered the "impossibility and hardship faced by…friends and family members who are caregivers."

The situation, Carroll writes, is "hugely disrupting and expensive. There's no system for it. It's a gaping hole." 

The writer cites as an example that following his surgery and chemotherapy, his friend's wife, mother-in-law, friends and co-workers needed to take lots of time off to care for him and take him to appointments.

Carroll also suggests that "if it was this hard for [Jim], it's probably unbearable for many others with fewer resources. People can be financially ruined by illness — and health insurance won't fix that."

Last year, the Times piece notes, "it's estimated that more than 1.7 million people faced a cancer diagnosis. The year before, America spent more than $147 billion caring for people with cancer. But that doesn't include the costs outside of health care."

This year, the article continues, "the National Cancer Institute will spend more than $5.7 billion on cancer research. Almost none of that will investigate how to support the families of those who have the disease."

Researchers in the past have estimated the "economic burden for caregivers for patients with lung and colorectal cancer," Carroll says. "They reported that the average cost to a caregiver in the initial phase of treatment was more than $7,000," with an additional $20,000 spent after treatment on so-called continuing care.

Another study cited caregiving costs for breast cancer at $38,000, lung cancer at $72,000, for ovarian cancer $66,000, for lymphoma $59,000.

Carroll concludes that it's crucial to recognize "that the efforts of caregivers are probably just as important to health as the drugs and procedures the medical system provides."

More details about the issues that helpmates have can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Rare, aggressive, often-fatal cancers cured

Immunotherapy puts ovarian cancers in 4 countries into remission despite docs' qualms

Although physicians declared that immunotherapy couldn't cure their ovarian cancer, the docs were mistaken.

According to a recent story by Gina Kolata in The New York Times, four young women — living in different countries — "had an extremely rare, aggressive and fatal form of ovarian cancer" and weren't expected to live much longer.

All four managed to get immunotherapy and their cancers, in total contrast to conventional wisdom, went into remission.

Dr. Jedd Wolchok

Kolata quotes Dr. Jedd Wolchok, chief of the melanoma and immunotherapeutics service at Memorial Sloan Kettering Cancer Center in New York, as saying, "What we are seeing here is that we have not yet learned the whole story of what it takes for tumors to be recognized by the immune system."

He contends that researchers and medical personnel "need to study the people who have a biology that goes against the conventional generalizations."

Dr. Drew Pardoll

Dr. Drew Pardoll, who directs the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins Medicine in Baltimore, notes that although four women hardly constitutes a clinical trial, "it is the exceptions that give you the best insights."

The cancer that had struck all four was hypercalcemic small cell ovarian cancer, which, Kolata writes, "occurs in a woman's teens or 20s [and] is so rare that most oncologist never see a single patient with it."

Immunotherapy drugs have been successful in treating lung cancer, a genetic type of colorectal cancer and melanoma but cancers of the prostate, pancreas, breast and ovaries have rarely responded.

More details about cancer research and trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Is Johnson & Johnson's talcum powder perilous?

4,800 file suits contending baby powder caused their ovarian cancer, N.Y. Times reports

Consumer goods giant Johnson & Johnson is being sued by thousands of women in the United States over its baby powder.

According to a recent story by Tiffany Hsu in The New York Times, the women, at least 4,800 strong, claim that "talcum particles in the popular products caused their ovarian cancer."

The plaintiffs "are taking the company to court one at a time," the story says, rather than work together to file a class action that can be tough to win. 

In addition to seeking restitution, they "are asking that Johnson & Johnson add a warning to its baby powder label or replace the product entirely with a similar one formulated with cornstarch."

Only seven cases have been decided so far. Of those, six verdicts favored those who sued.

Johnson & Johnson — which is also facing suits regarding Xarelto alleging that the drug caused uncontrollable bleeding, and its pelvic mesh for women, which supposedly caused "urinary dysfunction, loss of sexual function, constipation and other complications" — is appealing those verdicts.

Pretrial procedures "in nearly 900 talc cases have been consolidated into what is known as a multidistrict litigation, or MDL," according to the Times. "MDLs tend to reduce costs and time. Only one set of expert witnesses needs to be called."

Nora Freeman Engstrom

Hsu's story quotes Stanford Law School prof Nora Freeman Engstrom to the effect that no global settlement can be reached "until both sides have a really clear sense of the strengths and weaknesses and value of these claims. And the only way to test that is on the battlefield, which is trial."

The plaintiffs in the newest suits cite studies from 1977 on and claim "that talc in baby powder can be absorbed by the reproductive system and cause inflammation in the ovaries when applied for feminine hygiene purposes."

Experts don't necessarily support the plaintiffs' claims, however.

Hsu's story also quotes the National Cancer Institute website, for example, that "the weight of evidence does not support an association between perineal talc exposure and an increased risk of ovarian cancer."

Information on other studies about apparent heightened risks can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

'Transformative" treatments deemed possible

Race underway to create gene therapies for breast, prostate, ovary, lung, pancreas cancers

Pharmaceutical companies and universities are in a race to develop "utterly transformative" gene therapies, according to a recent article by Denise Grady in The New York Times.

The story says "one of the big goals now is to get them to work for many [cancers other than leukemia, for which approval is expected soon], including those of the breast, prostate, ovary, lung and pancreas."

The radically new class of treatments, it also says, may "re-engineer and turbocharge millions of patient's own immune cells, turning them into cancer killers that researchers call a 'living drug.'"

Dr. Stephan Grupp

The Times piece contends that the new leukemia drug, called CAR-T therapy, "has been utterly transformative in blood cancers," according to Dr. Stephan Grupp, director of the cancer immunotherapy program at the Children's Hospital of Philadelphia, a professor of pediatrics at the University of Pennsylvania, "and a leader of major studies."

Although Grupp cautions that it will take at least five years to make an accurate determination, he maintains that if the treatment "can start to work in solid tumors, it will be utterly transformative for the whole field."

The treatment apparently is also being studied in conjunction with "glioblastoma, the aggressive brain tumor that Sen. John McCain was found to have."

Grupp says one particularly encouraging potential avenue of research with children involves earlier stages of disease "instead of very late, as rules now require," the Times story indicates. 

Earlier treatment, it reports him as believing, "might help some patients avoid bone-marrow transplant, a grueling, last-ditch treatment. Children with less advanced disease also tend to have milder side effects."

Other studies are underway to combine the new therapy "with immunotherapy drugs called checkpoint inhibitors, which help unleash the cancer killing power of T-cells" — which the story describes as the white blood cells "often referred to as the soldiers of the immune system."

One of the big problems with the new treatment — which "involves removing millions of…T cells…from the patient's bloodstream, genetically engineering them to recognize and kill cancer, multiplying them and then infusing them back into the patient" — is its cost factor.

The process, the story explains, is very expensive (at least $300,000 per treatment, other articles have said)  "because each treatment has to be made separately for each person."

The treatment was developed at the University of Pennsylvania and licensed to Novartis.

More information about cancer research and clinical trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Gene mutation may portend four times the risk

Men worry about defective breast cancer genes as possible clue to deadly prostate cancer

Holy cow, it wasn't enough that I worried about women I know having BRCA1 and 2 mutant genes that portend breast and ovarian cancers.

Now I'm worrying about the guys, too.

Seems that, according to a recent article in The Washington Post by Laurie McGinley, men (like me) are becoming more aware that the defective genes — "the kind that prompted actress Angelina Jolie to have her breasts and ovaries removed preemptively," the story notes — have also been linked to aggressive, potentially deadly prostate cancer.

McKinley writes that "men with these mutations are more likely than non-carriers to contract aggressive, lethal prostate cancer, to be diagnosed at a more advanced stage and to ultimately die of the disease, researchers say."

A study recently presented to a meeting of  the American Urological Association found 17 percent of patients with BRCA2 "already had advanced [prostate] disease, four times the rate of patients without the mutation," the article states. 

Dr. Bruce Montgomery

McKinley's story quotes Dr. Bruce Montgomery, an oncologist at the Seattle Cancer Care Alliance-University of Washington Medical Center as saying, "The problem is, everyone associates this with women and their cancers. In men's minds, BRCA is about breast cancer, so they don't see it as relevant."

The implication, of course, is that they're wrong. It is not only relevant, knowledge about the mutation is a crucial part of a health-education learning curve.

Although "an estimated 12 percent of women will develop breast cancer during their lifetimes, according to the National Cancer Institute," McKinley's story says, "that proportion rises to as high as 65 percent of women who inherit a BRCA1 mutation and about 45 percent for those with a BRCA2 defect."

Men with the BRCA mutation also are at a higher risk of getting breast cancer. Currently, more than 2,000 American males contract that disease each year.

To learn even more about the BRCA defects, check out "Rollercoaster: How a man can survive his partner's breast cancer," the VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Superstar's surgeries blocking cancers

Angelina Jolie follows double mastectomy by removing her ovaries and fallopian tubes 

Angelina Jolie

Hollywood superstar Angelina Jolie's 2013 decision to have a prophylactic double mastectomy and reconstructive surgery is cited in my VitalityPress book, "Rollercoaster: How a man can survive his partner's breast cancer."

The reason, she'd explained at the time in an opinion piece in The New York Times, was that she'd inherited the BRCA1 gene.

That's a mutation that placed her at high risk of developing breast cancer.

Several paragraphs in my memoir/guide to research and meds detailed her choice — and the homage she paid to her then partner, now husband, Brad Pitt, whom she described as "so loving and supportive."

I also quoted her conclusion: "So to anyone who has a wife or girlfriend going through this, know that you are a very important part."

Which, in effect, is why I, Woody Weingarten, wrote "Rollercoaster" in the first place — to make sure men realize the crucial role they play — and to help them cope with the ups and downs they're likely to experience.

But now — in another op-ed piece in The New York Times in which she underscored that she wrote the first article because she "wanted other women at risk to know about the options" — Jolie has revealed that she's also had her ovaries and fallopian tubes removed.

The point?

To block her from contracting ovarian cancer.

She acknowledges the new operation was "less complex surgery than the mastectomy" but put her "into forced menopause."

In the new column, titled "Diary of a Surgery," she also noted that Pitt flew from France "within hours" to be by her side. "The beautiful things about such moments in life," she wrote, "is that there is so much clarity. You know what you live for and what matters. It is polarizing, and it is peaceful."

Her op-ed ended with this notion, which I wholeheartedly endorse: "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."