Two years after her double mastectomy, A-lister actress Angelina Jolie underwent another surgery again to have her ovaries and fallopian tubes removed. Like her mastectomy, cancer risks were the reason behind the latest surgery.

The 39-year-old actress wrote in an opinion piece in the Tuesday edition of New York Times about her latest medical procedure. She wrote that she had been planning to undergo the procedure for several months, reports Fox.

Two weeks ago, her doctor called and told her that her blood tests showed several inflammatory markers that are elevated. Those two indicators, when taken together, could be an early sign of cancer.

The examination found nothing, but during the surgery, doctors found a small benign tumour on one of her ovaries, although there was no sign of cancer.

In 2013, Jolie had a double mastectomy which removed both breasts because she had a gene mutation, BRCA1, which placed her at an 87 percent chance of developing breast cancer and 50 percent chance of ovarian cancer. The gene runs in her family since her mother, grandmother and an aunt died of breast cancer.

Jolie wrote that her recent surgery was less complex than the mastectomy, but its effects are more severe. She added that it is not possible to remove all risk, but she still remains prone to cancer.

With her surgery and already going through menopause, Jolie wrote that she won’t be able to have any more children, and she is anticipating some physical changes. She and husband Brad Pitt have three biological children and three adopted children.

Jolie, the special envoy for the UN High Commissioner for Refugees, wrote, “I went through what I imagine thousands of other women have felt. I told myself t stay calm, to be strong, and that I had no reason to think I wouldn’t live to see my children grow and to meet my grandchildren,” quotes CNN.

Bilateral oophorectomy, or the surgery to remove both the ovaries, reduces the amounts of hormones estrogen and progesterone circulating in the body. According to Mayo Clinic, although the procedure is a generally safe one, it has small risks of complications as well as it triggers early menopause that brings with it risk of bone thinning or osteoporosis and discomforts of menopause, higher risk of heart diseases and lingering risks of cancer.

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