What Will Smith, Angelina Jolie, and Sharon Osbourne Did to Prevent Cancer and You Can Too

Some experts newly suggest that to prevent cancer, women should consider removing their fallopian tubes, under certain circumstances, reports The New York Times. Experts say this applies even to women who don’t have elevated risk like genetic predisposition to certain cancers. Angelina Jolie had her ovaries and fallopian tubes removed in 2015; the surgery for her voluntary hysterectomy was called a laparoscopic bilateral salpingo-oophorectomy.

Oscar-winning actress Angelina Jolie, 47, has a genetic predisposition to certain cancers, including breast cancer and ovarian cancer. So she decided to take preventative action.

Angelina Jolie’s Prevention Act: A Double-Mastectomy & Voluntary Hysterectomy

Jolie lost her mother to breast and ovarian cancer in 2007. The actress underwent genetic testing due to her mom’s cancer battles. And the results showed that the Oscar winner carries the BRCA1 gene mutation, which greatly increases her risk of developing breast cancer and ovarian cancer.

The Maleficent actress penned a powerful OpEd in The New York Times in which she wrote about her decision to get a preventative double mastectomy in 2013. Because of this mastectomy, she vastly reduced her chances of getting breast cancer.

In an earlier interview with SurvivorNet, Dr. Rebecca Arend, an Associate Scientist at the University of Alabama-Birmingham, explains the BRCA mutations, like the kind Jolie carries.

"What a BRCA mutation is is it's a defect in your ability to repair a double-strand break. If you think about DNA being a double helix, that we've all learned about in basic science, if you have a single-strand break, a PARP enzyme is needed to repair that single-strand break. If you have a PARP inhibitor, then you can't repair that single-strand break," she says.

Dr. Arend continues, "And if you have a single-strand break that's not repaired, that actually leads to a double-strand break. So when both of the arms of the DNA helix are broken, then your body has normal mechanisms for repairing that. One of them is called homologous recombination."

She explains how this is the body's normal way of repairing a break. "But if you have a BRCA mutation, you actually cannot repair that break."

What is a BRCA Mutation?

Screening for Breast Cancer

We love how Jolie took action to drastically lower her risk of breast cancer.

Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.

For screening purposes, a woman is considered to be at average risk if she doesn't have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer such as a BRCA gene mutation (like Jolie has) or a medical history including chest radiation therapy before the age of 30. Beyond genetics, family history and experience with radiation therapy, experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.

In a previous interview with SurvivorNet, Dr. Connie Lehman, chief of the Breast Imaging Division at Massachusetts General Hospital, said people who hadn't reached menopause yet should prioritize getting a mammogram every year.

When Should I Get a Mammogram?

Will Smith’s Colonosocopy

Black men, like Oscar winner Will Smith, 54, are at higher risk for colon cancer than the general population, according to the American Cancer Society. Will Smith famously underwent a colonoscopy and shared it with the world.

Until recently, screening guidelines noted that all men should get colonoscopies starting at age 50, and then every ten years, and that black men should get them beginning at age 45. But new guidelines suggest everyone should get screened beginning at age 45, Dr. Heather Yeo, a colorectal surgeon at Weill Cornell Medical Center, tells SurvivorNet in an earlier interview.

Guidelines also recommend that those with a close family member who has had or has colon cancer should begin to screen approximately ten years earlier.

One of the major problems in cancer care is that people don't get screened early enough, even when they know they should. Dr. Zuri Murrell, a colorectal surgeon at Cedars-Sinai, spoke to the importance of screening for colorectal cancer in an earlier interview. He said that Black men especially don't get the colorectal cancer screening they need for cultural reasons. Often, without the right support and advocacy effort, men are embarrassed to undergo the screening, even if it could save their lives.

Smith’s Colonoscopy Experience & Colon Cancer Prevention

Smith introduced his colonoscopy video with his doctor, Dr. Stanford, saying, "I'm gonna have a medical procedure tomorrow." Then, leaning into the camera, he whispers, "I'm gonna have a colonoscopy. I'm 50 so people need to look up my stuff," he continued as his doctor nodded in agreement.

In the video, Smith, who was 51 at the time, walked through the process of preparing for his colonoscopy, writing in the video's text, "For the past 24 hours, my diet has consisted of clear liquids and over-the-counter laxatives." He explained the effect of the liquids and the way his bowels became clearer as his doctor's appointment approached.

"This is my gown," he continued. "It opens in the back so my **** is gonna be out … so they can get to it easy," he said. After the procedure, another doctor tells him that while his preparation wasn't totally perfect, everything went well. "He's like the Martin Scorscese of my ass," Smith joked about his doctor and the procedure, which requires a camera to search for colon cancer polyps.

Lowering Your Risk of Colon Cancer

Sharon Osbourne’s Prophylactic Mastectomy

Another person who underwent a preventative mastectomy is colon cancer survivor Sharon Osbourne.

Osbourne knows what it’s like to have a cancer battle. She was diagnosed with colon cancer at 49 in 2002, and she had no family history of the disease. For treatment, she underwent surgery to remove a foot of the large intestine and some surrounding lymph nodes on July 3, 2002. This surgery revealed that one of her lymph nodes was cancerous, meaning the disease had spread beyond her colon.

Her cancer was eventually deemed to be stage three, and she needed chemotherapy to kill any cancerous cells left behind. Thankfully, she had the support of her family along the way.

She later revealed she underwent a preventative double mastectomy after discovering she had a genetic mutation that raised her chances of developing breast cancer. A prophylactic, or preventative, mastectomy is a procedure where the breast tissue is removed to prevent cancer from developing in the future.

"As soon as I found out I had the breast cancer gene, I thought: 'The odds are not in my favor'," Sharon said in an interview in 2012 with Hello! magazine. "I've had cancer before and I didn't want to live under that cloud: I decided to just take everything off, and had a double mastectomy." The operation took 13 hours, but Sharon was happy with her decision.

In an earlier interview with SurvivorNet, Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, spoke about double mastectomies. Dr. Port explains the procedure, saying, "A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue, the real length, the total length of the surgery can often depend most on what type of reconstruction she has."

Dr. Port continues, "Most women who have removal surgery of both breasts do have reconstruction." Dr. Port says that the time for the reconstruction varies greatly. "With implant-based reconstruction, it can take two to three hours, so the total surgery is four to five hours."

She says that an alternative reconstruction involves a person's own tissue typically from the belly which is then used to reconstruct the breast.

Dr. Port says, "When you take tissue from another part of the body and transfer it to fill in the empty space where the breasts are, this is a very long operation. It can take anywhere from six to 12 hours because it's really like having a tummy tuck and then transferring the tissue and grafting the tissue, connecting the vessels."

She adds that it's not only a longer operation but that the recovery time is longer, too. Dr. Port explains how the type of reconstruction a person has informs the recovery period.

Is a Preventative Mastectomy Right for Me?

PSA Screening Tests for Preventing & Detecting Prostate Cancer

PSA tests are the screening method used to screen for prostate cancer. These tests look for PSA in the bloodstream, which could indicate the presence of prostate cancer.

People who have a family history of prostate cancer or other cancers should begin screening for prostate cancer earlier than the average person. The current recommendation is to begin screening at age 50 if you have an average risk of prostate cancer.

Urologic oncologist at Cedars-Sinai, Dr. Edwin Posadas, says it's important to notify your doctor about your risk factor, such as having a family history of prostate cancer. He tells SurvivorNet in an earlier interview, "We know as doctors that there are certain men who are at high risk for having prostate cancer. Men of African descent, for example, fall immediately into a high-risk category."

Dr. Posadas continues, "Men whose fathers or brothers had prostate cancer are at two to three times the risk of the general man living in America of having prostate cancer. Those pieces of information are critical to bring forward in an examination when you're seeing your doctor."

People at a high risk of developing prostate cancer should start screening at age 40 or 45, depending upon your specific circumstances. Speak with your doctor about what's best for you, and advocate for your health lead each doctor's appointment with a plan.

When Should I Get Tested for Prostate Cancer?

Prevention of Skin Cancer & Lowering Skin Cancer Risk

Skin cancer is the most commonly diagnosed type of cancer in the U.S., and you can protect yourself and lower your skin cancer risk by taking prevention steps. In an earlier interview, dermatologist Dr. Dendy Engelman outlines five easy ways to protect your skin, and lower your skin cancer risk. She tells us:

1. Avoid sun during peak hours. This means from 10 a.m. to 2 p.m. It doesn't mean you should never go outside during the middle of the day, but make sure you're protected when you do venture outdoors.
2. Cover your skin and eyes. A wide-brim hat and sunglasses will protect your face, the top of your head, your ears, and the delicate skin around your eyes.
3. Wear an SPF of 30 or higher. Plenty of facial moisturizers have SPF built into them. Reapply often.
4. Get an annual skin check. You can check your own skin for anything that looks out of the ordinary, but you should still get a yearly check to make sure you didn't miss anything. If you do happen to notice anything out of the ordinary in between checks, schedule an appointment to talk to your doctor about it ASAP it is always worth it to make sure.
5. Avoid tanning beds. "There's absolutely no benefit to going to a tanning bed," Dr. Engelman says.

Top 5 Ways to Protect Your Skin From Skin Cancer

Contributing: SurvivorNet staff

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