本日口譯文章：安吉麗娜·朱莉·皮特:手術日誌
兩年前，我曾寫過一篇文章，是關於我選取防備性雙乳切除手術的。由於一項簡略的血檢表現，我的BRCA1基因存在突變。這象征著我患乳癌的幾率高達87%，而患卵巢癌的幾率高達50%。別的，我的母親、外祖母和阿姨都因癌癥逝世。
為了讓其他高危女性懂得我的選取，我曾許諾會賡續更新有效的新聞，好比我接下來要做的防備性卵巢與輸卵管摘除手術。
為了這個手術，我已籌劃了一段時光。固然它沒有乳腺切除術龐雜，但影響卻更緊張，它會迫婢女性絕經，進入更年期。是以，我做了許多身心預備事情，與大夫商量其他方法，研討替換性藥物，計劃雌激素和孕激素取代物。但我仍然認為本身另有好幾個月的緩沖時光。
就在兩周前，我接到了大夫的手機，他告訴我血檢成果。聽到他說"你的CA-125正常"時，我舒了一口吻。血液中的CA-125卵白含量是用來檢測卵巢癌的一項指標。由於家屬病史，我每一年都邑做這項測試。
我馬上想到不計其數的女性們(在接到診斷關照書時)心中的體驗。我告知本身要堅持沉著和頑強，由於我必需活下去，看著我的孩子們長大，在世瞥見我的孫子孫女們出身。
我給身在法國的老公打了手機，幾個小時後他將登機。性命中最"美妙"的時候，莫過於統統都非常清楚明了清楚。你曉得了本身在世的目標，也曉得甚麽才最為主要。(謎底)固然極度，但也能鎮靜接收。
當天，我就去見外科大夫，她曾醫治過我的母親。上一次見她照樣我母親逝世之時，其時一見到我，她就哭著說："你跟你的母親長得真像。"我也隨之瓦解。但這一次，咱們都對相互笑了笑，商定要辦理全部題目，以是"讓咱們持續加油。"
超聲波檢討並沒有異常。我也終究松了口吻，由於縱然是癌癥，也很可能還位於初期階段。假如是身材其他部門的題目，我將會在五天內獲得關照。因而，我渡過了昏昏沉沉的五天，加入了孩子們的足球賽，忙著事情試圖堅持沉著和專註。
終究到了出成果的那天。PET/CT掃描清晰地表現沒有腫瘤跡象，而腫瘤檢測也呈陰性。只管由於體內有放射性示蹤劑，我還不克不及和孩子們擁抱，但我照樣滿心歡樂。固然，初期癌癥的危害仍在，然則比擬較周全暴發的腫瘤，這已不算甚麽了。光榮地是，我另有機遇可以選取舉行卵巢和輸卵管摘除術，因而我決議舉行手術。
我想告知其他女性的是，我做這個決議並不單單是由於攜帶了BRCA1突變基因。僅僅是BRCA基因檢測呈陽性，並不料味著你須要立刻接收手術。我曾咨詢過很多醫生、外科大夫，另有理療專家，得悉對此另有其他的醫治方法可供選取，好比口服避孕藥大概取代藥物，並聯合按期檢討舉行醫治。面臨康健題目，辦理之道每每不止一種，而最主要的是懂得這些辦理計劃，並從中選取最合適本身的一種。
拿我的例子來講，中西醫在診斷以後，都以為摘除卵巢和輸卵管是我最佳的選取，由於我不但攜帶突變BRCA基因，另有三位女性親人死於癌癥。我的大夫們表現，比擬女性親人們最先湧現癌癥癥狀的年事，我應當提早十年舉行防備性手術。我媽在49歲時被診斷出卵巢癌，而我本年已39歲了。
我還在身材裏打了個"補釘"，內裏裝著替換性雌激素。而我的子宮裏另有一個一個孕激素節育器，用以保持我的激素均衡，更主要的是防備子宮癌。我選取留下子宮，由於我的家屬病史中並無子宮癌。
消除全部的危害是弗成能的，究竟上我仍舊屬於癌癥多發人群。但我將會追求天然的方法加強免疫體系。我為本身和家庭做出了如許的選取，這是理智的。最少我的孩子們今後毫不會說 "我的媽媽死於卵巢癌"如許的話了。
固然我應用了激素取代物，然則我如今照樣停經了，不克不及再生養小孩，身材也將湧現變更。但我將安然接收全部的成果，這並非由於我何等頑強，而是由於這便是我性命的一部門，沒甚麽恐怖的。
我深深地諒解那些很早就遭受此劫，乃至還來不及具有本身孩子的女性，她們的處境比我更加艱苦。我還咨詢到了一種摘除輸卵管、保存卵巢的做法，接收這類醫治的女性就不會停經，保存生養才能。我願望她們能曉得這類選取。
做出如許的決議並不是易事，然則任何康健題目都是可控的，也有有備無患的大概。你可以追求發起，懂得分歧的辦理方法，做出最合適本身的選取。總而言之，常識便是力氣。
【參考譯文】
Angelina Jolie Pitt: Diary of a Surgery
Two years ago I wrote about my choice to have a preventive double mastectomy. A simple blood test had revealed that I carried a mutation in the BRCA1 gene. It gave me an estimated 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. I lost my mother, grandmother and aunt to cancer.
I wanted other women at risk to know about the options. I promised to follow up with any information that could be useful, including about my next preventive surgery, the removal of my ovaries and fallopian tubes.
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. So I was readying myself physically and emotionally, discussing options with doctors, researching alternative medicine, and mapping my hormones for estrogen or progesterone replacement. But I felt I still had months to make the date.
Then two weeks ago I got a call from my doctor with blood-test results. "Your CA-125 is normal," he said. I breathed a sigh of relief. That test measures the amount of the protein CA-125 in the blood, and is used to monitor ovarian cancer. I have it every year because of my family history.
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.
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.
That same day I went to see the surgeon, who had treated my mother. I last saw her the day my mother passed away, and she teared up when she saw me: "You look just like her." I broke down. But we smiled at each other and agreed we were there to deal with any problem, so "let's get on with it."
Nothing in the examination or ultrasound was concerning. I was relieved that if it was cancer, it was most likely in the early stages. If it was somewhere else in my body, I would know in five days. I passed those five days in a haze, attending my children's soccer game, and working to stay calm and focused.
The day of the results came. The PET/CT scan looked clear, and the tumor test was negative. I was full of happiness, although the radioactive tracer meant I couldn't hug my children. There was still a chance of early stage cancer, but that was minor compared with a full-blown tumor. To my relief, I still had the option of removing my ovaries and fallopian tubes and I chose to do it.
I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery. I have spoken to many doctors, surgeons and naturopaths. There are other options. Some women take birth control pills or rely on alternative medicines combined with frequent checks. There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally.
In my case, the Eastern and Western doctors I met agreed that surgery to remove my tubes and ovaries was the best option, because on top of the BRCA gene, three women in my family have died from cancer. My doctors indicated I should have preventive surgery about a decade before the earliest onset of cancer in my female relatives. My mother's ovarian cancer was diagnosed when she was 49. I'm 39.
I have a little clear patch that contains bio-identical estrogen. A progesterone IUD was inserted in my uterus. It will help me maintain a hormonal balance, but more important it will help prevent uterine cancer. I chose to keep my uterus because cancer in that location is not part of my family history.
It is not possible to remove all risk, and the fact is I remain prone to cancer. I will look for natural ways to strengthen my immune system. I feel feminine, and grounded in the choices I am making for myself and my family. I know my children will never have to say, "Mom died of ovarian cancer."
Regardless of the hormone replacements I'm taking, I am now in 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.
I feel deeply for women for whom this moment comes very early in life, before they have had their children. Their situation is far harder than mine. I inquired and found out that there are options for women to remove their fallopian tubes but keep their ovaries, and so retain the ability to bear children and not go into menopause. I hope they can be aware of that.
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.
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