安吉麗娜·朱莉·皮特:手術日記

Angelina Jolie Pitt: Diary of a Surgery

安吉麗娜·朱莉·皮特：手術日記

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.

兩年前，我曾寫過一篇文章，是關於我選擇預防性雙乳切除手術的。因爲一項簡單的血檢顯示，我的BRCA1基因存在突變。這意味着我患乳癌的概率高達87%，而患卵巢癌的概率高達50%。此外，我的母親、外祖母和姨媽都因癌症去世。 　　

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.

爲了讓其他高危女性瞭解我的選擇，我曾經承諾會不斷更新有用的消息，比如我接下來要做的預防性卵巢與輸卵管摘除手術。

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.

爲了這個手術，我已計劃了一段時間。雖然它沒有乳腺切除術複雜，但影響卻更嚴重，它會迫使女性絕經，進入更年期。因此，我做了很多身心準備工作，與醫生探討其他辦法，研究替代性藥物，規劃雌激素和孕激素代替物。但我依然覺得自己還有好幾個月的緩衝時間。

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.

就在兩週前，我接到了醫生的電話，他告知我血檢結果。聽到他說"你的CA-125正常"時，我舒了一口氣。血液中的CA-125蛋白含量是用來檢測卵巢癌的一項指標。因爲家族病史，我每年都會做這項測試。

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.

我頓時想到成千上萬的女性們（在接到診斷通知書時）心中的感受。我告訴自己要保持冷靜和堅強，因爲我必須活下去，看着我的孩子們長大，活着看見我的孫子孫女們出生。

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.

我給身在法國的老公打了電話，幾個小時後他將登機。生命中最"美好"的時刻，莫過於一切都無比明瞭清晰。你知道了自己活着的目的，也知道什麼才最爲重要。（答案）雖然極端，但也能平靜接受。

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."

當天，我就去見外科醫生，她曾治療過我的母親。上一次見她還是我母親去世之時，當時一見到我，她就哭着說："你跟你的母親長得真像。"我也隨之崩潰。但這一次，我們都對彼此笑了笑，約定要解決所有問題，所以"讓我們繼續加油。"

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.

超聲波檢查並無異樣。我也終於鬆了口氣，因爲即使是癌症，也極可能還處於早期階段。如果是身體其他部分的問題，我將會在五天內得到通知。於是，我度過了昏昏沉沉的五天，參加了孩子們的足球賽，忙着工作試圖保持冷靜和專注。

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.

終於到了出結果的那天。PET/CT掃描清楚地顯示沒有腫瘤跡象，而腫瘤檢測也呈陰性。儘管因爲體內有放射性示蹤劑，我還不能和孩子們擁抱，但我還是滿心歡喜。雖然，早期癌症的風險仍在，但是相比較全面爆發的腫瘤，這已經不算什麼了。慶幸地是，我還有機會可以選擇進行卵巢和輸卵管摘除術，於是我決定進行手術。

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.

我想告訴其他女性的是，我做這個決定並不僅僅是因爲攜帶了BRCA1突變基因。僅僅是BRCA基因檢測呈陽性，並不意味着你需要立即接受手術。我曾諮詢過許多大夫、外科醫生，還有理療專家，得知對此還有其他的治療方式可供選擇，比如口服避孕藥或者代替藥物，並結合定期檢查進行治療。面對健康問題，解決之道往往不止一種，而最重要的是瞭解這些解決方案，並從中選擇最適合自己的一種。

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.

拿我的例子來說，中西醫在診斷之後，都認爲摘除卵巢和輸卵管是我最好的選擇，因爲我不僅攜帶突變BRCA基因，還有三位女性親人死於癌症。我的醫生們表示，相比女性親人們最早出現癌症症狀的年紀，我應該提前十年進行預防性手術。我媽在49歲時被診斷出卵巢癌，而我今年已經39歲了。

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.

我還在身體裏打了個"補丁"，裏面裝着替代性雌激素。而我的子宮裏還有一個一個孕激素節育器，用以維持我的激素平衡，更重要的是預防子宮癌。我選擇留下子宮，因爲我的家族病史中並沒有子宮癌。

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."

排除所有的風險是不可能的，事實上我依舊屬於癌症高發人羣。但我將會尋求自然的方式增強免疫系統。我爲自己和家庭做出了這樣的選擇，這是理智的。至少我的孩子們以後絕不會說 "我的媽媽死於卵巢癌"這樣的話了。

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.

雖然我使用了激素代替物，但是我現在還是停經了，不能再生育小孩，身體也將出現變化。但我將坦然接受所有的結果，這並不是因爲我多麼堅強，而是因爲這就是我生命的一部分，沒什麼可怕的。

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.

我深深地體諒那些很早就遭遇此劫，甚至還來不及擁有自己孩子的女性，她們的處境比我更爲艱難。我還諮詢到了一種摘除輸卵管、保留卵巢的做法，接受這種治療的女性就不會停經，保留生育能力。我希望她們能知道這種選擇。 　

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.

做出這樣的決定並非易事，但是任何健康問題都是可控的，也有防患未然的可能。你可以尋求建議，瞭解不同的解決辦法，做出最適合自己的選擇。總而言之，知識就是力量。