安吉丽娜·朱莉·皮特:手术日记

Angelina Jolie Pitt: Diary of a Surgery

安吉丽娜·朱莉·皮特：手术日记

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.

两年前，我曾写过一篇文章，是关于我选择预防性双乳切除手术的。因为一项简单的血检显示，我的BRCA1基因存在突变。这意味着我患乳癌的概率高达87%，而患卵巢癌的概率高达50%。此外，我的母亲、外祖母和姨妈都因癌症去世。

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.

为了让其他高危女性了解我的选择，我曾经承诺会不断更新有用的消息，比如我接下来要做的预防性卵巢与输卵管摘除手术。

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.

为了这个手术，我已计划了一段时间。虽然它没有乳腺切除术复杂，但影响却更严重，它会迫使女性绝经，进入更年期。因此，我做了很多身心准备工作，与医生探讨其他办法，研究替代性药物，规划雌激素和孕激素代替物。但我依然觉得自己还有好几个月的缓冲时间。

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.

就在两周前，我接到了医生的电话，他告知我血检结果。听到他说"你的CA-125正常"时，我舒了一口气。血液中的CA-125蛋白含量是用来检测卵巢癌的一项指标。因为家族病史，我每年都会做这项测试。

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.

我顿时想到成千上万的女性们(在接到诊断通知书时)心中的感受。我告诉自己要保持冷静和坚强，因为我必须活下去，看着我的孩子们长大，活着看见我的孙子孙女们出生。

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.

我给身在法国的老公打了电话，几个小时后他将登机。生命中最"美好"的时刻，莫过于一切都无比明了清晰。你知道了自己活着的目的，也知道什么才最为重要。(答案)虽然极端，但也能平静接受。

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."

当天，我就去见外科医生，她曾治疗过我的母亲。上一次见她还是我母亲去世之时，当时一见到我，她就哭着说："你跟你的母亲长得真像。"我也随之崩溃。但这一次，我们都对彼此笑了笑，约定要解决所有问题，所以"让我们继续加油。"

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.

超声波检查并无异样。我也终于松了口气，因为即使是癌症，也极可能还处于早期阶段。如果是身体其他部分的问题，我将会在五天内得到通知。于是，我度过了昏昏沉沉的五天，参加了孩子们的足球赛，忙着工作试图保持冷静和专注。

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.

终于到了出结果的那天。PET/CT扫描清楚地显示没有肿瘤迹象，而肿瘤检测也呈阴性。尽管因为体内有放射性示踪剂，我还不能和孩子们拥抱，但我还是满心欢喜。虽然，早期癌症的风险仍在，但是相比较全面爆发的肿瘤，这已经不算什么了。庆幸地是，我还有机会可以选择进行卵巢和输卵管摘除术，于是我决定进行手术。

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.

我想告诉其他女性的是，我做这个决定并不仅仅是因为携带了BRCA1突变基因。仅仅是BRCA基因检测呈阳性，并不意味着你需要立即接受手术。我曾咨询过许多大夫、外科医生，还有理疗专家，得知对此还有其他的治疗方式可供选择，比如口服避孕药或者代替药物，并结合定期检查进行治疗。面对健康问题，解决之道往往不止一种，而最重要的是了解这些解决方案，并从中选择最适合自己的一种。

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.

拿我的例子来说，中西医在诊断之后，都认为摘除卵巢和输卵管是我最好的选择，因为我不仅携带突变BRCA基因，还有三位女性亲人死于癌症。我的医生们表示，相比女性亲人们最早出现癌症症状的年纪，我应该提前十年进行预防性手术。我妈在49岁时被诊断出卵巢癌，而我今年已经39岁了。

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.

我还在身体里打了个"补丁"，里面装着替代性雌激素。而我的子宫里还有一个一个孕激素节育器，用以维持我的激素平衡，更重要的是预防子宫癌。我选择留下子宫，因为我的家族病史中并没有子宫癌。

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."

排除所有的风险是不可能的，事实上我依旧属于癌症高发人群。但我将会寻求自然的方式增强免疫系统。我为自己和家庭做出了这样的选择，这是理智的。至少我的孩子们以后绝不会说 "我的妈妈死于卵巢癌"这样的话了。

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.

虽然我使用了激素代替物，但是我现在还是停经了，不能再生育小孩，身体也将出现变化。但我将坦然接受所有的结果，这并不是因为我多么坚强，而是因为这就是我生命的一部分，没什么可怕的。

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.

我深深地体谅那些很早就遭遇此劫，甚至还来不及拥有自己孩子的女性，她们的处境比我更为艰难。我还咨询到了一种摘除输卵管、保留卵巢的做法，接受这种治疗的女性就不会停经，保留生育能力。我希望她们能知道这种选择。

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.

做出这样的决定并非易事，但是任何健康问题都是可控的，也有防患未然的可能。你可以寻求建议，了解不同的解决办法，做出最适合自己的选择。总而言之，知识就是力量。