Angelina Jolie-Pitt has written an open letter to the New York Times, entitled 'Diary of a surgery,' sharing her news that she has undergone a second elective surgery relating to her status as a BRCA1 gene mutation carrier. The actress and philanthropist opened up in the letter about her decision to have a preventative surgery called 'bilateral salpingo-oophorectomy', which involves surgically removing both ovaries and fallopian tubes. 

"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."

Like any carrier of the BRCA1 gene mutation, Jolie-Pitt has a 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. Her risk of breast cancer was dramatically reduced in 2013 when she underwent her first elective preventative double mastectomy surgery. 

"It is not easy to make these decisions," she said in the letter. "But it is possible to take control and tackle head-on any health issue." she goes on to describe: "My doctors indicated I should have preventive surgery about a decade before the earliest onset of cancer in my female relatives," wrote Jolie, 39, whose mother passed away from the disease at the age of 49. And following some routine tests that revealed "a number of elevated markers" she concluded that the surgery would be the next best step for her. 

She credits her husband, Brad Pitt, and family for their continued support and shares how the moments of fear were laced with moments of clarity about life's priorities:"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."

"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"

Although the operation is technically more straight forward than the previous mastectomy, it carries more complicated side effects, namely it enforces a state of forced early on-set menopause. But Jolie is happy to manage these consequences, for the peace of mind of knowing that "I know my children will never have to say, "Mom died of ovarian cancer."

Jolie says she is still at risk for cancer but is at ease with her preventative measures, which she asserts were a personal choice and may not be for others in a similar situation. She ends her letter by saying: "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." We commend her outspoken transparency in sharing such a challenging personal situation and share her hope that by sharing she can help raise awareness and help save lives.