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What to ask your doctor about Angelina's cancer surgery.
When Angelina Jolie writes about her personal health struggles in the New York Times, it makes a splash. In 2013, Jolie set off a media storm by writing about her double mastectomy and genetic predisposition for cancer, then wrote about a second surgery, this time to remove her ovaries and fallopian tubes, in 2015.
High drama, yes, but it’s hard not to admire her candour. Jolie writes that she is now in full menopause and using bio-identical estrogen patches and an IUD to replace the hormones she’s lost. That’s no small reveal for anyone, let alone an actress known for her vitality and sex appeal.
Jolie also added a note of caution, knowing that the "Jolie effect" is now a recognized factor in doctor-patient conversations and that her preventative surgeries are an extreme course of action.
"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," she writes.
On this point, Canadian doctors and cancer experts agree. High drama may be a good way to start a conversation but calm heads makes the soundest decisions.
A cancer doctor weighs in
Dr. Marcus Bernardini a surgical oncologist at Toronto’s Princess Margaret Cancer Centre at University Health Network told us there are a few things Canadian women should know in the wake of Jolie’s announcement:
1. There is actually no effective general screening for high-grade serious ovarian cancer and screening is not recommended.
2. Preventative surgery is recommended for high-risk women (those who carry the BRCA1 or BRCA2 mutation).
3. Jolie mentions a scenario in which only the fallopian tubes are removed (called a salpingectomy) for women who still hope to get pregnant. Dr. Bernardini calls this "an intriguing strategy," but for now the removal of the ovaries and fallopian tubes (a salpingo-oophorectomy) is the recommended course of action.
4. There are four questions Dr. Bernardini suggests discussing with your doctor if you have concerns raised by Angelina Jolie’s story:
- Am I at risk for ovarian cancer?
- Is there a history of ovarian cancer in my family?
- How does one find out if they are eligible for testing?
- I know there are different types of ovarian cancer, are all preventable in this way?
Family history is the starting point
Responding to the Jolie news this week, Gillian Bromfield, the director of Cancer Control Policy at the Canadian Cancer Society also pointed out that it’s important that people try to learn their family health history.
The group also has information for women with a known strong family history of breast and ovarian cancer, including information on genetic testing, and preventive strategies that may be available to them, she says.
"The decision to have a preventive surgery is a very personal one that a woman would make in consultation with her healthcare provider based on her medical history and her personal preferences," she says.
Here’s hoping Jolie’s candour leads to more information being shared – not more panic.
Read on for more information on menopause and genetic testing.
Enjoy hearty oats in more ways than just a bowl of oatmeal. Oats are a nutritious ingredient in both sweet and savoury recipes.
This is the ultimate in comfort food, combining two all-time homegrown favourites: cinnamon buns and bubbly, sweet apple cobbler. Sprinkling a cinnamon filling into rolled buttermilk biscuits offers a quick alternative to a yeast-risen cinnamon bun.
Adding fresh apples to this muffin batter is a nice way to incorporate fruit in a baked treat. Dried cranberries add a touch of tartness, but you can use raisins or any other dried fruit.
You won't miss the nuts in this deluxe granola. Make sure it is completely cool before adding the chocolate.
Enjoy all the pleasures of crumble-topped apple pie in a delightful hand-held size. Serve warm with vanilla ice cream for an even more indulgent dessert.
Sweet-tart cranberries are cooked with a hint of orange to make an easy jam-like filling, then sandwiched between layers of crisp almond pastry. Freshly ground almonds are crunchier than the storebought ground variety, so whirl whole nuts in a food processor for the ultimate nutty crust.
These decadent drops are incredibly easy to prepare, making them perfect for a last-minute cookie exchange. The chocolate-dipped pretzel topping adds an easy, festive flair.
For anyone with a sweet tooth on your list, these sweet bites take almost no prep time and great for last-minute treats.
Make weeknight dinners fun (for adults and kids) with these veggie-packed, tomato sauce–topped mini meat loaves. Cooking your potatoes on the stove top with the help of a little steam gets dinner on the table more quickly. Steamed green beans make a nice veggie side dish.
Treat yourself with these fruity, buttery bites. Sweet blueberry filling packed between layers of classic oat meal crumble will have you reminiscing of grandma's baked goods.
Warm up cool evenings by filling empty tummies with hearty soup. Sprinkle a little Parmesan cheese over top or add a handful of cooked noodles to make leftovers new again.
Veggie burgers should be just as juicy as the original hamburger. Add your favourite toppings and condiments or switch it up by going bunless and wrap in a large lettuce leaf.
Shredded coconut in the crumble topping adds tropical flair to an otherwise classic recipe. Many people with celiac disease can still consume oats, but to be absolutely sure yours haven't been in contact with gluten from other products, look for bags labelled "pure uncontaminated oats."
These muffins are big on flavour and sure to entice even those who have no trouble with gluten. Play around with the fruit: Try dried blueberries, strawberries, raspberries or chopped apricots.
These nut-free treats are chewy and packed with flavour, thanks to the tasty fruit and toasted quinoa, which also add fibre and protein to stave off hunger. Pack one in her knapsack for snack emergencies!
The versatility of these cookies is endless. White or milk chocolate, or dried apricots or currants make delicious substitutions for the dark chocolate.
This sweet granola has a surprising yet gentle hint of ginger and is the perfect partner for the tangy rhubarb topping. Set out the yogurt, granola and compote with small bowls or pretty glasses so guests can make their own parfaits.
This free-form pastry tastes just as delicious as apple pie—but with no upper crust or fluting to worry about, it's forgiving to make. The crispy oatmeal streusel helps insulate the filling while baking, keeping the apples juicy. Serve with a scoop of vanilla ice cream.
Meat loaf is a popular comfort food not only because it's quick and easy to toss together but also because it's hearty and always delicious – especially this one with its glossy vegetable topping.
Nothing beats a home-style crumble at the end of a Sunday meal. Serve warm with a dollop of fresh whipped cream or ice cream for an indulgent treat.
Classic cookies are always a weekend favourite and easy for even a novice baker. Freeze scooped portions to thaw and bake at another time.
Multigrain flour, rolled oats and wheat germ give these quite chewy pancakes a wholesome flavour. Multigrain flour is a combination of all-purpose and whole wheat flours, cracked wheat and rye and whole flaxseeds.
These squares have all of the layered goodness of apple pie with the ease of a crumble.
This springtime twist on classic date squares features a tangy-sweet pink rhubarb filling. If fresh rhubarb is unavailable, measure the same amount of frozen rhubarb, then thaw and drain.
Here's the perfect ending to a summer meal: a rustic home-style crumble made with juicy stone fruit. There's no need to peel the plums and nectarines—the skins soften as the fruit cooks and impart a lovely blush colour to the sauce.
Beyond Thanksgiving dessert and carving jack-o’-lanterns, this autumn gourd has a host of health benefits. Here are five ways pumpkins can improve your diet, sleep and skin, plus five easy and nutritious pumpkin recipes.
1. Healthy eyes
Pumpkin is a rich source of beta-carotene—it’s what gives it that rich, vibrant colour. Packed with potent antioxidants, it helps protect your vision from degeneration. Bonus: You’ll also see stronger nails and healthier hair.
2. Glowing skin
Pumpkins are rich in a host of skin-healthy vitamins: the properties from antioxidant-rich vitamin A (retinol) act as a shield for your skin, protecting you from the damaging affects of free radicals; vitamin C helps promote collagen production and renew the skin for a glowing face; and vitamin E improves skin tone.
3. Energy boost
The daily recommended iron intake for women is higher than for men, and as women age or become pregnant, the necessary dose increases. Pumpkins are full of iron, an immunity-boosting mineral that can help ward of illness and fatigue and keep your energy high.
4. Better diet
High in fibre (7 grams per one cup of canned pumpkin) and low in calories (26 calories for 100g), pumpkins can help you stay full longer and keep your digestion on track. The Heart & Stroke association recommends 21 to 38 grams of fibre a day, however most people don’t quite reach half that amount.
5. Improved sleep and mood
Don’t toss the seeds. Raw pepitas (hulled pumpkin seeds) are rich in tryptophan (yes, the same snooze-inducing amino acid that kicks in post-turkey dinner) and can help you get more Zs. This compound also supports serotonin, which not only helps you sleep better, but boosts your mood, too.
Whether you use the whole pumpkin, the pulp or the seeds, here are five must-try recipes, ranging from savoury to sweet.
Thai Pumpkin Coconut Soup
This silky soup is a mix of traditional sweet and sour Thai flavours and has only 159 calories per serving. It’s guaranteed to be your go-to winter warm-up soup.
Pumpkin Spice Muffins
A muffin is a great grab-and-go treat. Skip the maple cream cheese spread to keep the calorie count (250 calories) low.
Arugula and Pepita Pesto
Add this pesto to salad, soups or over meat. Keeps in the freezer for up to six months.
Almond Pepita Butter
This fragrant nut butter with a mix of almond and pepita is a super-satisfying topper.
Pumpkin Pie Granola
A mix of pepitas, pecans, flaxseeds, puffed rice cereal and a medley of aromatic spices, such as cinnamon, ginger and cloves gives this granola loads of flavour.
Illustration by Matthew Billington Credits: Illustration by Matthew Billington
|This content is vetted by medical experts |
|This story was originally part of "Stand and Deliver" in the September 2015 issue. |
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