Angelina Jolie

Angelina Jolie . Biography


 

30 Juni 2013

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Angelina Jolie (/ˈl/ joh-LEE, born Angelina Jolie Voight; June 4, 1975) is an American Actress, film director, screenwriter, and author. She has received an Academy Award, two Screen Actors Guild Awards, and three Golden Globe Awards, and was named Hollywood’s highest-paid actress by Forbes in 2009 and 2011. Jolie promotes humanitarian causes, and is noted for her work with refugees as a Special Envoy and former Goodwill Ambassador for the United Nations High Commissioner for Refugees (UNHCR). She has often been cited as the world’s “most beautiful” woman, a title for which she has received substantial media attention.

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Angelina Jolie

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Jolie at the May 2012 launch of a UK initiative on preventing sexual violence in conflict
Born Angelina Jolie Voight
June 4, 1975 (age 38)
Los Angeles, California, U.S.
Citizenship United States, Cambodia, Sarajevo (honorary)
Occupation Actress, film director, screenwriter
Years active 1982; 1991–present
Spouse(s)
  • Jonny Lee Miller (m. 1996–d. 1999)
  • Billy Bob Thornton (m. 2000–d. 2003)
Partner(s) Brad Pitt (2005–present)
Children 6 (Six)
Parents Jon Voight
Marcheline Bertrand
Relatives James Haven (brother)
Chip Taylor (uncle)

Jolie made her screen debut as a child alongside her father, Jon Voight, in Lookin’ to Get Out (1982), but her film career began in earnest a decade later with the low-budget production Cyborg 2 (1993). Her first leading role in a major film was in the cyber-thriller Hackers (1995). She starred in the critically acclaimed biographical television films George Wallace (1997) and Gia (1998), and won an Academy Award for Best Supporting Actress for her performance in the drama Girl, Interrupted (1999).

Jolie achieved wide fame after her portrayal of the video game heroine Lara Croft in Lara Croft: Tomb Raider (2001), and established herself among the highest-paid actresses in Hollywood with the sequel The Cradle of Life (2003). She continued her action star career with Mr. & Mrs. Smith (2005), Wanted (2008), and Salt (2010)—her biggest live-action commercial successes to date—and received further critical acclaim for her performances in the dramas A Mighty Heart (2007) and Changeling (2008), which earned her a nomination for an Academy Award for Best Actress. Jolie made her directorial debut with the wartime drama In the Land of Blood and Honey (2011).

Divorced from actors Jonny Lee Miller and Billy Bob Thornton, Jolie now lives with actor Brad Pitt, in a relationship notable for fervent media attention. Jolie and Pitt have three biological children and three adopted children.

Early Life and Family

Born in Los Angeles, California, Jolie is the daughter of actors Jon Voight and Marcheline Bertrand. She is the sister of actor James Haven, niece of singer-songwriter Chip Taylor, and goddaughter of actors Jacqueline Bisset and Maximilian Schell. On her father’s side, Jolie is of German and Slovak descent, and on her mother’s side, she is of primarily French Canadian, Dutch, and German ancestry. Like her mother, Jolie has stated that she is part Iroquois, although her only known Native American ancestor was a Huron woman born in 1649.

After her parents’ separation in 1976, Jolie and her brother lived with their mother, who had abandoned her acting ambitions to focus on raising her children. As a child, Jolie often watched movies with her mother and explained this had inspired her interest in acting; she stated that she was not influenced by her father’s career. When she was six years old, her mother and stepfather, filmmaker Bill Day, moved the family to Palisades, New York; they returned to Los Angeles five years later. She then decided she wanted to act and enrolled at the Lee Strasberg Theatre Institute, where she trained for two years and appeared in several stage productions.

At the age of 14, Jolie dropped out of her acting classes and aspired to become a funeral director. She began working as a fashion model, modeling mainly in Los Angeles, New York, and London. During this period, she wore black clothing, experimented with knife play, and went out moshing with her live-in boyfriend. Two years later, after the relationship had ended, she rented an apartment above a garage a few blocks from her mother’s home. She graduated from high school and returned to theater studies, though in recent times she has referred to this period with the observation, “I am still at heart—and always will be—just a punk kid with tattoos.

Jolie suffered episodes of suicidal depression throughout her teens and early twenties. She felt isolated at Beverly Hills High School among the children of some of the area’s affluent families, as her mother survived on a more modest income, and she was teased by other students, who targeted her for being extremely thin and for wearing glasses and braces. She found it difficult to emotionally connect with other people, and as a result she started to self-harm;later commenting, “I collected knives and always had certain things around. For some reason, the ritual of having cut myself and feeling the pain, maybe feeling alive, feeling some kind of release, it was somehow therapeutic to me. She also began experimenting with drugs; by the age of 20, she had tried “just about every drug possible,” including heroin.

Jolie's father, Jon Voight, in 2011
Jolie’s father, Jon Voight, in 2011

Jolie has had a difficult relationship with her father. Because of Voight’s marital infidelity and the resulting breakup of her parents’ marriage, she was estranged from her father for many years. They reconciled and he appeared with her in Lara Croft: Tomb Raider (2001), but their relationship again deteriorated. In July 2002, Jolie—who had long used her middle name as a stage name to establish her own identity as an actress—filed a request to legally drop Voight as her surname, which was granted on September 12, 2002. In August of that year, Voight claimed his daughter had “serious mental problems” on Access Hollywood. In response, Jolie released a statement in which she indicated that she no longer wished to pursue a relationship with her father. She explained that because she had adopted her son Maddox, she did not think it was healthy for her to associate with Voight. In the wake of her mother’s death from ovarian cancer on January 27, 2007, Jolie again reconciled with her father after a six-year estrangement.

Career

Early Work: 1982; 1991–1997

When she was seven years old, Jolie had a small part in Lookin’ to Get Out (1982), a movie co-written by and starring her father, Jon Voight. She committed to acting at the age of 16, but initially found it difficult to pass auditions, often being told that she was “too dark. She appeared in five of her brother’s student films, made while he attended the USC School of Cinema-Television, as well as in several music videos, namely Lenny Kravitz’s “Stand by My Woman” (1991); Antonello Venditti’s version of Crowded House’s hit “Don’t Dream It’s Over”, “Alta Marea” (1991); The Lemonheads’s “It’s About Time” (1993); and Meat Loaf’s “Rock and Roll Dreams Come Through” (1993). She began to learn from her father, as she noticed his method of observing people to become like them. Their relationship during this time was less strained, with Jolie realizing that they were both “drama queens.

Jolie began her professional film career in 1993, when she played her first leading role in the low-budget, straight-to-video science-fiction sequel Cyborg 2, as Casella “Cash” Reese, a near-human robot, designed to seduce her way into a rival manufacturer’s headquarters and then self-detonate. Jolie was so disappointed with the film that she did not audition again for a year. Following a supporting role in the independent film Without Evidence (1995), Jolie starred as Kate “Acid Burn” Libby in her first Hollywood picture, Hackers (1995). The New York Times wrote, “Kate (Angelina Jolie) stands out. That’s because she scowls even more sourly than [her co-stars] and is that rare female hacker who sits intently at her keyboard in a see-through top. Despite her sullen posturing, which is all this role requires, Ms. Jolie has the sweetly cherubic looks of her father, Jon Voight. The movie failed to make a profit at the box office, but developed a cult following after its video release.

She next appeared in the 1996 comedy Love Is All There Is, a modern-day loose adaptation of Romeo and Juliet set among two rival Italian family restaurant owners in The Bronx, New York. In the road movie Mojave Moon (1996) she played a young woman who falls for Danny Aiello’s middle-aged character, while he develops feelings for her mother, played by Anne Archer. That same year, Jolie also portrayed Margret “Legs” Sadovsky, one of five teenage girls who form an unlikely bond in the film Foxfire after they beat up a teacher who has sexually harassed them. The Los Angeles Times wrote about her performance, “It took a lot of hogwash to develop this character, but Jolie, Jon Voight’s knockout daughter, has the presence to overcome the stereotype. Though the story is narrated by Maddy, Legs is the subject and the catalyst.

In 1997, Jolie starred with David Duchovny in the thriller Playing God, set in the Los Angeles underworld. The movie was not well received by critics; Roger Ebert noted that “Angelina Jolie […] finds a certain warmth in a kind of role that is usually hard and aggressive; she seems too nice to be Blossom’s girlfriend, and maybe she is. She then appeared in the television film True Women (1997), a historical romantic drama set in the American West and based on the book by Janice Woods Windle. That year, she also appeared as a stripper in the music video for “Anybody Seen My Baby?” by the Rolling Stones.

Breakthrough: 1998–2000

Jolie’s career prospects began to improve after she won a Golden Globe Award for her performance in TNT’s George Wallace (1997). She portrayed Cornelia Wallace, the second wife of Alabama Governor George Wallace, played by Gary Sinise. The film was very well received by critics and won, among other awards, the Golden Globe Award for Best Miniseries or Television Film. Jolie also received an Emmy Award nomination for her performance.

In 1998, Jolie starred in HBO’s Gia, portraying supermodel Gia Carangi. The film chronicled the destruction of Carangi’s life and career as a result of her addiction to heroin, and her decline and death from AIDS in the mid-1980s. Vanessa Vance from Reel.com noted, “Angelina Jolie gained wide recognition for her role as the titular Gia, and it’s easy to see why. Jolie is fierce in her portrayal—filling the part with nerve, charm, and desperation—and her role in this film is quite possibly the most beautiful train wreck ever filmed. For the second consecutive year, Jolie won a Golden Globe Award and was nominated for an Emmy Award. She also won her first Screen Actors Guild Award.

In accordance with Lee Strasberg’s method acting, Jolie preferred to stay in character in between scenes during many of her early films, and as a result had gained a reputation for being difficult to deal with. While shooting Gia, she told her then-husband Jonny Lee Miller that she would not be able to phone him: “I’d tell him: ‘I’m alone; I’m dying; I’m gay; I’m not going to see you for weeks. After Gia wrapped in 1997, Jolie announced that she had given up acting for good, because she felt that she had “nothing else to give. She separated from Miller and moved to New York, where she enrolled at New York University to study filmmaking and attend writing classes; she later described it as “just good for me to collect myself. Encouraged by her Golden Globe Award win for George Wallace and the positive critical reception of Gia, she resumed her career.

Jolie returned to film in the 1998 gangster movie Hell’s Kitchen. Later that year, she appeared in Playing by Heart, part of an ensemble cast that included Sean Connery, Gillian Anderson, Ryan Phillippe, and Jon Stewart. The film received predominantly positive reviews, and Jolie was praised in particular. The San Francisco Chronicle wrote, “Jolie, working through an overwritten part, is a sensation as the desperate club crawler learning truths about what she’s willing to gamble.” Jolie won the Breakthrough Performance Award from the National Board of Review of Motion Pictures.

In 1999, she starred in the comedy-drama Pushing Tin, alongside John Cusack, Billy Bob Thornton, and Cate Blanchett. The film received a mixed reception from critics, and Jolie’s character—Thornton’s seductive wife—was particularly criticized. The Washington Post wrote, “Mary (Angelina Jolie) [is] a completely ludicrous writer’s creation of a free-spirited woman who weeps over hibiscus plants that die, wears lots of turquoise rings and gets real lonely when Russell spends entire nights away from home. She then co-starred with Denzel Washington in The Bone Collector (1999), an adaptation of a crime novel by Jeffery Deaver. Jolie played a police officer haunted by her cop father’s suicide, who reluctantly helps Washington track down a serial killer. The movie grossed $151 million worldwide,[9] but was a critical failure. The Detroit Free Press concluded, “Jolie, while always delicious to look at, is simply and woefully miscast.

“Jolie is emerging as one of the great wild spirits of current movies, a loose cannon who somehow has deadly aim.”

—Roger Ebert on Jolie’s performance in Girl, Interrupted (1999)

Jolie next took the supporting role of the sociopathic mental patient Lisa Rowe in Girl, Interrupted (1999), an adaptation of author Susanna Kaysen’s memoir of the same name. While Winona Ryder played the main character in what was hoped to be a comeback for her, the film instead marked Jolie’s final breakthrough in Hollywood. She won her third Golden Globe Award, her second Screen Actors Guild Award, and an Academy Award for Best Supporting Actress. Variety noted, “Jolie is excellent as the flamboyant, irresponsible girl who turns out to be far more instrumental than the doctors in Susanna’s rehabilitation.

In 2000, Jolie appeared in her first summer blockbuster, Gone In 60 Seconds, in which she played Sarah “Sway” Wayland, the ex-girlfriend of car thief Nicolas Cage. The role was small, and The Washington Post criticized that “all she does in this movie is stand around, cooling down, modeling those fleshy, pulsating muscle-tubes that nest so provocatively around her teeth. She later explained that the film had been a welcome relief after the emotionally heavy role of Lisa Rowe. It became her highest-grossing movie to that point, earning $237 million internationally.

International Success: 2001–2005

Although highly regarded for her acting abilities, Jolie’s films to date had often not appealed to a wide audience, but Lara Croft: Tomb Raider (2001) made her an international superstar. An adaptation of the popular Tomb Raider videogame, Jolie was required to learn an English accent and undergo extensive martial arts training to play the title role of Lara Croft. She was generally praised for her physical performance, but the movie generated mostly negative reviews. Slant commented, “Angelina Jolie was born to play Lara Croft but [director] Simon West makes her journey into a game of Frogger. The movie was an international success nonetheless, earning $275 million worldwide, and launched her global reputation as a female action star.

Jolie at the Cologne premiere of Alexander in 2004

Jolie then starred opposite Antonio Banderas as his mail-order bride in Original Sin (2001), a thriller based on the novel Waltz into Darkness by Cornell Woolrich. The film was a major critical failure, with The New York Times noting, “The story plunges more precipitously than Ms. Jolie’s neckline. In 2002, she starred in Life or Something Like It as an ambitious television reporter who is told that she will die in a week. The film was poorly received by critics, though Jolie’s performance received positive reviews. CNN’s Paul Clinton wrote, “Jolie is excellent in her role. Despite some of the ludicrous plot points in the middle of the film, this Academy Award-winning actress is exceedingly believable in her journey towards self-discovery and the true meaning of fulfilling life.

Jolie reprised her role as Lara Croft in Lara Croft Tomb Raider: The Cradle of Life (2003), which established her among Hollywood’s highest-paid actresses.[8] The sequel was not as lucrative as the original, earning $156 million at the international box office.[9] She appeared in the music video for Korn’s “Did My Time”, which was used to promote the film. She next starred in Beyond Borders (2003), as a socialite who joins aid workers in Africa and Asia. The film reflected Jolie’s real-life interest in promoting humanitarian relief, but it was critically and financially unsuccessful. The Los Angeles Times wrote, “Jolie, as she did in her Oscar-winning role in Girl, Interrupted, can bring electricity and believability to roles that have a reality she can understand. She can also, witness the Lara Croft films, do acknowledged cartoons. But the limbo of a hybrid character, a badly written cardboard person in a fly-infested, blood-and-guts world, completely defeats her.

In 2004, Jolie starred alongside Ethan Hawke in the thriller Taking Lives. She portrayed an FBI profiler summoned to help Montreal law enforcement hunt down a serial killer. The movie received mixed reviews and The Hollywood Reporter concluded, “Angelina Jolie plays a role that definitely feels like something she has already done, but she does add an unmistakable dash of excitement and glamour. She also provided the voice of the angelfish Lola in the DreamWorks animated movie Shark Tale (2004), and had a brief appearance in Sky Captain and the World of Tomorrow (2004), a science fiction adventure film shot entirely with actors in front of a bluescreen. That same year, Jolie played Olympias in Alexander, about the life of Alexander the Great. The film failed domestically, which director Oliver Stone attributed to disapproval of the depiction of Alexander’s bisexuality, but it succeeded internationally, with revenue of $139 million outside the United States.

Continued Success: 2005–2011

Jolie then starred opposite Brad Pitt in the 2005 action-comedy Mr. & Mrs. Smith, which tells the story of a bored married couple, John and Jane Smith, who find out that they are both secret assassins. The film received mixed reviews, but was generally lauded for the chemistry between the two leads. The Star Tribune noted, “While the story feels haphazard, the movie gets by on gregarious charm, galloping energy and the stars’ thermonuclear screen chemistry. The movie earned $478 million worldwide, making it the seventh-highest grossing film of 2005.

Jolie as Christine Collins on the set of Changeling in 2007
Jolie as Christine Collins on the set of Changeling in 2007

Jolie next appeared in Robert De Niro’s The Good Shepherd (2006), a film about the early history of the CIA, as seen through the eyes of Edward Wilson, an officer based on James Jesus Angleton and played by Matt Damon. Jolie played the supporting role of Margaret “Clover” Russell, Wilson’s neglected wife. According to the Chicago Tribune, “Jolie ages convincingly throughout, and is blithely unconcerned with how her brittle character is coming off in terms of audience sympathy.

In 2007, Jolie made her directorial debut with the documentary A Place in Time, which captures daily life in 27 locations around the world during a single week. The film was screened at the Tribeca Film Festival and was intended for distribution to high schools through the National Education Association. Jolie then starred as Mariane Pearl in the documentary-style drama A Mighty Heart (2007). Based on Pearl’s memoir of the same name, the film chronicles the kidnapping and murder of her husband, The Wall Street Journal reporter Daniel Pearl, in Pakistan. The Hollywood Reporter described Jolie’s performance as “well-measured and moving,” played “with respect and a firm grasp on a difficult accent. Jolie was nominated for a Golden Globe Award and a Screen Actors Guild Award for her performance. She also played Grendel’s mother in the animated epic Beowulf (2007), which was created through the motion capture technique.

Jolie co-starred alongside James McAvoy and Morgan Freeman in the 2008 action movie Wanted, an adaptation of Mark Millar’s graphic novel of the same name. The film received predominately favorable reviews and proved an international success, earning $342 million worldwide.[9] She also provided the voice of Master Tigress in the DreamWorks animated movie Kung Fu Panda (2008). With revenue of $632 million internationally, it became the third-highest grossing film of 2008. That same year, Jolie took on the lead role in Clint Eastwood’s drama Changeling. Based in part on the Wineville Chicken Coop Murders, the film stars Jolie as Christine Collins, who is reunited with her kidnapped son in 1928 Los Angeles—only to realize the boy is an impostor. The Chicago Tribune noted, “Jolie really shines in the calm before the storm, the scenes […] when one patronizing male authority figure after another belittles her at their peril.”[53] Jolie received nominations for an Academy Award, a Golden Globe Award, a Screen Actors Guild Award, and a BAFTA Award.

Jolie on the Salt panel at the San Diego Comic-Con in 2010
Jolie on the Salt panel at the San Diego Comic-Con in 2010

Jolie next starred in the 2010 thriller Salt, her first film in two years. She starred alongside Liev Schreiber as CIA agent Evelyn Salt, who goes on the run after she is accused of being a KGB sleeper agent. Originally written as a male character, Salt underwent a gender change after a Columbia Pictures executive suggested Jolie for the role to director Phillip Noyce. The film was an international success with revenues of $294 million. It received mixed to positive reviews, with Jolie’s performance earning praise; Empire remarked, “When it comes to selling incredible, crazy, death-defying antics, Jolie has few peers in the action business.

She also starred opposite Johnny Depp in The Tourist (2010), which was a major critical failure. Peter Travers wrote, “Depp and Jolie hit career lows, producing the chemistry of high-fashion zombies. Roger Ebert defended Jolie, stating she “does her darndest” and “plays her femme fatale with flat-out, drop-dead sexuality. Despite the general criticism, after a slow start at the domestic box office, the film went on to gross a respectable $278 million worldwide. Jolie received a controversial Golden Globe Award nomination for her performance, which gave rise to speculation that it had been given merely to ensure her high-profile presence at the awards ceremony.

2011–Present

In 2011, Jolie reprised her voice role as Master Tigress in the animated DreamWorks sequel Kung Fu Panda 2. It became the fourth-highest grossing film of 2011 and Jolie’s highest grossing film to date, earning $666 million at the international box office. She also made her directorial feature debut with In the Land of Blood and Honey (2011), a love story between a Serb soldier and a Bosniak prisoner of war, set during the 1992–95 Bosnian War. Jolie, who had twice visited Bosnia and Herzegovina in her capacity as a UNHCR Goodwill Ambassador, explained that she made the film to rekindle attention for the survivors of a war that took place in recent history.[60] The film, which Jolie also scripted and co-produced, aroused both praise and criticism in the Balkans; the response from Bosniak war-victims advocacy organizations was “overwhelmingly positive,”[61] while a Serb war prisoners group decried the film for its alleged anti-Serb bias.[62] Sarajevo’s regional government named Jolie an honorary citizen of the capital for raising awareness of the war.[63] In the Land of Blood and Honey won the Stanley Kramer Award from the Producers Guild of America, which honors films that highlight provocative social issues. It also received a nomination for a Golden Globe Award for Best Foreign Language Film.

Jolie will play the Disney villain Maleficent in the upcoming film of the same name, where the character’s background story will be revealed.

In February 2013, it was announced that Jolie will be teaming up with the Coen brothers to tell the story of World War II hero Louis Zamperini. The brothers are set to rewrite Unbroken, the adaptation of the 2010 book by Laura Hillenbrand. Jolie is set to direct the film.

Humanitarian Work

Jolie stated that she first became personally aware of worldwide humanitarian crises while filming Lara Croft: Tomb Raider (2001) in Cambodia. She contacted the United Nations High Commissioner for Refugees (UNHCR) for information on international trouble spots. To learn more about the conditions in these areas, Jolie began visiting refugee camps around the world. In February 2001, she went on her first field visit, an 18-day mission to Sierra Leone and Tanzania; she later expressed her shock at what she had witnessed. In the following months, she returned to Cambodia for two weeks and met with Afghan refugees in Pakistan.[69][70] She covered all costs related to her missions and shared the same rudimentary working and living conditions as UNHCR field staff on all of her visits Jolie was named a UNHCR Goodwill Ambassador at UNHCR headquarters in Geneva on August 27, 2001.

“We cannot close ourselves off to information and ignore the fact that millions of people are out there suffering. I honestly want to help. I don’t believe I feel differently from other people. I think we all want justice and equality, a chance for a life with meaning. All of us would like to believe that if we were in a bad situation someone would help us.”

—Jolie on her motives for joining UNHCR in 2001

Since then, Jolie has been on field missions around the world and met with refugees and internally displaced persons in more than 30 countries.Asked what she hoped to accomplish, she stated, “Awareness of the plight of these people. I think they should be commended for what they have survived, not looked down upon. Jolie aims to visit what she terms “forgotten emergencies,” crises that media attention has shifted away from. She is noted for not shying away from traveling to areas that are at war: She visited the Darfur region of Sudan during the Darfur conflict in 2004; Pakistan with Brad Pitt to see the impact of the 2005 Kashmir earthquake in 2005; Chad during its civil war in 2007; Iraq during the Second Gulf War in 2007 and 2009; Afghanistan during the ongoing war in 2008 and 2011;  and Libya during the Libyan revolution in 2011.

After more than a decade of service as Goodwill Ambassador, Jolie was promoted to the rank of Special Envoy of High Commissioner António Guterres on April 17, 2012. As Special Envoy, she represents the UNHCR and High Commissioner António Guterres at the diplomatic level and works to facilitate long-term solutions for people displaced by large-scale crises, such as Afghanistan and Somalia. “This is an exceptional position reflecting an exceptional role she has played for us,” said a UNHCR spokesman.

Secretary of State Condoleezza Rice and Jolie at World Refugee Day in 2005
Secretary of State Condoleezza Rice and Jolie at World Refugee Day in 2005

In addition to her work with the UNHCR, Jolie uses her public profile to promote humanitarian causes through the mass media. Her early field visits were chronicled in her book Notes from My Travels, which was published in conjunction with the release of her film Beyond Borders (2003). She filmed a 2005 MTV special, The Diary of Angelina Jolie & Dr. Jeffrey Sachs in Africa, portraying her and noted economist Dr. Jeffrey Sachs on a trip to a remote group of villages in Western Kenya. Jolie has also regularly released public service announcements promoting World Refugee Day and other causes.

Over time, Jolie became more involved in promoting humanitarian causes on a political level. She has regularly attended World Refugee Day in Washington, D.C., and she was an invited speaker at the World Economic Forum in Davos in 2005 and 2006. She also began lobbying humanitarian interests in the U.S. capital, where she met with members of Congress at least 20 times between 2003 and 2006, during which she pushed for several bills to aid refugees and vulnerable children in the Third World and the United States. She explained in 2006, “As much as I would love to never have to visit Washington, that’s the way to move the ball.”[71] In 2007, she became a member of the Council on Foreign Relations.

Jolie has established several charitable organizations. In 2003, she founded the Maddox Jolie-Pitt Foundation—named the Maddox Jolie Project until 2007—which is dedicated to community development and environmental conservation in Cambodia’s northwestern province Battambang. In 2006, she partnered with the Global Health Committee to establish the Maddox Chivan Children’s Center, a daycare facility for children afflicted and affected by HIV in the Cambodian capital Phnom Penh. That same year, she and her partner Brad Pitt founded the Jolie-Pitt Foundation, to aid humanitarian causes worldwide. In 2007, Jolie and noted economist Dr. Gene Sperling founded the Education Partnership for Children of Conflict, which funds education programs for children affected by man-made or natural disasters. In 2008, she collaborated with the Microsoft Corporation to establish Kids in Need of Defense, a pro bono movement of law firms, corporate law departments, NGOs and volunteers committed to providing legal counsel to unaccompanied immigrant children in the U.S. In 2010, she established the Jolie Legal Fellows Programme, which recruits lawyers to support governmental child protection efforts in Haiti.

Jolie has received wide recognition for her humanitarian work. In 2002, she received the inaugural Humanitarian Award by the Church World Service’s Immigration and Refugee Program. In 2003, she was the first recipient of the Citizen of the World Award by the United Nations Correspondents Association. In 2005, she was awarded the Global Humanitarian Award by the UNA-USA.On July 31, 2005, King Norodom Sihamoni awarded Jolie Cambodian citizenship for her conservation work in the country. In 2007, Jolie received the Freedom Award by the International Rescue Committee.[93] In 2011, United Nations High Commissioner for Refugees António Guterres presented Jolie with a gold pin reserved for the most long-serving staff, in recognition of her decade as a UNHCR Goodwill Ambassador.

Personal life

Relationships

Jolie had a serious boyfriend for two years from the age of 14. Her mother allowed them to live together in her home, of which Jolie later said, “I was either going to be reckless on the streets with my boyfriend or he was going to be with me in my bedroom with my mom in the next room. She made the choice, and because of it, I continued to go to school every morning and explored my first relationship in a safe way. She has compared the relationship to a marriage in its emotional intensity, and said that the breakup compelled her to dedicate herself to her acting career at the age of 16.

During filming of Hackers (1995), Jolie had a romance with British actor Jonny Lee Miller, her first lover since the relationship in her early teens. They were not in touch for many months after production ended, but eventually reconnected and married soon after on March 28, 1996. She attended her wedding in black rubber pants and a white T-shirt, upon which she had written the groom’s name in her blood. Jolie and Miller separated in September 1997 and divorced on February 3, 1999. They remained on good terms, and Jolie later explained, “It comes down to timing. I think he’s the greatest husband a girl could ask for. I’ll always love him, we were simply too young.

Jolie and her partner Brad Pitt at the Deauville premiere of The Assassination of Jesse James in 2007
Jolie and her partner Brad Pitt at the Deauville premiere of The Assassination of Jesse James in 2007

Jolie had a brief relationship with model-actress Jenny Shimizu on the set of Foxfire (1996). She later said, “I would probably have married Jenny if I hadn’t married my husband. I fell in love with her the first second I saw her. Shimizu claimed in 2005 that her relationship with Jolie had lasted many years and continued even while Jolie was romantically involved with other people. In 2003, asked if she was bisexual, Jolie responded, “Of course. If I fell in love with a woman tomorrow, would I feel that it’s okay to want to kiss and touch her? If I fell in love with her? Absolutely! Yes!

After a two-month courtship, Jolie married actor Billy Bob Thornton on May 5, 2000, in Las Vegas. They met on the set of Pushing Tin (1999), but did not pursue a relationship at that time as Thornton was engaged to actress Laura Dern. As a result of their frequent public declarations of passion and gestures of love—most famously wearing one another’s blood in vials around their necks—their marriage became a favorite topic of the entertainment media.[103] Jolie and Thornton announced the adoption of a son from Cambodia in March 2002, but abruptly separated three months later. Their divorce was finalized on May 27, 2003. Asked about the sudden dissolution of their marriage, Jolie stated, “It took me by surprise, too, because overnight, we totally changed. I think one day we had just nothing in common. And it’s scary but… I think it can happen when you get involved and you don’t know yourself yet.

In early 2005, Jolie was involved in a well-publicized Hollywood scandal when she was accused of being the reason for the divorce of actors Brad Pitt and Jennifer Aniston. She and Pitt were alleged to have started an affair during filming of Mr. & Mrs. Smith (2005). She denied this on several occasions, but later admitted that they “fell in love” on the set. She explained in 2005, “To be intimate with a married man, when my own father cheated on my mother, is not something I could forgive. I could not look at myself in the morning if I did that. I wouldn’t be attracted to a man who would cheat on his wife. Jolie and Pitt did not publicly comment on the nature of their relationship until January 2006, when Jolie confirmed to People that she was pregnant with Pitt’s child.[106] Pitt and Jolie announced their engagement in April 2012, after seven years together. The couple—dubbed “Brangelina” by the entertainment media—are the subject of worldwide media coverage.

Children

On March 10, 2002, Jolie adopted her first child, seven-month-old Maddox Chivan, from an orphanage in Phnom Penh, Cambodia. He was born as Rath Vibol on August 5, 2001, in a local village. Jolie applied for adoption after she had visited Cambodia twice, while filming Lara Croft: Tomb Raider (2001) and on a UNHCR field mission. The adoption process was halted in December 2001 when the U.S. government banned adoptions from Cambodia amid allegations of child trafficking. Once the adoption was finalized, she took custody of Maddox in Namibia, where she was filming Beyond Borders (2003). Although Jolie and her then-husband Billy Bob Thornton announced the adoption together, she in fact adopted Maddox as a single parent.

Jolie adopted a daughter, six-month-old Zahara Marley, from an orphanage in Addis Ababa, Ethiopia, on July 6, 2005. Zahara was born as Yemsrach on January 8, 2005, in Awasa. At the time of the adoption, Zahara was wrongly believed to be an AIDS orphan and it was unknown whether she herself had contracted HIV, but she later tested negative. Shortly after they returned to the United States, Zahara was hospitalized for dehydration and malnutrition.[115] In November 2007, media outlets reported that Zahara’s biological mother wanted her daughter back, but she denied these reports, saying she thought Zahara was “very fortunate” to have been adopted by Jolie.

A pregnant Jolie with director Clint Eastwood at the Cannes premiere of Changeling in 2008
A pregnant Jolie with director Clint Eastwood at the Cannes premiere of Changeling in 2008

Jolie was accompanied by her partner Brad Pitt when she traveled to Ethiopia to take custody of Zahara. She later indicated that she and Pitt had made the decision to adopt from Ethiopia together. In December 2005, Pitt’s publicist announced that Pitt was seeking to adopt Maddox and Zahara. To reflect this, Jolie filed a request to legally change her children’s surnames from Jolie to Jolie-Pitt, which was granted on January 19, 2006. The adoptions were finalized soon after.

In an attempt to avoid the media frenzy surrounding their relationship, Jolie and Pitt went to Namibia for the birth of their first biological child. On May 27, 2006, Jolie gave birth to a daughter, Shiloh Nouvel, in Swakopmund. Pitt confirmed that their newborn daughter would have a Namibian passport. The couple decided to sell the first pictures of Shiloh through the distributor Getty Images themselves, rather than allowing paparazzi to make these valuable photographs. People paid a reported $4.1 million for the North American rights, while Hello! obtained the British rights for a reported $3.5 million.[122] All profits were donated to charities serving African children.

On March 15, 2007, Jolie adopted a son, three-year-old Pax Thien, from an orphanage in Ho Chi Minh City (HCMC), Vietnam. He was born as Pham Quang Sang on November 29, 2003, in HCMC, where he was abandoned soon after birth.[124] Jolie adopted Pax as a single parent, because Vietnam’s adoption regulations do not allow unmarried couples to co-adopt. The rights for the first post-adoption images of Pax were sold to People for a reported $2 million, as well as to Hello! for an undisclosed amount. In April, Jolie filed a request to legally change her son’s surname from Jolie to Jolie-Pitt, which was approved on May 31, 2007. Pitt’s adoption of Pax was finalized in the United States on February 21, 2008.

At the Cannes Film Festival in May 2008, Jolie confirmed that she was expecting twins. For the two weeks she spent in a seaside hospital in Nice, France, reporters and photographers camped outside on the promenade. She gave birth to a son, Knox Léon, and a daughter, Vivienne Marcheline, on July 12, 2008. The rights for the first images of Knox and Vivienne were jointly sold to People and Hello! for a reported $14 million—the most expensive celebrity pictures ever taken. The proceeds were donated to the Jolie-Pitt Foundation.

Cancer Prevention Treatment

On February 16, 2013, at the age of 37, Jolie underwent a preventive double mastectomy after learning she had an 87% risk of developing breast cancer due to a defective BRCA1 gene. Her family history warranted genetic testing for BRCA mutations: her mother, actress Marcheline Bertrand, had breast cancer and died from ovarian cancer at the age of 56, while her maternal grandmother had ovarian cancer and died aged 45. Her maternal aunt Debbie Martin, who had the same defective BRCA1 gene as Jolie, was diagnosed with breast cancer in 2004 and died at age 61 on May 26, 2013. Jolie’s mastectomy lowered her chances of developing breast cancer to under 5 percent, and testing of the removed breast tissue showed no signs of cancerous cells. On April 27, Jolie had reconstructive surgery involving implants and allografts. She reportedly intends to undergo a preventive oophorectomy, as she still has a 50% risk of developing ovarian cancer due to the same genetic anomaly.

Jolie kept news of her mastectomy private until she had completed the three-month process. On May 14, The New York Times published an op-ed titled “My Medical Choice” in which Jolie wrote about her decision and procedures, with the aim of helping other women make informed health choices. To that end, her treatment regimen was posted on the website of the Pink Lotus Breast Center, where she was treated. In her piece—published concurrently with U.S. Supreme Court deliberations on BRCA gene patent rights held by Myriad Genetics—Jolie acknowledged the largely prohibitive cost of BRCA gene testing and advocated wider accessibility. On June 13, 2013 the U.S. Supreme Court ruled that isolated genes are not patentable, invalidating the BRCA gene patents held by Myriad Genetics.

A Patient’s Journey: Angelina Jolie

In an article in the New York Times today, My Medical Choice, Angelina Jolie promised to share some background about her medical treatment with women seeking more information about BRCA gene mutations and what it might mean for them.

This blog describes the main stages of her treatment. It is important to emphasize that each woman’s case is different. Surgery will not necessarily be the right choice for everyone, and there are alternatives available. As Angelina says in her article, the important thing is to be aware of your options.

STAGE 1. Gathering Data and Information

  • BRCA stands for BReast CAncer.  BRCA genes help you fight cancer when it happens in your body. But some families carry mutated or broken BRCA genes that can be passed down from one generation to the next. Approximately 5-10% of all breast cancers and 14% of ovarian cancers occur from a BRCA1 or BRCA2 genetic mutation that is inherited from either parent.
  • Women carrying BRCA1 or BRCA2 gene mutations have up to an 87% lifetime chance of breast cancer and 54% chance of ovarian cancer vs. a general population risk of 12% for breast cancer and less than 1% for ovarian cancer. Prevention does not yet exist. More details about the risks of breast and ovarian cancer, including how risk changes with each decade of life, can be found in our BRCA Gene Mutations blog post.
  • Given the high likelihood of getting breast or ovarian cancer with BRCA mutations, family history usually triggers testing for the gene. Angelina’s mother had breast cancer, and sadly passed away from ovarian cancer.  Her maternal grandmother was also diagnosed with ovarian cancer. This family history would certainly meet any insurance carrier’s criteria to cover genetic testing. To find out if there is enough risk for you to consider a BRCA mutation genetic test, we encourage you to take our Genetics Quiz that reviews a variety of information, including your family history.

STAGE 2. After diagnosis: Traveling the Road of Surveillance

We follow a standard surveillance plan at our center for BRCA mutation carriers, which I used for Angelina:

Beginning at age 18, or 10 years younger than the youngest relative with breast cancer, every 3 months, you have breast imaging or an exam. An example plan follows:

  • Month 1: Mammogram (wait until 25 years old)Whole breast screening ultrasound (begin at 18)
  • Month 4: Clinical breast exam with a breast specialist
  • Month 7: Breast MRI, timed to menstrual cycle days 7-10 (day 1 is the day bleeding starts); Contrast Enhanced Spectral Mammography (CESM) for those who cannot have an MRI
  • Month 10: Clinical breast exam with a breast specialist
  • Every month: Self breast exams (cycle days 7-10). If you don’t know how to do a self breast exam, please watch our how-to video.

For those who prefer twice-a-year surveillance, we combine the imaging with clinical breast exams, and meet every 6 months.

Ovarian surveillance begins at age 35, or 10 years prior to youngest relative with ovarian cancer, and includes the following:

  • Transvaginal Pelvic ultrasound every 6 months (cycle days 1-10)
  • CA-125 blood marker testing every 6 months (after cycle day 5)
  • Pelvic exam by gynecologist every 6 months

For additional screening details, including risk reduction strategies and holistic and integrative medicine, see our blog on BRCA Gene Mutations.

STAGE 3. Committing to an operation

When first meeting a woman newly diagnosed with a BRCA mutation, my immediate goal is to learn about her, including her family situation, whether she is in a stable relationship, and whether she is planning to have children. In the course of these discussions, it becomes clear whether the patient will proceed to a mastectomy.

STAGE 4. Preparing for the operations

The questions any patient needs to address at this stage include: (1) whether or not to preserve the nipples, (2) if so, whether or not to perform a “nipple delay” procedure, (3) where to place the incision, (4) whether or not to test sentinel nodes, (5) what kind of reconstruction will be done, (6) what supplements might enhance healing and recovery, and finally (7) where should we operate.

NIPPLE: Women undergoing preventive mastectomies can always consider keeping their nipples. While no one can guarantee that the nipples will survive an operation, much can be done to ensure the greatest chance of success.

NIPPLE DELAY: The delay, performed 1-2 weeks prior to the actual mastectomies, uses the planned mastectomy incision and lifts half of the skin off of the breast surface. A small disc of the tissue directly behind the nipple and areola is also removed and analyzed by a pathologist. This is done to rule out the presence of any disease directly behind the nipples, which would make preserving them a dangerous proposition. Additionally, it recruits extra blood flow to the area, lessening the chances of nipple and skin loss due to insufficient blood supply after the mastectomy. Since starting this technique in 2008, my loss of skin and nipple after mastectomy has decreased to less than 2%. In Angelina’s case, she judged it worth taking this extra step of caution.

INCISION: Incision locations must take into consideration a cancer location (if cancer is present), any prior incisions, breast size reduction (if desired), and the technical skill of the surgeon (smaller incisions make for a harder and longer operation). For Angelina, her optimal incision choices were around the areola, or underneath the breast in the inframammary fold – the latter was chosen.

SENTINEL NODE BIOPSY/PBDI: Whenever a breast contains cancer and the armpit lymph nodes cannot be felt on exam, we routinely perform a sentinel node biopsy, which is the removal of the first nodes that receive breast lymphatic drainage. By injecting blue dye into the breast, which then travels to the lymph node(s), we find out if cancer spread beyond the breast. Until now, the trend has been not to perform sentinel node biopsies in conjunction with prophylactic (preventive) mastectomies since the discovery of cancer in breasts removed prophylactically only ranges from 2-8%. Therefore, most women do not want to take the additional risks associated with a sentinel node biopsy, especially since they can have complications, such as pain, numbness, arm swelling (lymphedema), fluid buildup (seroma), limited arm movement, and infection. This dilemma has been resolved with a new technique that was pioneered at the Pink Lotus Breast Center, called Prophylactic Breast Dye Injection, or PBDI. PBDI allows the sentinel node to be identified, but not surgically removed, giving more control and peace of mind to women. I developed this technique while treating Angelina, and I hope other women will now benefit from it. It was at her friendly insistence that I wrote the rationale for it in our blog post, Prophylactic Breast Dye Injection.

RECONSTRUCTION: Reconstruction options vary depending on a number of factors.  The two broad categories of reconstruction include implants and flaps. Implants are the most common reconstruction, often requiring two stages, whereby a tissue expander is placed prior to the final implant. A tissue expander is a deflated implant that goes behind the pectoral muscles and gets slowly inflated with saline over a period of 2-3 months, until the chosen volume is reached. A second operation is performed to swap the expander for the final implant (usually silicone). A different implant option can be a “one-step” operation, where the final implant is placed at the time of mastectomy, skipping the expander phase.

Two improvements which I believe can enhance the final outcome for those patients choosing implants include: (1) the newly FDA-approved anatomic implants, which are teardrop shaped, and (2) allograft, or synthetic sheets of material, that create a more natural look.

Autologous flaps use your own skin, fat and sometimes muscle from the abdomen, back (latissimus), thigh (gracilis), or buttock to create a potentially more natural breast reconstruction than implants can achieve. Flaps, however, create scars at the donor site, potential weakness in the donor area, and involve a longer operation than implants, with longer recovery periods and associated hospital stays.

Angelina’s body type was best suited to an implant reconstruction with allograft.  Although tissue expanders required an additional operation, she preferred to use them.  Expanders maximize blood flow to the breast skin and nipple (because they are not fully expanded right after placement, they do not compress the tiny blood vessels in the skin), and they allow us to optimize the final implant size, location and appearance.

SUPPLEMENTS AND PREP: To prepare for and to recover from operations, patients can use a variety of supplements.  Angelina followed the regimen below, written onto a calendar:

To enhance wound healing (for each operation):

A) Vitamin C: 1000mg tablets; one tablet once daily for one week before and one week after surgery.

B) Multi-Vitamin: one tablet once daily for one week before and one week after surgery.

C) Zinc: 50 mg; one tablet once daily for one week before and one week after surgery.

To reduce the risk of infection (operations 2 and 3):

D) Bactroban ointment: Applied twice a day beginning 3 days prior to surgery x 7 days.

E) Hibiclens shower: Hibiclens soap applied to upper torso and abdomen – left on for 5 minutes, then rinsed. Applied once a day for 3 days prior to surgery.

F) Keflex: 250mg (antibiotic); one tablet 4x a day for 7 days, beginning with 2 doses the day of the operation.

To reduce postoperative nausea and vomiting (for each operation):

G) Emend: 40mg; one tablet by mouth the night before surgery

To reduce postoperative swelling and bruising (for each operation):

H) Arnica Forte (Arnica and Bromelain): two capsules daily x 7 days, beginning one day prior to surgery.

To help eliminate anesthesia from the system (for each operation):

I) Exchem: 10 drops in water or directly in the mouth twice daily, beginning the day before surgery and continuing for one week after surgery.

J) Lymphomyosot: 10 drops in water or directly in the mouth twice daily, beginning the day before surgery and continuing for one week after surgery.

To increase oxygen to the skin (operations 1 and 2):

K) Cutagenix: Applied to breast every 6 hours x 3 days. Skin care specialists use this topical cream after laser resurfacing to increase oxygen flow to the outer layers of skin. We decided in Angelina’s case to apply it to the mastectomy skin to give it an oxygen boost and to help ensure adequate blood flow to her skin postoperatively.

To minimize scarring (after operation 3):

L) BioCorneum: Rubbed into scars twice a day for 12 weeks – begin after the third operation once steri strips are removed.

Medications “as needed” for comfort:

Percocet: 1-2 tablets every 4-6 hours as needed for pain

Colace: 250mg twice a day

MiraLax: One tablespoon diluted in 8oz water once a day

Ativan: 1mg every 8 hours as needed for muscle spasm

Zofran: 8mg oral dissolving tablet placed on tongue every 6 hours as needed for nausea

LOCATION: Angelina chose to have her care, including her three operations, performed at the Pink Lotus Breast Center. Some people might think that a hospital is the only place to have a mastectomy.  However, outpatient surgery centers provide an attractive, peaceful alternative when coupled with attentive nursing care at recovery facilities. You can learn more about our comprehensive and integrative breast center by exploring this website.

STAGE 5. Recovering from the operations

On February 2, 2013, Angelina was in the operating room for the first operation, the nipple delay. Her partner was on hand to greet her as soon as she came around from the anesthetic, as he was during each of the operations.

After the operation, her skin was slightly bruised but soon returned to normal.  Two days after her procedure, great news arrived: the tissue behind both nipples came back completely normal.

On February 16 she had the main surgery, which can last up to eight hours.  The mastectomies went smoothly, with sentinel nodes identified but not removed.  After the mastectomies, I assisted plastic surgeon, Dr. Jay Orringer, as we performed the first stage breast reconstruction by placing tissue expanders with allograft.

To a large extent, I believe recovery reflects expectation. Angelina expected to feel well, to be active. On Monday, the pathology returned and I called Angelina to confirm our biggest hope: all of the breast tissue was benign. On day four after her mastectomies, I was pleased to find her not only in good spirits with bountiful energy, but with two walls in her house covered with freshly assembled storyboards for the next project she is directing. All the while she spoke, six drains dangled from her chest, three on each side, fastened to an elastic belt around her waist.

The next day she had her first injection of saline into the expanders, thus beginning the process that would gradually prepare the tissues for the final stage of her operations, reconstruction. Four of the six drains were removed.  Four days after that, on postoperative day nine, the last two drains were removed.  A second saline fill occurred on March 4. Over the next four weeks she was hard at work.

The final operation occurred on April 27, 2013, ten weeks after the mastectomies: reconstruction of the breasts with implant, which went extremely well, bringing an end to her surgical journey.

Angelina Jolie dan Mastektomi

CONCLUSION

Many women unfortunately do not know that BRCA gene mutations exist and could affect them. Breast and ovarian cancers take lives every day – knowledge and action can help prevent the premature loss of those who love us, and whom we deeply love in return.

Like Angelina, I urge women who feel they might have reason to be at risk for a BRCA gene mutation – perhaps because of a strong family history of cancer – to seek medical advice and to take control of their futures.

Jolie’s announcement drew extensive public attention; a Time cover story titled

“The Angelina Effect” observed that Jolie brought “genetic testing in the spotlight,” and noted her ability to influence people on a large scale. Various public figures applauded Jolie for her decision; UK foreign secretary William Hague, who visited refugee camps in Congo-Kinshasa with Jolie in March, called her “an inspiration to many. Most medical experts who weighed in publicly agreed that Jolie made the right choice for herself, but differed in their response to its expected influence on the public. Her decision was met with praise from health campaigners, who welcomed her raising awareness of the options available to those at risk, while other experts feared a widespread overestimation of BRCA mutation occurrence, as less than 1% of all women carry this genetic condition, and a misunderstanding of the risks involved for those who do test positive. Eric Topol, a geneticist and director of the Scripps Translational Science Institute in California, told attendees at a genetics symposium “This is the moment that will propel genomic medicine forward”, saying that Jolie’s announcement was “incredibly important symbolically”.

In the Media

Jolie at the New York premiere of A Mighty Heart in 2007; several of her tattoos are visible
Jolie at the New York premiere of A Mighty Heart in 2007; several of her tattoos are visible

During the first decade of her career, Jolie—who does not employ a publicist or an agent—maintained a “wild child” persona in her communication with the media. She openly discussed her love life, including her bisexuality and her interest in BDSM. After she kissed her brother during the Academy Awards in 2000, their close relationship became the subject of tabloid media speculation, which she dismissed. She spoke about her experiences with drugs and depression, and recalled the time, in 1997, when she almost hired a hitman to kill her, as well as the three days, just before her marriage to Billy Bob Thornton, that she was sectioned at UCLA’s psychiatric ward. By the mid-2000s, Jolie’s involvement with the UNHCR and the adoption of her son Maddox had transformed her public image from Hollywood eccentric into humanitarian and devoted mother.

Jolie has attracted notable media attention for her physical appearance—particularly her full lips and her many tattoos, being her most distinctive features. She has been named the world’s “most beautiful” or “sexiest” woman by various media outlets, including Vogue in 2002, Esquire in 2004, American FHM and British Harper’s Bazaar in 2005, People and Hello! in 2006, Empire in 2007, and Vanity Fair in 2009. People named her one of 2012’s Most Beautiful at Every Age.

Jolie’s extensive collection of tattoos has often been addressed by interviewers. She has fourteen known tattoos, among which the Latin proverb “quod me nutrit me destruit” (what nourishes me destroys me), the Tennessee Williams quote “A prayer for the wild at heart, kept in cages,” two sak yant designs featuring a prayer of protection and a twelve-inch-by-eight-inch tiger, and seven sets of geographical coordinates indicating the birthplaces of her children and her partner Brad Pitt. Over time, she has covered or lasered several of her tattoos, including the name of her second husband, “Billy Bob”, and the Chinese characters “死” (death) and “勇” (courage).

Jolie holds a private pilot license and owns a single-engine Cirrus SR22 aircraft.

Today, Jolie is one of the best-known celebrities around the world. According to the Q Score, in 2000, subsequent to her Oscar win, 31% of respondents in the United States said Jolie was familiar to them; by 2006 she was familiar to 81% of Americans. In a 2006 global industry survey by ACNielsen in 42 international markets, Jolie, together with partner Brad Pitt, was found to be the favorite celebrity endorser for brands and products worldwide. She was the face of St. John and Shiseido from 2006 to 2008, and in 2011 had an endorsement deal with Louis Vuitton reportedly worth $10 million—a record for a single advertising campaign.[158] She was among the Time 100, a list of the most influential people in the world as assembled by Time, in 2006 and 2008. Forbes named her Hollywood’s highest-paid actress in 2009 and 2011, with estimated annual earnings of $27 million and $30 million respectively, and she topped the magazine’s Celebrity 100, a ranking of the world’s most powerful celebrities, in 2009.

Filmography

Angelina Jolie is an American actress, film director and screenwriter. She is an Academy Award winner for the Best Supporting Actress for Girl, Interrupted in 1999. She made her debut with Lookin’ to Get Out in 1982. The following is her complete filmography.

Jolie at the 2007 Cannes Film Festival.
Jolie at the 2007 Cannes Film Festival.

As Actor

Title Year Role Notes
Lookin’ to Get Out 1982 Tosh As Angelina Jolie Voight
Cyborg 2 1993 Casella “Cash” Reese Direct-to-video film
Without Evidence 1995 Jodie Swearingen  
Hackers 1995 Kate “Acid Burn” Libby  
Love Is All There Is 1996 Gina Malacici  
Mojave Moon 1996 Eleanor “Elie” Rigby  
Foxfire 1996 Margret “Legs” Sadovsky  
True Women 1997 Georgia Virginia Lawshe Woods TV film
George Wallace 1997 Cornelia Wallace TV film
Golden Globe Award for Best Supporting Actress – Series, Miniseries or Television Film
Nominated – CableACE Award for Supporting Actress in a Movie or Miniseries
Nominated – Primetime Emmy Award for Outstanding Supporting Actress in a Miniseries or a Movie
Playing God 1997 Claire  
Gia 1998 Gia Carangi TV film
Golden Globe Award for Best Actress – Miniseries or Television Film
Grand Jury Award for Outstanding Actress in a Feature Film
Satellite Award for Best Actress – Miniseries or Television Film
Screen Actors Guild Award for Outstanding Performance by a Female Actor in a Miniseries or Television Movie
Nominated – Primetime Emmy Award for Outstanding Lead Actress in a Miniseries or a Movie
Hell’s Kitchen 1998 Gloria McNeary  
Playing by Heart 1998 Joan National Board of Review of Motion Pictures Award for Breakthrough Performance
Pushing Tin 1999 Mary Bell  
The Bone Collector 1999 Amelia Donaghy  
Girl, Interrupted 1999 Lisa Rowe Academy Award for Best Supporting Actress
Blockbuster Entertainment Award for Best Supporting Actress
Broadcast Film Critics Association Award for Best Supporting Actress
Golden Globe Award for Best Supporting Actress – Motion Picture
San Diego Film Critics Society Award for Best Supporting Actress (2nd place)
Screen Actors Guild Award for Outstanding Performance by a Female Actor in a Supporting Role
Nominated – Chicago Film Critics Association Award for Best Supporting Actress
Nominated – Empire Award for Best Actress
Nominated – Teen Choice Award for Choice Movie Actress Drama
Nominated – Teen Choice Award for Choice Movie Hissy Fit
Gone in 60 Seconds 2000 Sara “Sway” Wayland  
Lara Croft: Tomb Raider 2001 Lara Croft Nominated – MTV Movie Award for Best Female Performance
Nominated – MTV Movie Award for Best Fight
Nominated – Razzie Award for Worst Actress
Nominated – Saturn Award for Best Actress
Nominated – Teen Choice Award for Choice Movie Actress
Original Sin 2001 Julia Russell/Bonny Castle Nominated – Razzie Award for Worst Actress
Life or Something Like It 2002 Lanie Kerrigan
Lara Croft Tomb Raider: The Cradle of Life 2003 Lara Croft
Beyond Borders 2003 Sarah Jordan
Taking Lives 2004 Illeana Scott Nominated – Razzie Award for Worst Actress
Nominated – Teen Choice Award for Choice Movie Scary Scene
Shark Tale 2004 Lola Voice
Sky Captain and the World of Tomorrow 2004 Francesca “Franky” Cook People’s Choice Award for Favorite Female Action Star
Nominated – Saturn Award for Best Supporting Actress
Alexander 2004 Olympias Nominated – Razzie Award for Worst Actress
Mr. & Mrs. Smith 2005 Jane Smith Nominated – People’s Choice Award for Favorite Female Action Star
Nominated – People’s Choice Award for Favorite Female Movie Star
The Good Shepherd 2006 Margaret “Clover” Russell  
A Mighty Heart 2007 Mariane Pearl Santa Barbara International Film Festival Award for Outstanding Performance of the Year
Nominated – Broadcast Film Critics Association Award for Best Actress
Nominated – Chicago Film Critics Association Award for Best Actress
Nominated – Dallas-Fort Worth Film Critics Association Award for Best Actress
Nominated – Empire Award for Best Actress
Nominated – Golden Globe Award for Best Actress – Motion Picture Drama
Nominated – Independent Spirit Award for Best Female Lead
Nominated – London Film Critics Circle Award for Actress of the Year
Nominated – NAACP Image Award for Outstanding Actress – Motion Picture
Nominated – Online Film Critics Society Award for Best Actress
Nominated – Satellite Award for Best Actress – Motion Picture Drama
Nominated – Screen Actors Guild Award for Outstanding Performance by a Female Actor in a Leading Role
Nominated – Teen Choice Award for Choice Movie Actress Drama
Beowulf 2007 Grendel’s mother  
Kung Fu Panda 2008 Master Tigress Voice
Wanted 2008 Fox People’s Choice Award for Favorite Female Action Star
Nominated – MTV Movie Award for Best Female Performance
Nominated – MTV Movie Award for Best WTF Moment
Nominated – National Movie Award for Best Female Performance
Nominated – People’s Choice Award for Favorite Female Movie Star
Changeling 2008 Christine Collins Satellite Award for Best Actress – Motion Picture Drama
Saturn Award for Best Actress
Nominated – Academy Award for Best Actress
Nominated – BAFTA Award for Best Actress in a Leading Role
Nominated – Broadcast Film Critics Association Award for Best Actress
Nominated – Chicago Film Critics Association Award for Best Actress
Nominated – Empire Award for Best Actress
Nominated – Golden Globe Award for Best Actress – Motion Picture Drama
Nominated – Irish Film & Television Award for Best International Actress
Nominated – London Film Critics Circle Award for Actress of the Year
Nominated – Screen Actors Guild Award for Outstanding Performance by a Female Actor in a Leading Role
Nominated – Teen Choice Award for Choice Movie Actress Drama
Salt 2010 Evelyn Salt Rembrandt Award for Best International Actress
Nominated – People’s Choice Award for Favorite Action Star
Nominated – People’s Choice Award for Favorite Female Movie Star
Nominated – Saturn Award for Best Actress
Nominated – Choice Summer Movie Star Female
The Tourist 2010 Elise Clifton-Ward Teen Choice Award for Choice Movie Actress Action
Nominated – Golden Globe Award for Best Actress – Motion Picture Musical or Comedy
Kung Fu Panda 2 2011 Master Tigress Voice
Maleficent Film has yet to be released 2014 Maleficent  

As Director

Director
Title Year Notes
A Place in Time 2007 Documentary
In the Land of Blood and Honey 2011 Cinema for Peace Award for Most Valuable Movie of the Year
NAACP Image Award for Outstanding Foreign Motion Picture
Producers Guild of America Stanley Kramer Award
Sarajevo Film Festival Honorary Award
Nominated – Golden Globe Award for Best Foreign Language Film
Nominated – NAACP Image Award for Outstanding Directing – Motion Picture

Selected Awards

Year Award Category Film Result
1998 Emmy Award Outstanding Supporting Actress – Miniseries or Movie George Wallace Nominated
1998 Golden Globe Award Best Supporting Actress – Series, Miniseries or Television Film George Wallace Won
1998 National Board of Review of Motion Pictures Award Breakthrough Performance Playing by Heart Won
1998 Emmy Award Outstanding Lead Actress – Miniseries or Movie Gia Nominated
1999 Golden Globe Award Best Actress – Miniseries or Television Film Gia Won
1999 Screen Actors Guild Award Outstanding Female Actor – Miniseries or Television Movie Gia Won
2000 Academy Award Best Supporting Actress Girl, Interrupted Won
2000 Golden Globe Award Best Supporting Actress – Motion Picture Girl, Interrupted Won
2000 Screen Actors Guild Award Outstanding Supporting Female Actor Girl, Interrupted Won
2008 Golden Globe Award Best Actress – Motion Picture Drama A Mighty Heart Nominated
2008 Screen Actors Guild Award Outstanding Leading Female Actor A Mighty Heart Nominated
2009 Academy Award Best Actress Changeling Nominated
2009 BAFTA Award Best Leading Actress Changeling Nominated
2009 Golden Globe Award Best Actress – Motion Picture Drama Changeling Nominated
2009 Screen Actors Guild Award Outstanding Leading Female Actor Changeling Nominated
2011 Golden Globe Award Best Actress – Motion Picture Musical or Comedy The Tourist Nominated
2012 Golden Globe Award Best Foreign Film (as producer) In the Land of Blood and Honey Nominated
2012 Producers Guild of America Award Stanley Kramer Award (as producer) In the Land of Blood and Honey Won

Compiled from many sources

Mau Jadi Pengusaha Sukses dan Kaya? Cek Dulu 10 Tips Ini

29 Juni 2013

ask-history-dollar-sign

Setiap pengusaha pasti ingin memperoleh pendapatan hingga jutaan dolar Amerika Serikat (AS), atau miliaran rupiah dalam 5 tahun bisnisnya berjalan. Apa saja tips-tips penting untuk menggapai hal tersebut?

Dikutip dari Sydney Morning Herald, Rabu (22/5/2013), pengusaha asal Australia yaitu Rohan Gamble, Tristan Sternson, dan Paul Wilson telah memulai usaha mereka dari bawah hingga memperoleh pendapatan US$ 1 juta dolar pada 5 tahun pertama bisnisnya berjalan.

Gamble, menginvestasikan seluruh uangnya untuk memulai bisnis Mozo, yang membandingkan suku bunga dan biaya kartu kredit, pinjaman rumah, dan berbagai macam produk finansial.

Bisnis tersebut diluncurkan pada Oktober 2008, di tengah krisis keuangan global yang terjadi, namun sekarang bisnis tersebut menghasilkan omzet US$ 5 juta atau sekitar Rp 47,5 miliar.

Sementara Sternson, sukses lewat perusahaannya yaitu InfoReady yang dibangun sejak 2008. Perusahaan tersebut menawarkan informasi dan konsultasi dengan mempekerjakan 70 pegawai di Melbourne, Brisbane, dan Sydney. Saat ini, perusahaan tersebut telah memiliki omzet US$ 10 juta. Dengan melayani klien besar seperti Telstra dan Energex, InfoReady menargetkan pendapatan US$ 20 juta.

Lalu Wilson, mempunyai perusahaan digital bernama Blocks Global yang dalam 5 bulan mendapatkan pendapatan US$ 2 juta. Dalam 3 tahun, bisnis ini menghasilkan pendapatan US$ 5 juta hingga US$ 10 juta.

Belajar dari tiga orang pengusaha ini, ada 10 tips penting menjadi sukses dalam 5 tahun. Apa saja?

  1. Jangan kompromi terhadap kualitas hasil kerja. Biasanya di awal-awal memulai usaha kita sangat bersemangat, terkadang kita diuji untuk menjadi serakah, sehingga mengorbankan kualitas dari produk atau jasa yang kita jual. Padahal kualitas itu yang membangun merek atau hasil kerja kita, dan orang bakal balik ke kita apabila kita memberikan pekerjaan dengan kualitas terbaik.
  2. Tak ada perjalanan yang dimulai dan diakhiri di tempat yang sama. Siap-siap untuk memodifikasi atau bahkan meninggalkan rencana bisnis yang telah anda buat dengan kerja keras. Karena untuk bisa bertahan, anda harus sangat fleksibel untuk mengubah berbagai rencana.
  3. Fokus pada pekerjaan yang bisa Anda lakukan, dan berikan pekerjaan yang tidak bisa Anda lakukan kepada orang lain. Kemudian carilah perusahaan yang menyediakan sumber daya yang Anda butuhkan, serta berikan waktu dan ruang kepada perusahaan Anda untuk fokus mengerjakan hal-hal yang menjadi kekuatan anda.
  4. Berikan diri anda waktu untuk berpikir. Terdengar sederhana, namun banyak orang yang bekerja 60 jam per minggu dan tidak mempunyai waktu untuk mengulas kembali pekerjaan yang telah dilakukan dengan baik dan yang kurang baik. Karena tanpa refleksi tersebut, anda bisa terus melakukan kebiasaan buruk dalam pekerjaan anda.
  5. Terus melakukan riset dan selalu responsif. Sediakan waktu beberapa menit tiap hari untuk melakukan riset secara online terhadap kompetitor Anda untuk melihat apa yang mereka lakukan. Cobalah untuk terus berada satu langkah di depan, Gunakan data dan analisa sehingga bisa terus memperbaiki layanan Anda dan mengikuti tren yang ada.
  6. Jangan menerima semua tawaran. Memang cukup sulit untuk menolak semua proyek atau permintaan agar roda bisnis bisa terus berjalan. Tapi mengambil pekerjaan yang salah bisa menghambat pertumbuhan bisnis.
  7. Perbanyak hubungan. Lewat banyaknya rekan dan kenalan bisa mendorong pertumbuhan bisnis dan ekspansi.
  8. Percaya pada diri Anda. Pasti akan banyak orang yang meragukan Anda dan mengatakan bahwa Anda gila. Namun Anda harus tetap bertahan dan percaya pada diri Anda sendiri. Jangan terus menerus tenggelam mengira-ngira apakah tindakan Anda benar atau tidak.
  9. Tetap berkomitmen pada bisnis yang ideal. Ini akan sulit dan membuat stres, tapi jangan menyerah.
  10. Jangan bertaruh terlalu besar. Banyak pengusaha yang membuat kesalahan dengan berinvestasi pada sesuatu yang tidak mereka yakini bakal berhasil. Gunakan sedikit uang Anda untuk menguji apakah ide baru yang muncul bakal menguntungkan. Anda harus bisa membuktikan bahwa dengan modal US$ 1, anda bisa menghasilkan US$ 10.

10 Tips Menghilangkan dan Membersihkan Karang Gigi

KESEHATAN

29 Juni 2013

Gigi yang putih, serta dan berkilau tanpa karang gigi merupakan keinginan semua orang. Karang gigi banyak memberikan efek kurang baik, selain meyebabkan gigi nampak jelek juga memberikan efek gusi berdarah serta memberikan bau tidak sedap pada mulut anda. Sebab karang gigi merupakan sarang kuman. Dari hal tersebut dapat membuat kepercayaan diri anda berkurang, utamanya bagi anda yang bekerja dengan orang banyak.

Hampir sebagian besar orang memiliki karang gigi di mulutnya dengan tingkat keparahan yang berbeda. Sampai saat ini karang gigi merupakan penyebab kedua terbesar hilangnya gigi setelah karies (gigi berlubang). Karang gigi menjadi tempat melekatnya bakteri.

Makanya banyak orang yang ingin mengetahui Cara Menghilangkan Karang Gigi dengan cepat dan tanpa rasa sakit tentunya. Pada karang gigi yang semakin menebal akan menjadi sarang kuman. Menurut penelitian oleh beberapa pakar kesehatan dunia, masalah karang gigi ini dapat memicu terjadinya penyakit jantung makanya mari kita ikuti Cara Menghilangkan Karang Gigi yang kami berikan sebagai berikut….

Membersihkan Karang gigi

Menghilangkan karang gigi

Berikut 10 Cara Menghilangkan dan Membersihkan Karang gigi:

1. Menyikat gigi dengan benar minimal dua kali sehari

Bagian gusi juga mesti kita bersihkan. Gusi bagian atas dengan menggosoknya ke arah atas ke bawah, sedangkan untuk gusi rahang bawah dari arah bawah ke atas.

2. Biji asam kawak bisa kita gunakan untuk menghilangkan karang gigi

Caranya sangrai biji asam kawak, kemudian haluskan dengan cara diblender atau ditumbuk. Bubuk dari biji asam kawak bisa kita gunakan untuk menggosok karang gigi dengan bantuan sikat gigi atau kapas.

3. Cengkeh juga bisa kita gunakan untuk membersihkan karang gigi

Siapkan cengkeh sebanyak 7 buah. Tumbuk halus dan hasilnya kita gunakan untuk menggosok karang gigi. Bubuk cengkeh ini bisa pula kita gunakan untuk berkumur.

4. Konsumsi buah apel

Mengonsumsi buah apel tanpa dikupas kulitnya juga akan membantu membersihkan gigi dari karang gigi. Selain manfaat dari kandungan gizinya, sekaligus menjaga gigi dari plak. Tentu saja ini mesti kita lakukan secara rutin.

5. Batu Merah

Batu merah dihaluskan hingga berbentuk bubuk dan kemudian gosokkan pada bagian gigi yang ingin dibersihkan dari karang. Setelah itu bersihkan dan ulangi hingga tiga kali.

6. Rajin gosok gigi setelah makan dan sebelum tidur dengan pasta gigi/odol yang mencegah plak

Rajin menggosok gigi dengan pasta gigi yang mencegah plak dapat membantu anda membersihkan karang gigi.

7. Rajin minum air putih yang bersih sambil kumur-kumur

8. Rajin membersihkan bekas sisa makanan/jigong yang ada di pojok dan sela-sela gigi dengan benang gigi

Benang gigi dapat anda manfaatkan agar sisa makanan tidak tertinggal pada gigi. Sebab hal itulah yang menyebabkan karang gigi terbentuk jika tinggal dalam waktu yang lama.

9. Rajin kumur-kumur dengan cairan pembersih mulut/dental floss yang bisa mencegah plak karang gigi

10. Rajin makan buah dan atau sayur karena seratnya dapat membantu menghilangkan sisa makanan di gigi dan gusi kita

Nah seperti itulah rangkuman 10 Tips Menghilangkan dan Membersihkan Karang gigi ,Terima kasih telah mengunjungi blog ini.

Gejala Asam Urat

JENIS-JENIS PENYAKIT 150x11

29 Juni 2013

asam-urat-5

Penyakit Asam Urat merupakan akibat dari konsumsi zat purin secara berlebihan. Purin diolah tubuh menjadi asam urat, tapi jika kadar asam urat berlebih, ginjal tidak mampu mengeluarkan sehingga kristal asam urat menumpuk di persendian. Akibatnya sendi terasa nyeri, bengkak dan meradang.

Asam Urat adalah penyakit dari sisa metabolisme zat purin yang berasal dari sisa makanan yang kita konsumsi. Purin sendiri adalah zat yang terdapat dalam setiap bahan makanan yang berasal dari tubuh makhluk hidup. Dengan kata lain, dalam tubuh makhluk hidup terdapat zat purin ini, lalu karena kita memakan makhluk hidup tersebut, maka zat purin tersebut berpindah ke dalam tubuh kita. Berbagai sayuran dan buah-buahan juga terdapat purin. Purin juga dihasilkan dari hasil perusakan sel-sel tubuh yang terjadi secara normal atau karena penyakit tertentu. Biasanya asam urat menyerang pada usia lanjut, karena penumpukan bahan purin ini.

Pantangan Penderita Asam Urat

  • Jeroan: ginjal, limpa, babat, usus, hati, paru dan otak
  • Seafood: udang, cumi-cumi, sotong, kerang, remis, tiram, kepiting, ikan teri, ikan sarden
  • Ekstrak daging seperti abon dan dendeng
  • Makanan yang sudah dikalengkan (contoh: kornet sapi, sarden)
  • Daging kambing, daging sapi, daging kuda
  • Bebek, angsa dan kalkun
  • Kacang-kacangan: kacang kedelai (termasuk hasil olahan seperti tempe, tauco, oncom, susu kedelai), kacang tanah, kacang hijau, tauge, melinjo, emping
  • Sayuran: kembang kol, bayam, asparagus, buncis, jamur kuping, daun singkong, daun pepaya, kangkung
  • Keju, telur, krim, es krim, kaldu atau kuah daging yang kental
  • Buah-buahan tertentu seperti durian, nanas dan air kelapa
  • Makanan yang digoreng atau bersantan atau dimasak dengan menggunakan margarin/mentega
  • Makanan kaya protein dan lemak

Hyperuricemia, yang umumnya dikenal sebagai kadar asam urat tinggi, mengacu pada jumlah asam urat yang berlebihan dalam aliran darah. Kadar asam urat yang tinggi umumnya lebih sering didiagnosis pada pria dibandingkan wanita, dan pada orang di atas usia 65 tahun.

Penyebab Asam Urat Tinggi

Beberapa penyebab umum dari kadar asam urat tinggi termasuk

  • Kondisi Medis,
  • Obat-obatan,
  • Predisposisi Genetik,
  • Ffaktor Makanan.

1. Obat dan Vitamin

Obat-obatan yang bersifat diuretik, niasin, vitamin B3 dan obat imunosupresif dapat menjadi pemicu asam urat.

2. Kondisi Medis

Tiroid kurang aktif (hipotiroidisme), leukemia, psoriasis, dan obesitas.

3. Makanan

Konsumsi kafein dan alkohol dalam jumlah tinggi, makanan kaya purin (daging dan produk daging, makanan laut, ikan bercangkang, dan kacang-kacangan).

Gejala Asam Urat Tinggi

Peningkatan kadar asam urat mungkin tidak terdiagnosis karena beberapa orang mungkin asimtomatik. Namun, beberapa orang dengan kadar asam urat tinggi mungkin mengalami gejala karena efek dari asam urat yang berlebihan pada tubuh mereka. Misalnya, hiperurisemia dapat menyebabkan Gout (Radang Sendi) dan penyakit Ginjal seperti Batu ginjal dan Gagal ginjal. Kondisi medis ini akan dieksplorasi secara rinci sebagai berikut:

1. Nyeri Sendi

asam-urat-6

Nyeri sendi karena asam urat terjadi terutama pada sendi yang sering mendapat tekanan misalkan, mata kaki, pangkal jempol kaki dan tangan, tumit, siku dan bisa juga di daerah telinga. Gejala nyeri dirasakan terutama pada malam atau pagi hari pada saat cuaca dingin. Rasa nyeri ini disebabkan karena penumpukan kadar asam urat di celah sendi dan menimbulkan peradangan. Bila sudah terjadi secara kronis, maka akan terjadi kerusakan permanen di sendi tersebut.

2. Batu Ginjal

batu-ginjalBatu ginjal dapat berkembang pada orang yang menderita kadar asam urat tinggi, dan batu ginjal mungkin tidak terdeteksi sampai mereka terjebak dalam ureter yang dapat menyebabkan rasa sakit yang luar biasa menyakitkan dan membuat seseorang sering buang air kecil, kencing darah, mual dan muntah. Gejala klasik dari batu ginjal adalah nyeri tiba-tiba dan intens dalam perut, panggul, dan daerah pangkal paha, yang cenderung datang secara bertubi-tubi. Gejala tambahan mencakup kencing darah dan rasa nyeri saat buang air kecil.

ginjal

3. Gagal Ginjal

Tb_penyakit_ginjal

Pasien Gagal Ginjal
Pasien Gagal Ginjal

Gejala yang paling parah terkait dengan kadar asam urat tinggi adalah gagal ginjal, yang bermanifestasi menjadi kurang kencing, sesak napas, pembengkakan pada tungkai, kebingungan dan mengantuk, kelelahan, atau nyeri dada. Gagal ginjal dapat berkembang pada pasien dengan leukemia, limfoma Hodgkin dan limfoma non-Hodgkin karena kadar asam urat. Ini biasanya merupakan konsekuensi dari kemoterapi, yang membunuh sel-sel ganas.

gagal-ginjal5

4. Penyakit Lain

Meskipun penelitian terakhir telah menunjukkan bahwa kadar asam urat tinggi terkait dengan hipertensi, diabetes (kencing manis) dan penyakit jantung, hal itu masih harus diteliti apakah mengurangi kadar asam urat akan mengurangi kondisi tersebut.

Mencegah dan Mengobati Asam Urat

Bagaimana cara mencegah dan mengobatinya? Cara yang terbaik tentu dengan menghindari makanan tinggi purin seperti yang disebutkan di atas. Beberapa hal yang menarik antara lain:

  1. Konsumsi kopi (bukan teh) dapat menurunkan kadar asam urat secara signifikan (menarik ya?)
  2. Dalam kondisi terjadi serangan akut, obat penurun asam urat justru memperberat rasa sakit sehingga harus dihindari
  3. Konsumsi alkohol akan menurunkan buangan asam urat melalui ginjal
  4. Minum air minimal 8 gelas sehari efektif untuk membuang asam urat

Bila hal di atas sudah Anda lakukan dan belum berhasil, maka diperlukan peranan dokter dalam memberikan obat pengendali asam urat. Dan jangan lupa, di kesempatan berikutnya saya akan membahas mengenai Obat asam urat tradisional dan Makanan Pencegah vs Pemicu Asam Urat.

Tips Tambahan Bagi Penderita Asam Urat

  • Konsumsi makanan yang mengandung potasium tinggi seperti kentang, yogurt, dan pisang.
  • Konsumsi buah yang banyak mengandung vitamin C, seperti jeruk, pepaya dan stroberi.
  • Contoh buah dan sayuran untuk mengobati penyakit asam urat: buah naga, belimbing wuluh, jahe, labu kuning, sawi hijau, sawi putih, serai dan tomat.
  • Perbanyak konsumsi karbohidrat kompleks seperti nasi, singkong, roti dan ubi.
  • Kurangi konsumsi karbohidrat sederhana jenis fruktosa seperti gula, permen, arum manis, gulali dan sirup.
  • Jangan minum aspirin.
  • Jangan bekerja terlalu keras/kelelahan.
  • Pada orang yang kegemukan (obesitas), biasanya kadar asam urat cepat naik tapi pengeluaran sedikit, maka sebaiknya turunkan berat badan dengan olahraga yang cukup.
  • Sesuaikan asupan energi dengan kebutuhan tubuh, berdasarkan tinggi dan berat badan.

Untuk menyembuhkan penyakit ini ada beberapa hal yang harus dilakukan, diantaranya :

  • Menghindari makanan yang dapat meningkatkan asam urat, seperti jeroan (hati, ginjal, limpa, babat, usus, paru dan otak), hindari makanan laut (udang, kerang, cumi, kepiting); makanan kaleng (kornet, sarden dan ekstrak daging), telur, kaldu atau kuah daging yang kental.
  • Menghindari makanan seperti emping, melinjo, kangkung dan bayam, daun singkong, daun jambu mete, asparagus, buncis dan kembang kol. Hindari kacang-kacangan (kacang tanah, kacang hijau, kacang kedelai, tempe, tauco, tauge, oncom) dan susu kedelai.
  • Menghindari makan buah durian, alpukat, nanas, air kelapa.
  • Hindari minuman dan makanan beralkohol.
  • Pada orang gemuk, asam urat biasanya naik sedangkan pengeluarannya sedikit, maka untuk keamanan, orang biasanya dianjurkan menurunkan berat badan.
  • Banyak minum air putih, karena dengan banyak minum air putih, kita dapat membantu membuang purin yang ada dalam tubuh.

ASAM URAT 1-verthumanorgansrangka-manusia

Gejala Kanker Payudara

KANKER PAYUDARA 20

 

28 Juni 2013

PERIKSA PAYUDARA ANDA SEKARANG
PERIKSA PAYUDARA ANDA SEKARANG

Adapun beberapa gejala Kanker Payudara antara lain:

Benjolan Pada Payudara

Umumnya benjolan sebagai gejala kanker payudara ini tidak terasa nyeri, karena itu kadang kanker ini tidak disadari keberadaannya. Benjolan ini mula-mula berukuran kecil, namun semakin lama akan semakin besar, melekat pada kulit atau menimbulkan perubahan pada kulit payudara atau pada puting susu.

benjolan-kanker-payudara

Erosi atau Eksema Puting Susu

Kulit atau puting susu tadi menjadi tertarik ke dalam (retraksi), berwarna merah muda atau kecoklat-coklatan sampai menjadi oedema hingga kulit kelihatan seperti kulit jeruk (peau d’orange), mengkerut, atau timbul borok (ulkus) pada payudara. Borok itu semakin lama akan semakin besar dan mendalam sehingga dapat menghancurkan seluruh payudara, sering berbau busuk, dan mudah berdarah. Biasanya borok ini muncul pada saat kanker sudah mencapai stadium III. Gejala kanker payudara lainnya antara lain:

  • Pendarahan pada puting susu
  • Rasa sakit atau nyeri pada umumnya baru timbul apabila tumor sudah besar, sudah timbul borok, atau bila sudah muncul metastase ke tulang-tulang.
  • Kemudian timbul pembesaran kelenjar getah bening di ketiak, bengkak (edema) pada lengan, dan penyebaran kanker ke seluruh tubuh (Handoyo, 1990).

Gejala kanker payudara lanjut lebih dan sangat mudah dikenali dengan mengetahui kriteria operbilitas Heagensen sebagai berikut:

  • terdapat edema luas pada kulit payudara (lebih 1/3 luas kulit payudara)
  • adanya nodul satelit pada kulit payudara
  • kanker payudara jenis mastitis karsinimatosa
  • terdapat model parasternal
  • terdapat nodul supraklavikula
  • adanya edema lengan
  • adanya metastase jauh
  • serta terdapat dua dari tanda-tanda locally advanced, yaitu ulserasi kulit, edema kulit, kulit terfiksasi pada dinding toraks, kelenjar getah bening aksila berdiameter lebih 2,5 cm, dan kelenjar getah bening aksila melekat satu sama lain.

Keluarnya Cairan (Nipple Discharge)

Nipple discharge adalah keluarnya cairan dari puting susu secara spontan dan tidak normal. Cairan yang keluar disebut normal apabila terjadi pada wanita yang hamil, menyusui dan pemakai pil kontrasepsi. Seorang wanita harus waspada apabila dari puting susu keluar cairan, mungkin saja itu gejala kanker payudara. Apalagi jika telihat seperti berdarah, cairan encer dengan warna merah atau coklat, keluar sendiri tanpa harus memijit puting susu, berlangsung terus menerus, hanya pada satu payudara (unilateral), dan cairan selain air susu.

gejala-kanker-payudara

Berbagai Sumber

Apa Itu Kanker Payudara

 

KANKER PAYUDARA 20

Juni 28 2013

breastcancer

Kanker Payudara

breast-cancer-pink-ribbon-awareness

kanker-payudara-longtron-altervista-org-1024

Kanker Payudara adalah kanker pada jaringan payudara.Ini adalah jenis kanker paling umum yang diderita kaum wanita. Kaum pria juga dapat terserang kanker payudara, walaupun kemungkinannya lebih kecil dari 1 di antara 1000. Pengobatan yang paling lazim adalah dengan pembedahan dan jika perlu dilanjutkan dengan kemoterapi maupun radiasi.

Deteksi Awal Kanker Payudara
Deteksi Awal Kanker Payudara
Deteksi Diri Kanker Payudara
Deteksi Diri Kanker Payudara

1. Definisi

Kanker adalah suatu kondisi dimana sel telah kehilangan pengendalian dan mekanisme normalnya, sehingga mengalami pertumbuhan yang tidak normal, cepat dan tidak terkendali.

Selain itu, kanker payudara (Carcinoma mammae) didefinisikan sebagai suatu penyakit neoplasma yang ganas yang berasal dari parenchyma. Penyakit ini oleh World Health Organization (WHO) dimasukkan ke dalam International Classification of Diseases (ICD) dengan kode nomor 17.

obat-tradisional-kanker-payudara

2. Patofisiologi

Beberapa jenis kanker payudara sering menunjukkan disregulasi hormon HGF dan onkogen Met, serta ekspresi berlebih enzim PTK-6.

2.1 Transformasi

Sel-sel kanker dibentuk dari sel-sel normal dalam suatu proses rumit yang disebut transformasi, yang terdiri dari tahap inisiasi dan promosi.

2.1.1 Fase Inisiasi

Pada tahap inisiasi terjadi suatu perubahan dalam bahan genetik sel yang memancing sel menjadi ganas. Perubahan dalam bahan genetik sel ini disebabkan oleh suatu agen yang disebut karsinogen, yang bisa berupa bahan kimia, virus, radiasi (penyinaran) atau sinar matahari. Tetapi tidak semua sel memiliki kepekaan yang sama terhadap suatu karsinogen. Kelainan genetik dalam sel atau bahan lainnya yang disebut promotor, menyebabkan sel lebih rentan terhadap suatu karsinogen. Bahkan gangguan fisik menahunpun bisa membuat sel menjadi lebih peka untuk mengalami suatu keganasan.

Progesteron, sebuah hormon yang menginduksi ductal side-branching pada kelenjar payudara dan lobualveologenesis pada sel epitelial payudara, diperkirakan berperan sebagai aktivator lintasan tumorigenesis pada sel payudara yang diinduksi oleh karsinogen. Progestin akan menginduksi transkripsi regulator siklus sel berupa siklin D1 untuk disekresi sel epitelial. Sekresi dapat ditingkatkan sekitar 5 hingga 7 kali lipat dengan stimulasi hormon estrogen, oleh karena estrogen merupakan hormon yang mengaktivasi ekspresi pencerap progesteron pada sel epitelial. Selain itu, progesteron juga menginduksi sekresi kalsitonin sel luminal dan morfogenesis kelenjar.

2.1.2 Fase Promosi

Pada tahap promosi, suatu sel yang telah mengalami inisiasi akan berubah menjadi ganas. Sel yang belum melewati tahap inisiasi tidak akan terpengaruh oleh promosi. Karena itu diperlukan beberapa faktor untuk terjadinya keganasan (gabungan dari sel yang peka dan suatu karsinogen).

2.1.3 Fase Metastasis

Metastasis menuju ke tulang merupakan hal yang kerap terjadi pada kanker payudara, beberapa diantaranya disertai komplikasi lain seperti simtoma hiperkalsemia, pathological fractures atau spinal cord compression. Metastasis demikian bersifat osteolitik, yang berarti bahwa osteoklas hasil induksi sel kanker merupakan mediator osteolisis dan mempengaruhi diferensiasi dan aktivitas osteoblas serta osteoklas lain hingga meningkatkan resorpsi tulang.

Tulang merupakan jaringan unik yang terbuat dari matriks protein yang mengandung kalsium dengan kristal hydroxyappatite sehingga mekanisme yang biasa digunakan oleh sel kanker untuk membuat ruang pada matriks ekstraselular dengan penggunaan enzim metaloproteinase matriks tidaklah efektif. Oleh sebab itu, resorpsi tulang yang memungkinkan invasi neoplastik terjadi akibat interaksi antara sel kanker payudara dengan sel endotelial yang dimediasi oleh ekspresi VEGF.[8] VEGF merupakan mitogen angiogenik positif yang bereaksi dengan sel endotelial. Tanpa faktor angiogenik negatif seperti angiostatin, sel endotelial yang berinteraksi dengan VEGF sel kanker melalui pencerap VEGFR-1 dan VEGFR-2, akan meluruhkan matriks ekstraselular, bermigrasi dan membentuk tubulus.

3. Klasifikasi

Terdapat beberapa jenis sel kanker yang dapat terkultur pada kanker payudara, yaitu sel MCF-7, sel T-47D, sel MDA-MB-231, sel MB-MDA-468, sel BT-20 dan sel BT-549.

3.1 Histopatologi

Berdasarkan WHO Histological Classification of breast tumor, kanker payudara diklasifikasikan sebagai berikut:

  1. Non-invasif karsinoma
    • Non-invasif duktal karsinoma
    • Lobular karsinoma in situ
  2. Invasif karsinoma
    • Invasif duktal karsinoma
      • Papilobular karsinoma
      • Solid-tubular karsinoma
      • Scirrhous karsinoma
      • Special types
      • Mucinous karsinoma
      • Medulare karsinoma
    • Invasif lobular karsinoma
      • Adenoid cystic karsinoma
      • karsinoma sel squamos
      • karsinoma sel spindel
      • Apocrin karsinoma
      • Karsinoma dengan metaplasia kartilago atau osseus metaplasia
      • Tubular karsinoma
      • Sekretori karsinoma
      • Lainnya
  3. Paget’s Disease

3.2 Stadium

Stadium penyakit kanker adalah suatu keadaan dari hasil penilaian dokter saat mendiagnosis suatu penyakit kanker yang diderita pasiennya, sudah sejauh manakah tingkat penyebaran kanker tersebut baik ke organ atau jaringan sekitar maupun penyebaran ketempat lain. Stadium hanya dikenal pada tumor ganas atau kanker dan tidak ada pada tumor jinak. Untuk menentukan suatu stadium, harus dilakukan pemeriksaan klinis dan ditunjang dengan pemeriksaan penunjang lainnya yaitu histopatologi atau PA, rontgen , USG, dan bila memungkinkan dengan CT scan, scintigrafi, dll. Banyak sekali cara untuk menentukan stadium, namun yang paling banyak dianut saat ini adalah stadium kanker berdasarkan klasifikasi sistem TNM yang direkomendasikan oleh UICC (International Union Against Cancer dari World Health Organization)/AJCC (American Joint Committee On cancer yang disponsori oleh American Cancer Society dan American College of Surgeons).

3.2.1 Sistem TNM

TNM merupakan singkatan dari “T” yaitu tumor size atau ukuran tumor , “N” yaitu node atau kelenjar getah bening regional dan “M” yaitu metastasis atau penyebaran jauh. Ketiga faktor T, N, dan M dinilai baik secara klinis sebelum dilakukan operasi, juga sesudah operasi dan dilakukan pemeriksaan histopatologi (PA). Pada kanker payudara, penilaian TNM sebagai berikut:

  • T (tumor size), ukuran tumor:
    • T 0: tidak ditemukan tumor primer
    • T 1: ukuran tumor diameter 2 cm atau kurang
    • T 2: ukuran tumor diameter antara 2-5 cm
    • T 3: ukuran tumor diameter > 5 cm
    • T 4: ukuran tumor berapa saja, tetapi sudah ada penyebaran ke kulit atau dinding dada atau pada keduanya, dapat berupa borok, edema atau bengkak, kulit payudara kemerahan atau ada benjolan kecil di kulit di luar tumor utama
  • N (node), kelenjar getah bening regional (kgb):
    • N 0: tidak terdapat metastasis pada kgb regional di ketiak/aksilla
    • N 1: ada metastasis ke kgb aksilla yang masih dapat digerakkan
    • N 2: ada metastasis ke kgb aksilla yang sulit digerakkan
    • N 3: ada metastasis ke kgb di atas tulang selangka (supraclavicula) atau pada kgb di mammary interna di dekat tulang sternum
  • M (metastasis), penyebaran jauh:
    • M x: metastasis jauh belum dapat dinilai
    • M 0: tidak terdapat metastasis jauh
    • M 1: terdapat metastasis jauh

Setelah masing-masing faktor T, N, dan M didapatkan, ketiga faktor tersebut kemudian digabung dan akan diperoleh stadium kanker sebagai berikut:

  • Stadium 0: T0 N0 M0
  • Stadium 1: T1 N0 M0
  • Stadium II A: T0 N1 M0/T1 N1 M0/T2 N0 M0
  • Stadium II B: T2 N1 M0 / T3 N0 M0
  • Stadium III A: T0 N2 M0/T1 N2 M0/T2 N2 M0/T3 N1 M0
  • Stadium III B: T4 N0 M0/T4 N1 M0/T4 N2 M0
  • Stadium III C: Tiap T N3 M0
  • Stadium IV: Tiap T-Tiap N-M1

tumor-payudara Stage IA

stadium-iia3a3b

3.3 Genetik

3.3.1 Array-Mikro DNA

Array-mikro DNA merupakan suatu metode yang diawali dengan membandingkan sel normal dengan sel kanker dan melihat perbedaan yang terjadi pada ekspresi genetik antara dua jenis sel. Walaupun perbedaan ekspresi genetik tersebut belum tentu menunjukkan ciri khas onkogen sel kanker, namun beberapa grup periset mempertimbangkan bahwa beberapa grup/kluster gen mempunyai kecenderungan untuk meninggalkan jejak genetik pada sel lain hingga terjadi ekspresi genetik yang sama, yang disebut profil genetik. Dengan demikian, dinamika fungsional gen dan genom dapat diamati seperti proses transkripsi mRNA, identifikasi domain pengikat dari protein asam nukleat, analisis single-nucleotide polymorphism.

Sejumlah profil genetik telah diajukan oleh berbagai pihak, beberapa diantaranya adalah:

  • Profil genetik dari American Society of Clinical Oncology yang menawarkan klasifikasi berdasarkan CA 15.3, CA 27.29, CEA, pencerap estrogen, pencerap progesteron, pencerap faktor pertumbuhan epidermal-2, aktivator plasminogen urokinase, penghambat aktivator plasminogen 1. Penggunaan kategori berikut sebagai dasar diagnosa juga dianggap belum cukup; DNA/ploiditas dengan penggunaan sitometri, p53, cathepsin D, siklin E, multiparameter assays tertentu, deteksi metastasis-mikro pada sumsum tulang dan kadar sel tumor dalam sirkulasi darah.
  • Profil genetik yang disebut normal breast-like, basal, luminal A, luminal B, dan ERBB2+.
  • Subtipe berdasarkan ESR1/ERBB2 dengan profil ESR1+/ERBB2-, ESR1-/ERBB2-, dan ERBB2+.

3.3.1.1 Profil intrinsik Perou-Sørlie

Dari sudut pandang histologi, sel tumor payudara merupakan jaringan kompleks yang terdiri dari berbagai jenis sel selain sel kanker. Untuk mendapatkan profil genetik dari sebuah tumor, perlu diketahui ekspresi genetik khas dari tiap sel yang merupakan hasil transkripsi kluster gen tertentu, kemudian dicari kesamaan kluster pada sel lain dari jenis yang berbeda.

Pada profil intrinsik, ditemukan 8 kluster genetik yang merupakan variasi sel-sel tertentu yang terdapat di dalam tumor.

  1. Sel endotelial. Sebuah kluster gen merupakan ciri khas ekspresi genetik sel endotelial, seperti CD34, CD31, faktor von Willebrand, baik sel endotelial dari kultur HUVEC maupun HMVEC.
  2. Sel stromal. Ekspresi protein dari sel stromal merupakan kluster genetik yang teridentifikasi terlebih dahulu dan meliputi beberapa isomer kolagen
  3. Sel payudara normal maupun yang kaya akan adiposa dengan kluster genetik meliputi fatty-acid binding protein 4 dan PPAR
  4. Sel B, meninggalkan jejak genetik seperti ekspresi gen berupa protein imunoglobulin saat melakukan infiltrasi dan memberikan variasi pada kluster genetik seperti yang terjadi pada ekspresi sel RPMI-8226 dari kultur mieloma multipel.
  5. Sel T juga meninggalkan jejak genetik yang menjadi indikasi aktivitas infiltrasi. Sebuah kluster geneteik meliputi kluster diferensiasi CD3 dan 2 subunit pencerap sel T ditemukan pada sel MOLT-4 dari kultur leukimia.
  6. Makrofaga. Sebuah kluster genetik yang nampaknya merupakan ciri khas makrofaga/monosit adalah ekspresi CD68, acid phosphatase 5, chitinase dan lysozyme.

Terdapat dua jenis sel epitelial pada kelenjar ini, yaitu sel basal atau sel mioepitelial, dan sel epitelial luminal. Banyak gen yang hanya dimiliki oleh salah satu jenis sel ini dan jarang ditemukan gen yang dimiliki oleh kedua sel. Kluster genetik sel basal meliputi keratin-5, keratin-17, integrin-4 dan laminin. Sedangkan kluster genetik sel luminal meliputi faktor transkripsi yang berkaitan dengan pencerap estrogen seperti GATA-binding protein-3, X-box binding protein-1 dan hepatocyte nuclear factor-3.

3.4 Lintasan Onkogenik

Klasifikasi menurut lintasan onkogenik terbagi menjadi 4 subtipe yang disebut

  • luminal A yang disertai ekspresi pencerap hormon, baik estrogen, progesteron maupun keduanya, dan tanpa ekspresi HER-2 (bahasa Inggris: human epidermal growth factor receptor 2). Pada subtipe luminal A, terjadi ekspresi berlebihan protein yang berperan dalam lintasan metabolisme asam lemak dan lintasan transduksi sinyal selular yang menggunakan steroid, khususnya melalui ekspresi pencerap estrogen.
  • luminal B dengan pencerap hormon +, HER-2 +.
  • triple negative dengan pencerap hormon , HER-2 .
  • HER-2 over-expressing dengan pengecerap hormon , HER-2 +.

Berdasarkan klasifikasi ini, hasil sampling dari 2.544 kasus yang terjadi di Amerika, 73% didapati mengidap subtipe luminal A, 12% penderita luminal B, 11% adalah kanker triple negative dan 4% merupakan jenis HER-2 over-expressing.

Beberapa ahli lain menambahkan subtipe seperti;

  • basal-like dengan ekspresi berlebih protein yang berperan pada proliferasi dan diferensiasi sel, lintasan p21 dan transduksi sinyal dalam siklus sel pada checkpoint antara fase G1 dan fase S.
  • basal A dengan lintasan ETS dan gen BRCA1.
  • basal B dengan lintasan sel mesenkimal dan/atau sel punca/sel progenitor

4. Gejala Klinis

Gejala Klinis Kanker Payudara dapat berupa:

4.1 Benjolan Pada Payudara

benjolan-kanker-payudara

Umumnya berupa benjolan yang tidak nyeri pada payudara. Benjolan itu mula-mula kecil, semakin lama akan semakin besar, lalu melekat pada kulit atau menimbulkan perubahan pada kulit payudara atau pada puting susu.

4.2 Erosi atau Eksema Puting Susu

Kulit atau puting susu tadi menjadi tertarik ke dalam (retraksi), berwarna merah muda atau kecoklat-coklatan sampai menjadi oedema hingga kulit kelihatan seperti kulit jeruk (peau d’orange), mengkerut, atau timbul borok (ulkus) pada payudara. Borok itu semakin lama akan semakin besar dan mendalam sehingga dapat menghancurkan seluruh payudara, sering berbau busuk, dan mudah berdarah. Ciri-ciri lainnya antara lain:

  • Pendarahan pada puting susu.
  • Rasa sakit atau nyeri pada umumnya baru timbul apabila tumor sudah besar, sudah timbul borok, atau bila sudah muncul metastase ke tulang-tulang.
  • Kemudian timbul pembesaran kelenjar getah bening di ketiak, bengkak (edema) pada lengan, dan penyebaran kanker ke seluruh tubuh (Handoyo, 1990).

Kanker payudara lanjut sangat mudah dikenali dengan mengetahui kriteria operbilitas Heagensen sebagai berikut:

  • terdapat edema luas pada kulit payudara (lebih 1/3 luas kulit payudara);
  • adanya nodul satelit pada kulit payudara;
  • kanker payudara jenis mastitis karsinimatosa;
  • terdapat model parasternal;
  • terdapat nodul supraklavikula;
  • adanya edema lengan;
  • adanya metastase jauh;
  • serta terdapat dua dari tanda-tanda locally advanced, yaitu ulserasi kulit, edema kulit, kulit terfiksasi pada dinding toraks, kelenjar getah bening aksila berdiameter lebih 2,5 cm, dan kelenjar getah bening aksila melekat satu sama lain.

4.3 Keluarnya Cairan (Nipple Discharge)

gejala-kanker-payudara

Nipple discharge adalah keluarnya cairan dari puting susu secara spontan dan tidak normal. Cairan yang keluar disebut normal apabila terjadi pada wanita yang hamil, menyusui dan pemakai pil kontrasepsi. Seorang wanita harus waspada apabila dari puting susu keluar cairan berdarah cairan encer dengan warna merah atau coklat, keluar sendiri tanpa harus memijit puting susu, berlangsung terus menerus, hanya pada satu payudara (unilateral), dan cairan selain air susu.

5. Faktor-faktor Penyebab

5.1 Faktor Resiko

Menurut Moningkey dan Kodim, penyebab spesifik kanker payudara masih belum diketahui, tetapi terdapat banyak faktor yang diperkirakan mempunyai pengaruh terhadap terjadinya kanker payudara diantaranya:

  1. Faktor Reproduksi: Karakteristik reproduktif yang berhubungan dengan risiko terjadinya kanker payudara adalah nuliparitas, menarche pada umur muda, menopause pada umur lebih tua, dan kehamilan pertama pada umur tua. Risiko utama kanker payudara adalah bertambahnya umur. Diperkirakan, periode antara terjadinya haid pertama dengan umur saat kehamilan pertama merupakan window of initiation perkembangan kanker payudara. Secara anatomi dan fungsional, payudara akan mengalami atrofi dengan bertambahnya umur. Kurang dari 25% kanker payudara terjadi pada masa sebelum menopause sehingga diperkirakan awal terjadinya tumor terjadi jauh sebelum terjadinya perubahan klinis.
  2. Penggunaan Hormon: Hormon estrogen berhubungan dengan terjadinya kanker payudara. Laporan dari Harvard School of Public Health menyatakan bahwa terdapat peningkatan kanker payudara yang signifikan pada para pengguna terapi estrogen replacement. Suatu metaanalisis menyatakan bahwa walaupun tidak terdapat risiko kanker payudara pada pengguna kontrasepsi oral, wanita yang menggunakan obat ini untuk waktu yang lama mempunyai risiko tinggi untuk mengalami kanker payudara sebelum menopause. Sel-sel yang sensitive terhadap rangsangan hormonal mungkin mengalami perubahan degenerasi jinak atau menjadi ganas.
  3. Penyakit Fibrokistik: Pada wanita dengan adenosis, fibroadenoma, dan fibrosis, tidak ada peningkatan risiko terjadinya kanker payudara. Pada hiperplasis dan papiloma, risiko sedikit meningkat 1,5 sampai 2 kali. Sedangkan pada hiperplasia atipik, risiko meningkat hingga 5 kali.
  4. Obesitas: Terdapat hubungan yang positif antara berat badan dan bentuk tubuh dengan kanker payudara pada wanita pasca menopause. Variasi terhadap kekerapan kanker ini di negara-negara Barat dan bukan Barat serta perubahan kekerapan sesudah migrasi menunjukkan bahwa terdapat pengaruh diet terhadap terjadinya keganasan ini.
  5. Konsumsi Lemak: Konsumsi lemak diperkirakan sebagai suatu faktor risiko terjadinya kanker payudara. Willet dkk. melakukan studi prospektif selama 8 tahun tentang konsumsi lemak dan serat dalam hubungannya dengan risiko kanker payudara pada wanita umur 34 sampai 59 tahun.
  6. Radiasi: Eksposur dengan radiasi ionisasi selama atau sesudah pubertas meningkatkan terjadinya risiko kanker payudara. Dari beberapa penelitian yang dilakukan disimpulkan bahwa risiko kanker radiasi berhubungan secara linier dengan dosis dan umur saat terjadinya eksposur.
  7. Riwayat Keluarga dan Faktor Genetik: Riwayat keluarga merupakan komponen yang penting dalam riwayat penderita yang akan dilaksanakan skrining untuk kanker payudara. Terdapat peningkatan risiko keganasan pada wanita yang keluarganya menderita kanker payudara. Pada studi genetik ditemukan bahwa kanker payudara berhubungan dengan gen tertentu. Apabila terdapat BRCA 1, yaitu suatu gen kerentanan terhadap kanker payudara, probabilitas untuk terjadi kanker payudara sebesar 60% pada umur 50 tahun dan sebesar 85% pada umur 70 tahun. Faktor Usia sangat berpengaruh -> sekitar 60% kanker payudara terjadi di usia 60 tahun. Resiko terbesar usia 75 tahun

5.2 Faktor Genetik

Kanker peyudara dapat terjadi karena adanya beberapa faktor genetik yang diturunkan dari orangtua kepada anaknya. Faktor genetik yang dimaksud adalah adanya mutasi pada beberapa gen yang berperan penting dalam pembentukan kanker payudara gen yang dimaksud adalah beberapa gen yang bersifat onkogen dan gen yang bersifat mensupresi tumor.

Gen pensupresi tumor yang berperan penting dalam pembentukan kanker payudara diantaranya adalah gen BRCA1 dan gen BRCA2.

6. Pengobatan kanker

Ada beberapa pengobatan kanker payudara yang penerapannya banyak tergantung pada stadium klinik penyakit (Tjindarbumi, 1994), yaitu:

6.1 Mastektomi

Mastektomi adalah operasi pengangkatan payudara. Ada 3 jenis mastektomi (Hirshaut & Pressman, 1992):

  • Modified Radical Mastectomy, yaitu operasi pengangkatan seluruh payudara, jaringan payudara di tulang dada, tulang selangka dan tulang iga, serta benjolan di sekitar ketiak.
  • Total (Simple) Mastectomy, yaitu operasi pengangkatan seluruh payudara saja, tetapi bukan kelenjar di ketiak.
  • Radical Mastectomy, yaitu operasi pengangkatan sebagian dari payudara. Biasanya disebut lumpectomy, yaitu pengangkatan hanya pada jaringan yang mengandung sel kanker, bukan seluruh payudara. Operasi ini selalu diikuti dengan pemberian radioterapi. Biasanya lumpectomy direkomendasikan pada pasien yang besar tumornya kurang dari 2 cm dan letaknya di pinggir payudara.

mastektomi2-240-horz

Angelina Jolie dan Mastektomi
Angelina Jolie dan Mastektomi

6.2 Radiasi

Penyinaran/radiasi adalah proses penyinaran pada daerah yang terkena kanker dengan menggunakan sinar X dan sinar gamma yang bertujuan membunuh sel kanker yang masih tersisa di payudara setelah operasi (Denton, 1996). Efek pengobatan ini tubuh menjadi lemah, nafsu makan berkurang, warna kulit di sekitar payudara menjadi hitam, serta Hb dan leukosit cenderung menurun sebagai akibat dari radiasi.

terapi-radiasi-buruk-untuk-kanker-paru-paru

6.3 Kemoterapi

Kemoterapi adalah proses pemberian obat-obatan anti kanker atau sitokina dalam bentuk pil cair atau kapsul atau melalui infus yang bertujuan membunuh sel kanker melalui mekanisme kemotaksis. Tidak hanya sel kanker pada payudara, tapi juga di seluruh tubuh (Denton, 1996). Efek dari kemoterapi adalah pasien mengalami mual dan muntah serta rambut rontok karena pengaruh obat-obatan yang diberikan pada saat kemoterapi.

Chemotherapy-BREAST CANCER

6.4 Lintasan Metabolisme

Asam bifosfonat merupakan senyawa penghambat aktivitas osteoklas dan resorpsi tulang yang sering digunakan untuk melawan osteoporosis yang diinduksi oleh ovarian suppression, hiperkalsemia dan kelainan metabolisme tulang, menunjukkan efektivitas untuk menurunkan metastasis sel kanker payudara menuju tulang. Walaupun pada umumnya asupan asam bifosfonat dapat ditoleransi tubuh, penggunaan dalam jangka panjang dapat menimbulkan efek samping seperti osteonekrosis dan turunnya fungsi ginjal.

CT dapat menginduksi sel kanker payudara untuk memproduksi cAMP dan menghambat perkembangan sel kanker.[21] Molekul cAMP tersebut terbentuk dari ekspresi pencerap CT yang terhubung adenylate cyclase oleh paling tidak satu buah guanine nucleotide-binding protein. Respon cAMP terhadap CT dapat menurun ketika sel terinkubasi senyawa mitogenik berupa 17beta-estradiol dan EGF; dan meningkat seiring inkubasi senyawa penghambat pertumbuhan seperti tamoxifen dan 1,25(OH)2D3; serta oligonukleotida dan proto-onkogen c-myc. Namun penggunaan tamoxifen meningkatkan risiko terjadi polip endometrial, hiperplasia dan kanker, melalui mekanisme adrenomedulin.

Respon berupa produksi cAMP yang kuat, tidak ditemukan pada senyawa selain CT. Senyawa efektor adenylate cyclase seperti forskolin dan senyawa beta-adrenergic receptor agonist seperti isoproterenol hanya menghasilkan sedikit produksi cAMP.

Pada sel MDA-MB-231, CT akan menginduksi fosforilasi c-Raf pada serina posisi ke 259 melalui lintasan protein kinase A dan menyebabkan terhambatnya fosforilasi ERK1/2 yang diperlukan bagi kelangsungan hidup sel MDA-MB-231, dan menghambat ekspresi mRNA uPA yang diperlukan sel MDA-MB-231 untuk invasi dan metastasis. Walaupun demikian kalsitonin tidak mempunyai efek yang signifan untuk menghambat proliferasi sel MCF-7. Apoptosis sel MDA-MB-231 juga diinduksi oleh asam lipoat yang menghambat fosforilasi Akt dan mRNA AKT, aktivitas Bcl-2 dan protein Bax, MMP-9 dan MMP-2, serta meningkatkan aktivitas kaspase-3.

7. Strategi Pencegahan

Pada prinsipnya, strategi pencegahan dikelompokkan dalam tiga kelompok besar, yaitu pencegahan pada lingkungan, pada pejamu, dan milestone. Hampir setiap epidemiolog sepakat bahwa pencegahan yang paling efektif bagi kejadian penyakit tidak menular adalah promosi kesehatan dan deteksi dini. Begitu pula pada kanker payudara, pencegahan yang dilakukan antara lain berupa:

gangguan-payudara-kanker-payudara-gbr-3-breast_exams3

Deteksi Dini Kanker Payudara
Deteksi Dini Kanker Payudara

See also:

7.1 Pencegahan Primer

Pencegahan primer pada kanker payudara merupakan salah satu bentuk promosi kesehatan karena dilakukan pada orang yang “sehat” melalui upaya menghindarkan diri dari keterpaparan pada berbagai faktor risiko dan melaksanakan pola hidup sehat. Pencagahan primer ini juga bisa berupa pemeriksaan SADARI (pemeriksaan payudara sendiri) yang dilakukan secara rutin sehingga bisa memperkecil faktor risiko terkena kanker payudara.

7.2 Pencegahan Sekunder

Pencegahan sekunder dilakukan terhadap individu yang memiliki risiko untuk terkena kanker payudara. Setiap wanita yang normal dan memiliki siklus haid normal merupakan populasi at risk dari kanker payudara. Pencegahan sekunder dilakukan dengan melakukan deteksi dini. Beberapa metode deteksi dini terus mengalami perkembangan. Skrining melalui mammografi diklaim memiliki akurasi 90% dari semua penderita kanker payudara, tetapi keterpaparan terus-menerus pada mammografi pada wanita yang sehat merupakan salah satu faktor risiko terjadinya kanker payudara. Karena itu, skrining dengan mammografi tetap dapat dilaksanakan dengan beberapa pertimbangan antara lain:

  • Wanita yang sudah mencapai usia 40 tahun dianjurkan melakukan cancer risk assessement survey.
  • Pada wanita dengan faktor risiko mendapat rujukan untuk dilakukan mammografi setiap tahun.
  • Wanita normal mendapat rujukan mammografi setiap 2 tahun sampai mencapai usia 50 tahun.

Foster dan Constanta menemukan bahwa kematian oleh kanker payudara lebih sedikit pada wanita yang melakukan pemeriksaan SADARI (Pemeriksaan Payudara Sendiri) dibandingkan yang tidak. Walaupun sensitivitas SADARI untuk mendeteksi kanker payudara hanya 26%, bila dikombinasikan dengan mammografi maka sensitivitas mendeteksi secara dini menjadi 75%

7.3 Pencegahan Tertier

Pencegahan tertier biasanya diarahkan pada individu yang telah positif menderita kanker payudara. Penanganan yang tepat penderita kanker payudara sesuai dengan stadiumnya akan dapat mengurangi kecatatan dan memperpanjang harapan hidup penderita. Pencegahan tertier ini penting untuk meningkatkan kualitas hidup penderita serta mencegah komplikasi penyakit dan meneruskan pengobatan. Tindakan pengobatan dapat berupa operasi walaupun tidak berpengaruh banyak terhadap ketahanan hidup penderita. Bila kanker telah jauh bermetastasis, dilakukan tindakan kemoterapi dengan sitostatika. Pada stadium tertentu, pengobatan yang diberikan hanya berupa simptomatik dan dianjurkan untuk mencari pengobatan alternatif dengan obat herbal kanker payudara.

PERIKSA PAYUDARA ANDA SEKARANG
PERIKSA PAYUDARA ANDA SEKARANG
Breast Cancer Surgery
Breast Cancer Surgery
Plastic Surgery
Plastic Surgery

8. Herbal Ampuh Untuk Pencegahan & Mengobatan Kanker Payudara

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4 Tips Atasi Pertengkaran Rumah Tangga

 

26 Juni 2013

Saling adu argumen adalah hal yang biasa dalam pernikahan. Namun jika Anda tidak benar dalam menanganinya, bisa-bisa masalah kecil menjadi besar. Daripada berteriak atau menangis ketika selisih paham dengan suami, sebaiknya simpan kemarahan Anda dengan mengikuti tips dari Boldsky berikut ini.

1. Ambil Waktu Sendiri

Jika Anda begitu frustasi dan tidak bisa berpikir jernih ketika bertengkar dengan suami, lebih baik ambil waktu untuk sendiri. Mungkin satu jam atau sepanjang hari, agar pikiran Anda dan pasangan kembali tenang untuk membicarakan masalah tersebut.

2. Saling Mendengarkan

Walaupun keadaan mulai memanas dan telah kehilangan akal sehat, namun Anda dan pasangan harus mencoba saling mendengarkan argumen masing-masing. Pada awal perbincangan, usahakan fokus pada topik dan tidak merambat ke masalah lain, atau mengungkit masa lalu. Ingat, Anda akan sulit menghentikan pertengkaran, jika Anda tidak mau tahu apa yang orang lain pikir atau rasakan.

3. Jangan Berteriak

Kebanyakan wanita akan berteriak dan menangis jika ingin didengarkan. Sebaiknya hindari hal ini. Kenapa? Memakai nada tinggi ketika bertengkar, justru membuat lawan bicara makin marah, yang berarti pertengkaran tidak akan selesai. Untuk itu, usahakan tetap tenang sehingga situasi tidak bertambah buruk.

4. Meminta Maaf

Jika kemarahan mulai mereda, segeralah minta maaf, tidak peduli siapa yang menyulut pertengkaran. Tak perlu merasa gengsi untuk langsung berbaikan dengan pasangan setelah bertengkar.

Antara Seks dan Cinta-200-horz-1

DENGAN MENINGKATKAN KEGIAATAN SEKS AKAN LEBIH MENDEKATKAN HUBUNGAN SUAMI & ISTRI DAN AKAN MENGHASILKA KEHARMONISAN KELUARGA. DENGAN SALING KOMUNIKASI DAN MENGERTI APA YANG MEMBUAT PASANGAN MERASAKAN KENIKMATAN SAAT MELAKUKAN HUBUNGAN INTIM.

Rahasia Seks dan Cinta-600-1

HUBUNGAN SEKS YANG BURUK MENCERMINKAN HUBUNGAN SUAMI & ISTRI YANG TIDAK BAIK

KEBAHAGIAAN ITU TIDAK DATANG DENGAN SENDIRINYA, KEBAHAGIAAN ADALAH HASIL DARI APA YANG KITA LAKUKAN BERSAMA KELUARGA TERCINTA KITA.

Kepuasan Seks antara Suami & Istri akan membuahkan Kehidupan Keluarga Yang Harminis
Kepuasan Seks antara Suami & Istri akan membuahkan Kehidupan Keluarga Yang Harminis

LOVE IS RESPECT

“HOW CAN YOU LOVE ME IF DON’T RESPECT ME?”

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Antara Seks dan Cinta

KHUSUS PASUTRI


26 Juni 2013

 

20440-woman-on-top

PEMBAHASAN soal seks dan cinta memang sangat menarik. Keduanya dapat dilihat dari beragam sudut pandang. Banyak yang menganggap seks dan cinta adalah dua hal yang berbeda.

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DI MATA sebagian orang, cinta kerap dipandang sebagai kebutuhan hati, sedangkan seks hanya sebatas kebutuhan nafsu semata. Ada pula yang mencoba menjadikan cinta sebagai jembatan untuk mendapatkan seks. Namun Jarang sekali orang menggunakan seks sebagai cara untuk mendapatkan cinta.

Pada kenyataannya, seperti yang terungkap dalam Guide to Sex hampir setiap pasangan yang merindukan relasi seksual yang luar biasa juga meyakini bahwa hal ini tumbuh dari relasi persahabatan yang terbina baik. Jadi, bila Anda merasa kelaparan dan mendambakan pasangan serta pengalaman seksual yang luar biasa, bertemanlah, lalu jatuh cinta. Ini merupakan awal yang baik dari semua itu. Jadi, tidak heran bila sepasang laki-laki- perempuan yang berteman lama dan membina relasi persahabatan yang cukup baik, tiba-tiba merasa jatuh cinta sama lain.

Oleh karena itu, buku karangan Anne Hooper itu menyarankan jika Anda benar-benar sangat ingin dekat dengan seseorang dan menikmati kehidupan seks yang begitu indah, akan lebih baik jika Anda mengawalinya dengan membina persahabatan yang ada.

Dan dalam banyak budaya, kelanjutan persahabatan ini menjadi makin sah dengan prosesi pernikahan yang meresmikan hubungan itu hingga layak dan boleh makin intim.

Jadi, cinta membuka jalan bagi terwujudnya pengalaman ngeseks. Di mana pun, sepanjang cinta pertama itu hadir biasanya akan membuka peluang bagi terjadinya pengalaman pertama melakukan hubungan seks. Jika Anda berasal dari latar belakang atau agama yang hanya memberi lampu hijau pada seks pascapernikahan, masalah seks tentu akan menjadi uji mental dan kesabaran Anda.

Pada hari-hari sebelum ditemukannya alat kontrasepsi yang aman, pria dan wanita biasanya harus bersusah payah melakukan apa yang disebut percumbuan (petting). Ini berarti bahwa mereka membuat cinta dengan menggunakan tangan dan mulut mereka.

Namun begitu, mereka tidak sampai pada tindakan yang lebih jauh. Mereka hanya melakukan apa yang disebut seks penetratif atau hubungan badan. Keuntungan dari pasangan yang tidak melakukan seks penetratif adalah mereka dapat memahami reaksi sensual satu sama lainnya. Mereka juga menjadi pasangan yang terampil tanpa khawatir akan terjadi kehamilan. Namun kerugiannya adalah mereka seringkali tidak merasa puas karena pengalaman mereka manjadi tidak sempurna.

Pengalaman seksual pertama Anda seringkali berjalan kurang mulus atau tidak sempurna. Ini sangat wajar karena kurangnya pengetahuan Anda dan Anda sendiri tak mengenal tubuh pasangan dengan baik.

Dari pihak si wanita sendiri, kerapkali banyak yang mengalami pengalaman menyakitkan atau kurang nyaman saat pertama kali ngeseks. Ini terjadi karena seks pertama kali, saat selaput dara yang menutupi bagian dalam vagina harus diterobos atau dirobek.

Di sinilah pentingnya pengenalan satu sama lain. Tak hanya sekedar kenal nama dan status masing-masing, tapi secara fisik satu sama lain mesti memahami apa yang dibutuhkan pasangan.

Jadi, meski kelihatannya cinta dan seks itu terpisah, sebenarnya dua pengalaman ini terkait erat satu sama lain. Relasi yang baik membawa ke pengalaman seksual yang luar biasa. Sebaliknya seks yang luar biasa tak bisa lepas dari pengenalan diri masing-masing (yang membawa ke pengalaman cinta)

LANGKAH AMAN

  • Lakukan seks hanya ketika Anda merasa yakin hal itu tepat buat Anda
  • Pastikan menghindari kehamilan dengan selalu menggunakan alat kontrasepsi
  • Pastikan pula menghindari AIDS atau penyakit menular seks lainnya dengan menggunakan karet pengaman atau kondom
  • Jangan pernah lakukan seks jika Anda merasa tindakan itu salah

30 April 2011337939190_orgasm_face_xlarge8d0894a0fbbd023246c239c96727326a

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Cinta dan Seks yang Tak Pernah Padam Itu Karena 5 Faktor Ini

KHUSUS PASUTRI


26 Juni 2013

 

Rahasia Seks dan Cinta-600-1

Nah ini ulasan mas Aditya Eka Prawira yang saya kira perlu saya share sama teman-2 Blogger di dunia. Penting untuk dibaca oleh semua orang yang Cinta Damai.

Sebuah studi baru dari University of Illionis menemukan bahwa ada beberapa hal dapat membuat hubungan Anda akan selalu dekat dengan kebahagian. Misalnya menjadi sosok yang lebih terbuka, menjadi lebih positif, memberikan jaminan, berbagi tugas, serta berbagi jejaring sosial.

Seperti dilansir menshealth, Sabtu (26/1/2013) ada beberapa perubahan sederhana yang dapat membuat hari ini akan memiliki efek riak pada kehidupan cinta Anda di dalam dan di luar kamar tidur Anda:

1. Berkata Jujur

Menjadi sosok orang yang jujur dan mengatakan apa yang sebenarnya terjadi baik untuk kesehatan Anda.

Penelitian terbaru dari University of Notre Dame menemukan bahwa orang yang dibohongi memiliki kesehatan mental lebih sedikit dan memiliki keluhan fisik dari pada para pembohong itu sendiri.

Jika pada saat Anda pulang dari bekerja dan Anda merasakan capek, katakanlah yang sejujurnya pada pasangan Anda bahwa Anda sangat capek dan ingin beristirahat.

2. Tersenyum Untuk Mengakhiri Perdebatan

Seorang wanita cenderung lebih memilih untuk mengandalkan bahasa tubuh, yaitu senyuman Anda, dari pada apa yang didengar olehnya.

Alasannya adalah bahwa tersenyum adalah sebuah isyarat yang paling penting untuk sebuah keramahan dan keamanan.

3. Sering Memberikan Pujian Untuk Pernikahan Lebih Bahagia

Melakukan hal-hal kecil dapat menambahkan usia pernikahan Anda menjadi lebih panjang.

Menurut sebuh studi yang dilakukan pada 373 pasangan menikah pada usia 25 tahun yang didanai oleh National Institute of Health menemukan fakta bahwa pasangan rutin memberikan penegasan yang afektif adalah pasangan yang paling bahagia.

Anda dapat melakukannya dengan cara mengatakan padanya bahwa ia tampak cantik ketika sedang memakai jeans barunya atau mengirimkan surat sebagai tanda Anda menghargainya.

4. Lakukan Pekerjaan Rumah Tangga Anda Untuk Seks Lebih

Penelitian dari Montclair State University menemukan bahwa frekuensi seksual pada 7.000 pasangan meningkat 0,06 persen per tahun untuk setiap kenaikkan 1 persen dalam pekerjaan rumah tangga mingguan ditangani oleh pria.

Jika Anda melakukan pekerjaan rumah tangga secara ganda, Anda akan mampu berhubungan seks 60 persen lebih sering.

5. Double Date

Menurut penelitian dari University of Maryland bahwa berteman dengan pasangan lain dapat membantu memperkuat hubungan Anda sendiri.

Mengapa demikian? Karena melihat wanita Anda menjadi orang yang mau bersosialisasi akan membuatnya lebih menarik dan mengungkapkan aspek baru dari kepribadiannya.

Sewaktu-waktu pasangan lain juga akan memberikan contoh apa saja yang harus Anda lakukan dan harus Anda hindari untuk membuat hubungan Anda dalam keadaan baik-baik saja. (Adt/Igw)

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Antara Seks dan Cinta-200-horz-1

Agar Seks Oral Jadi Lebih Seru

sex-jpg_203750

Rahasia Seks dan Cinta Yang Agak Terlupakan

KHUSUS PASUTRI


26 Juni 2013

Ini adalah ulasan dari Zainul Fuad (Kang Zain) seorang Pembicara, Penulis, & Konsultan yang saya kira sangat perlu dibaca oleh semua Pasangan Suami Istri di Jagat Raya ini.

Man-and-Woman-Couple-in-Bed

Mohon maaf artikel ini bukan artikel porno, kecuali bagi yang berpikir porno. Dan bagi yang sudah terlanjur berpikir porno, segeralah beristighfar, karena artikel ini bukan artikel porno, tapi ini adalah artikel spiritual yang berbau porno, bukan artikel porno yang berbau spiritual, karena memang spiritual itu nyaris meliputi semuanya, baik yang porno atau yang tidak porno.

Sahabatku yang spiritualis, SERINGKALI Tuhan menyimpan rahasia kehidupan di tempat yang terbuka, bahkan saking terbukanya maka kita anggap hal itu bukanlah rahasia sehingga kita enggan memahami hakikatnya, misal pada kasus seks dan cinta. Saking asiknya manusia berhubungan seks, maka banyak manusia yang lupa bahwa terdapat beberapa hakikat spiritual yang luar biasa di dalam berhubungan seks ….

Jika kita bicara cinta maka tidak selalu bicara tentang seks, dan jika kita bicara tentang seks maka seks terbaik adalah seks yang halal yang dilandasi rasa saling mencintai. Nah, ada apakah hubungan antara cinta dan seks?

Saya yakin bagi Anda yang pernah dan sedang menikah maka Anda pasti pernah melakukan Hubungan seks dengan pasangan Anda, kecuali yang belum sempat…. semoga Anda disempatkan-Nya karena banyak nuansa spiritual dalam seks dan cinta ….

Menurut Anda, dimanakah letak PUNCAK KENIKMATAN berhubungan seksual, khususnya dalam sudut pandang seorang Pria ? Silakan dijawab :

  1. Ketika Foreplay
  2. Ketika Masuknya alat kelaminnya ke dalam alat kelamin istrinya
  3. Ketika alat kelaminnya berhasil berlama-lama berada di dalam alat kelamin istrinya
  4. Ketika LEPASnya spermatozoa setelah sempat bertahan beberapa saat untuk memberikan kepuasan terbaik bagi istrinya
  5. Atau, Ketika LEPASnya spermatozoa tapi belum sempat MENAHAN cukup lama “stand by” berada di dalam alat kelamin istrinya

Antara Seks dan Cinta-200-horz-1

Saya yakin mayoritas dari Anda akan menjawab nomor 4, yaitu puncak kenikmatannya adalah “Ketika LEPASnya spermatozoa setelah sempat bertahan beberapa saat untuk memberikan kepuasan terbaik bagi istrinya.”

Bahkan bagi orang-orang bujang yang “kreatif” maka seringkali melakukan proses melepaskan ini yang disebut “Onani”, namun masalahnya Onani ini tidak melewati prosedur yang lumrah, tanpa perlu “masuk” dan “bertahan” di dalam alat kelamin wanita, yaitu yang penting sperma bisa LEPAS dari kandangnya…. tentu saja perilaku ini adalah hal yang kurang baik.. kok belum apa-apa sudah melepaskan.. bisa-bisa nanti kena “warisan” Ejakulasi Dini… nah bagi Anda yang sudah terlanjur kena penyakit Onani ini maka kunjungi artikel kami “Onani, antara maslah dan solusi” di : goo[dot]gl/H4Jml … semoga lekas sembuh yaa…

Baiklah, mari kita lanjutkan, ternyata : Saat “Mau Masuk” itu nikmat, Saat “Masuk” itu nikmat, Saat “bertahan di dalam” juga nikmat, dan saat “Keluar-Lepas” juga nikmat, nah, sekali lagi saya bertanya, bagi Anda yang pernah berhubungan seks, manakah yang lebih nikmat? Dimanakah puncak kenikmatan yang sungguh melegakan dan membuat Anda rileks?

couple-in-bed-fake-orgasm-w352-horz-600-1

Ya, sebagaimana yang juga saya rasakan bahwa puncak kenikmatan sejati dalam berhubungan seksual adalah di saat MELEPASKAN

  • SEKS bukan sekedar untuk Niat Memasuki-Mengenali … Memulai MISI … >> TEGANG karena SENANG
  • SEKS bukan sekedar untuk Memasuki-Menahan-Mengikat… Menjalankan MISI.. >> SENANG karena TEGANG
  • SEKS bukan sekedar untuk Keluar-Melepaskan… Menyelesaikan MISI.. >> TENANG karena sudah melewati masa TEGANG dan SENANG

Sehingga untuk mencapai maqom TENANG dalam kehidupan DUNIA ini maka kita perlu melewati prosedur yang namanya SENANG dan TEGANG …. tapi bagi Anda yang sudah terlatih dalam “Inner Peace” maka rasa TENANG akan hadir hampir di setiap saat di kehidupan Anda, walaupun Anda sedang SENANG ataupun TEGANG…

Nah, sekarang kita paham bahwa Puncak dari SEKS adalah MELEPASKAN. Lalu, dimanakah Puncak dari CINTA? Apakah di saat Saling “Memiliki-Mengikat” ataukah di saat “Saling Melepaskan”? Sebab kita paham bahwa dalam kehidupan CINTA pun melewati prosedur TEGANG, SENANG, dan TENANG.

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