Our Voices: A Blog by Links, Callers and Volunteers

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Wednesday, September 22, 2010

Ask Your DNA

By: Lisa Friedman, Ph.D., Sharsheret Peer Supporter

I recently attended the annual conference for FORCE (Facing Our Risk of Cancer Empowered), the national organization for hereditary breast and ovarian cancer. I was so happy to see Sharsheret’s exhibit booth there, because I realize what an important issue genetic cancer is for the Jewish community - and how so few women and men know that they are at risk. Sharsheret was a great help to me when I first needed to understand what it meant for me, as a Jewish woman, to be BRCA positive. I found information I urgently needed from Sharsheret's resources and website.

This is the information I wish I had known earlier in my own life: 1 in 40 Ashkenazi Jews carries a BRCA mutation that leads to extraordinarily high rates of genetic cancer in women. Women who carry a mutation have up to an 87% lifetime risk of breast cancer, and a 27% - 44% risk of ovarian cancer, depending on which kind of mutation they carry. BRCA mutations can lead to increased risk of cancers affecting men as well, such as prostate or pancreatic cancers, male breast cancer, and melanoma.

If women know about their risk ahead of time, they can choose from a wide range of options to help them find their cancer early or even to prevent it altogether. While recent research estimates that one million people in the U.S. carry high-risk BRCA mutations, only 5% of them know. I was one of those 95% who didn’t know, and I learned the hard way about the difference between knowing and not knowing.

I remember seeing articles about the BRCA gene in women’s magazines, but I always skipped right over them. My grandmothers had each lived long, healthy lives well into their eighties, and I never knew to look to my grandfathers’ sides of the family. I also never knew that the ovarian and pancreatic cancer in my family could be BRCA-related. Breast cancer seemed so separate — I never thought about it as genetically interlinked with other cancers. My doctors didn’t seem to know either. I have the classic family history that indicates testing is important: I am Ashkenazi Jewish, my mom died of ovarian cancer, and her father died of pancreatic cancer. Yet, not a single doctor ever suggested I check my DNA.

I ran into information on genetics by chance, as part of a research project on the future of healthcare. I was looking over a website for my project, when I noticed that it offered genetic testing that could help Ashkenazi Jews check for their risk of ovarian cancer. After talking with their genetic counselor, I signed up for a test.

I was shocked to discover I tested positive for one of the three BRCA mutations so common for Ashkenazi Jews. Once I learned I was at high risk, I had more extensive screening for cancer that I never would have had otherwise. After a completely normal mammogram, my MRI showed I already had breast cancer. I never would have had this MRI if my genes hadn’t provided advance warning about my risk. Learning my DNA potentially saved my life.

Friday, September 3, 2010

The Triumphant Call of the Shofar

By: Shera Dubitsky, Clinical Supervisor

Beginning in the Hebrew month of Elul until Yom Kippur, we hear the piercing notes of the Shofar and listen intently to its sounds. The reverberations of the Shofar can be heard in times of battle. I liken the sound to a heart beat. Most of the time, our hearts beat with a steady rhythm. We go about our regular routines, taking care of our families, meeting deadlines at work, volunteering in the community, spending time with friends. Tekiah. There are times when we are challenged, perhaps with a knowledge that one is a carrier of the BRCA mutation, or that one has been diagnosed with cancer or a recurrence. The rhythm of our hearts change reflecting our anxiety, our fears. Shevarim. Deep within the battle, our heart beat quickens as our anxiety heightens, and our fears overwhelm us. Teruah.

We don’t hear these sounds once. We hear the cycle of the Shofar notes throughout the holiday season, alternating between the steady calm notes of Tekiah to the quickened sounds of Teruah. So too, with the rhythm and challenges of our lives. When faced with difficult news, remember that with each Shevarim and Teruah, we return to the calmness of the single sound of Tekiah.

The Shofar can be a wake up call to stop and take time for introspection. As we listen to the notes of the Shofar, we can become aware of the changes of our beating heart. It is a reminder to attend to our bodies, to our instincts, to our emotions. The sounding of the Shofar can help us refocus and make sure that we are taking care of our hearts, minds, and souls. When we pay attention to the inner and outer sounds, we hear the last blast of the Shofar, a signal of hope and triumph. Tekiah Gedolah.

Shana Tova,

Shera