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Cancer Gene: Chabad of Riverdale Seeks Jewish Answer to Jewish Problem

Thursday, 24 October, 2013 - 2:28 pm

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The Susan G. Komen Foundation have promoted our upcoming class, "Ounce of Protection," which aims to raise community awareness about the heightened risk of breast and ovarian cancer among Jewish families. The class, which is the first in the six-week course, "Life in the Balance: Jewish Perspectives on Everyday Medical Dilemmas," will take place this Sunday, October 27.

The risk of carrying a BRCA gene mutation that causes breast and ovarian cancer is ten times greater among women of Ashkenazi Jewish descent than among the general population. With growing concern over what preventive measures Jewish women should take, Chabad of Riverdale, in conjunction with the Rohr Jewish Learning Institute (JLI), is organizing a community awareness workshop on how Jewish law views this modern day medical dilemma.

 The class - which will be held at Chabad of Riverdale, 535 West 246th Street, on Sunday, October 27, between 9:45-11:15 am - will explore the biblical requirement to safeguard one's health, and whether it obligates Jews of Ashkenazi descent to test for BRCA-1 and BRCA-2 gene mutations. Even more importantly, it will discuss whether Jewish law recommends women to undergo radical mastectomies or oophorectomies in case they do test positive, in order to save their lives.

Entitled "An Ounce of Prevention: BRCA, Genetic Testing, and Preventive Measures," the class is being offered by JLI in 362 communities in honor of National Breast Cancer Awareness Month. It is the first class of a new six-week course, titled Life in the Balance, about the Jewish perspective on everyday medical dilemmas. The course is accredited for Continuing Medical and Legal Education, and can help medical professionals develop a greater sensitivity to the concerns and decisions facing some of their Jewish patients.

One in forty women of Ashkenazi Jewish descent carry a BRCA gene mutation compared to about one in four hundred in the general population. If a woman carries the mutation, there is a 50 to 80 percent risk she will develop breast cancer, starting as early as her twenties, and a 20 to 40 percent risk she will develop ovarian cancer as early as her thirties. Although the risk is much lower for ovarian cancer it is much deadlier, since blood tests and ultrasound exams rarely diagnose the cancer until it has already reached stage three or four, and is then difficult to treat.

"Statistics like these are leaving women in the Jewish community with some tough decisions to make," said Rabbi Yanky Raskin, course instructor. "Some are reluctant to get tested, worried about the medical and financial repercussions, and the prospect of facing radical surgeries that could affect their self-image or ability to have children. Having to face decisions of such complexity has led many women to avoid addressing the issue altogether. But with mortality rates so high, this is hardly a problem the Jewish community can afford to ignore."

The issue of testing for the BRCA mutations and undergoing radical surgery to prevent the onset of cancer drew national media attention following Angelina Jolie's recent announcement that she had undergone a prophylactic mastectomy upon having been tested positive for a BRCA-1 mutation and learning she had an 85 percent risk of developing breast cancer. 

While the media spotlight made many women more aware of the risks, it also sparked some confusion in the Jewish community and intensified a debate among geneticists and medical professionals whether all women of Ashkenazi Jewish descent should be tested, or only those with family histories of breast or ovarian cancer.

Until recently it was thought that only women with a family history of these cancers should be screened for BRCA mutations, but Dr. Wendy Rubinstein, director of the National Institute of Health's genetic testing registry, calculated that testing all women of Ashkenazi Jewish descent would save 2,800 lives a year and be extremely cost-effective despite the relatively high cost of testing.

 "I still believe in family history. It tells you an enormous amount," said Rubenstein, one of the geneticists whose opinions will be shared in the JLI class. "The professional guidelines are that [family history] is enough and I really don't want to contradict that and say we ought to go farther. What I do think is that we ought to think seriously about a screening program as a community like we did for Tay-Sachs...which was so effective reducing the birth of Tay-Sachs-affected babies. I want to see a dialogue begin between the Jewish community, the medical community, and the public health community."

Others, such as geneticists at the Program for Jewish Genetic Health of Yeshiva University/Albert Einstein College of Medicine, say that because most BRCA studies have so far been limited to women with a family history of cancer, no one can know for certain whether a positive test result is a conclusive predictor for those with no family history of cancer.

In the JLI class students will be presented with different voices from the medical community as well as the perspective of Jewish law, so they can be prepared to make an informed decision in consultation with their physician and geneticist. 

"Some 1,500 years ago when rabbinic scholars wrote the Talmud, they didn't have questions about screening for cancer genes like we have today," said Rabbi Raskin. "However, there are guiding principles found in the Talmud that can help us determine how to respond to these very perplexing and life-altering medical quandaries. One of the Talmud's most important lessons that must guide our response is that saving one life is like saving an entire world."

Like all JLI programs, Life in the Balance is designed to appeal to people at all levels of Jewish knowledge, including those without any prior experience or background in Jewish learning.

 

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