Russian Roulette

Several weeks ago, following the advice of my inner voice that said, "go, go, go," I attended a symposium at Portland's Mittleman Jewish Community Center entitled, "Your Jewish Genes and Cancer." 

For some time I have known that I might be at high risk for breast cancer.  Both my mother and sister have dealt with breast cancer at different stages of their lives:  Mom at about age 73, and then, years later, my sister's cancer was discovered at age 44.   After their positive diagnoses, both had a lumpectomy, followed by a course of radiation, and both have been extremely fortunate --- with no cancer recurrence.  Then, last fall, while visiting relatives in the mid-West, I learned that a cousin there --- on my Dad's side --- had recently been diagnosed with breast cancer and undergone a mastectomy.

My family (both father and mother) are eastern European Jews called Ashkenazim, and generation after generation of these eastern Europen Jews living separately in ghettos in places like Latvia, Lithuania, Poland, Russia and Hungary, married among themselves which led to a proliferation of certain genetic mutations and a higher risk for some inherited diseases, among them, breast cancer.  At the April symposium, I learned that the risk of developing breast cancer among the general population is 1 in 400.  For Ashkenazic Jews, the risk is 1 in 40.  Quite a shocking difference! 

Admittedly, I have known of my risk for quite some time.  I am an well educated woman who as a rule, makes good decisions about my life.  Since my sister's bout with breast cancer, however, I have, you might say, been playing Russian Roulette. I read with interest what the so-called experts have to say about not needing a mammogram every year, and I go ahead and get one annually anyway, in spite of such "expert" opinions. And, every year I go feeling both unbelievably anxious and stressed.  And every year as I get older, that anxiety seems to increase.  

Reluctantly, following that persistent inner voice, I attended the April symposium at the Jewish Community Center.  Nothing could have prepared me for what I experienced that evening, walking into that room, seeing so many familiar faces!   I was in shock!  So many women, many of whom I have known for years, grown up with, worked with on various committees and boards, embraced me and  shared their stories of being diagnosed with BRCA1** and/or BRCA2**,  the genetic mutation that puts so many Jewish women at risk for breast cancer. Others were waiting for the results of genetic testing to determine if they are BRCA1 or BRCA2 carriers. If positive, this had significant implications for not just them, but their children and grandchildren as well. Apparently among my friends, this is a health topic that is not readily discussed. I continue to be amazed that so many women I know, are dealing with these same issues I have been avoiding.

I left that symposium a different person, certainly more aware that I had been hiding from the truth, and playing Russian Roulette with myself and my children. I need to assess my risk for breast cancer with an expert, a genetic counselor.  I need to find out what my health insurance will pay for, and what it won't pay for.  Most importantly, I need to begin to think about my options --- if --- such testing proves that I am a carrier of the BRCA1 or BRCA2 genes.  How will my family feel if it is determined a double mastectomy would be my best option?  What are my chances if I do nothing? What, what, what........

("The Angelina Jolie Factor:"  This famously beautiful young woman and mother, announced recently, she had undergone a double mastectomy and breast reconstruction after genetic testing proved she was a carrier of a  BRCA gene.  Breast cancer had been her mother's killer some years ago.)

My Portland Jewish lady-friends and vicariously, Angelina Jolie, are urging me toward genetic testing.  Yet, I continue to think, procrastinate, and have not yet made that call to the genetic counselor.  My husband's health and my mother's health seem to take up all my time, energy and priorities.  I keep promising myself to call that number, which even now, sits right in front of me.

                                            Me, my Mom, and my sister, c.1965

**BRCA1 and BRCA2 can also cause breast cancer in men.

Friends and Family:  Your thoughts and comments will be read and appreciated.