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Testimonials

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Sandro Rosell
FC Barcelona President
Wednesday, May 24, 2017

(Continued from last week)

Breast Cancer

Breast cancer is already more common in developed, Western countries than elsewhere — likely because women who delay childbirth until later in life and have fewer children do not enjoy as much of the positive, cancer risk-reducing effects of the hormonal changes associated with childbirth.

Ashkenazi Jews in particular have a significantly higher risk for breast cancer: They are about three times as likely as non-Ashkenazim to carry mutations in the BRCA-1 and BRCA-2 genes that lead to a very high chance of developing cancer. One of the BRCA-1 mutations is associated with a 65 percent chance of developing breast cancer. Based on family history, including on the father’s side, the chances could be even higher.

“Every Ashkenazi Jewish woman should be tested for these mutations,” said Levy-Lahad, who has done significant research work on the genetics of both breast and ovarian cancer. Iraqi Jews also have increased prevalence of one of the BRCA mutations, she said.

Levy-Lahad is collaborating on a long-term project with the University of Washington’s Dr. Mary-Claire King — the breast cancer research pioneer who discovered the BCRA-1 gene mutation that causes cancer — on a genome sequencing study of Israeli women with inherited breast and ovarian cancer genes. The two women are using a grant from the Israel Cancer Research Fund to apply genomic technology to study BRCA-1 and BRCA-2 mutations and their implications for breast cancer risk in non-Ashkenazi women in Israel, who are similar to populations in Europe and the United States.

In a project that is testing thousands of women for deadly cancer mutations, they are also studying how mutations in genes other than BRCA-1 and BRCA-2 impact inherited breast cancer in non-Ashkenazi Jews.

The earlier breast cancer mutations are discovered, the sooner women can decide on a course of action. Some choose to have bilateral mastectomies, which reduce the chances of breast cancer by 90-95 percent. Actress Angelina Jolie famously put a Hollywood spotlight on the issue when she wrote a 2013 op-ed in The New York Times about her decision to have the procedure.

But mastectomies are not the only option. Some women instead choose a very rigorous screening regimen, including more frequent mammograms and breast MRIs.

Early detection is the cornerstone of improving breast cancer survival rates.

“Breast cancer is not nearly as deadly as it once was,” Levy-Lahad said.

Ovarian Cancer

Of the three “Jewish” cancers, ovarian cancer is the deadliest.

Linked to the two BRCA mutations common among Jews, ovarian cancer is both stubbornly difficult to detect early and has a very high late-stage mortality rate. Women should be screened for the mutations by age 30, so they know their risks.

In its early stages, ovarian cancer usually has no obvious symptoms, or appears as bloating, abdominal pain or frequent urination that can be explained away by less serious causes. By the time it’s discovered, ovarian cancer is usually much more advanced than most other cancers and may have spread to surrounding organs. If that has occurred, the five-year survival rate drops considerably.

Women with the BRCA mutations have about a 50 percent chance of getting ovarian cancer. The best option is usually to remove the ovaries.

“We put a lot of pressure on women to have their ovaries removed because it’s a life-saving procedure,” Levy-Lahad said.

That doesn’t mean these women can’t have children. The recommendation is that women wait to have the procedure until after they complete child-bearing, usually around the age of 35-40.

Much work still needs to be done on prevention, early detection and treatment of ovarian cancer, but new research shows some promise.

“The exciting thing is that we live in a genomic age, and we have unprecedented abilities to understand the causes of cancer,” Levy-Lahad said. “There’s a whole field that, if you become affected, can look at the genetic makeup of the tumor you have.”

The study of these three “Jewish cancers” are a major component of the work of the Israel Cancer Research Fund, which raises money in North America for cancer research in Israel. Of the $3.85 million in grants distributed in Israel last year by the fund, roughly one-quarter were focused on breast cancer, ovarian cancer or melanoma, according to Ellen T. Rubin, the ICRF’s director of research grants. The organization’s Rachel’s Society focuses specifically on supporting women’s cancer awareness and research.

A significant amount of the organization’s grants is focused on basic research that may be applicable to a broad spectrum of cancers. For example, the group is supporting research by Dr. Varda Rotter of the Weizmann Institute of Science into the role played by the p53 gene in ovarian cancer. P53 is a tumor suppressor that when mutated is involved in the majority of human cancers.

Likewise, Dr. Yehudit Bergman of the Hebrew University Hadassah Medical School is using an ICRF grant to study how the biological mechanisms that switch genes on and off – called epigenetic regulation – operate in stem cells and cancer.

“Only through basic research at the molecular level will cancer be conquered,” said Dr. Howard Cedar of the Hebrew University Hadassah Medical School.

“Hopefully, one day there will be easier and better ways to detect and destroy the cancerous cells that lead to these diseases. But until those research breakthroughs, medical experts say that Jews, as members of a special high-risk category, should make sure they get genetic screenings and regular testing necessary for early detection and prevention.

By: Niv Elis