Genetic research has been called a mixed blessing, but these days there is nothing mixed about it. The announcement of the long and comprehensive studies of the prevalence of the BRCA1 and BRCA2 genes in Ashkenazi Jewish women has produced some important information for all of us. (You can find the article in the Washington Post [ed: Remember that the Post is only free for two weeks, so if you are checking after 8 November, there may be a fee to see the entire article]. Science Magazine, a fee-based web site and print publication, carried the original article.)
The short version is this: women who have inherited mutated versions of these genes are at a high risk of getting breast cancer and/or ovarian cancer. About one in forty Ashkenazi Jewish women carry this gene, and stand a better than fifty-fifty chance of developing breast cancer by age 60. The lifetime risk for ovarian cancer is 54%, compared with 2% of the general population. These statistics are independent of family history.
While the news is alarming, it is not dismal. Testing is available to identify the mutated genes, and preventative actions can dramatically reduce the incidence of these cancers. That brings me to the new mitzvah.
Piku’ach nefesh, preserving life, is certainly one of the most well known of our commandments. This new mitzvah is in a subset of piku’ach nefesh: active prevention of avoidable illness. Every person of Ashkenazi background must be tested for the presence of BRCA1 and BRCA2. Women and girls must do so for their own health. Men and boys, unaffected by the gene, can nonetheless pass it along to their offspring. Once the test results are known, you should follow the recommendations of your physician.
The study revealed that the emergence of the cancers can be forestalled by two kinds of preventative actions when a woman is in her teens and twenties. The first is regular exercise and a healthy diet, with special attention to avoiding obesity. Though the link between them and prevention is unclear, it seems nonetheless effective. If you have a loved one – including yourself – in those age groups, it is a mitzvah to insist on those healthy choices.
The second preventative action will certainly be more controversial. Pregnancy earlier in life seems to have a positive effect on these conditions as well. It has become the standard among Jews to postpone marriage and childbearing into the late twenties and thirties. While no one should rush into marriage for its own sake, young women (and men) should be encouraged to place family life as a priority earlier rather than later.
This column is a summary of a summary. You should read more and ask your health care professionals for more information as well. But we all know too many people who have struggled with these cancers. Many of them have overcome its aggressiveness, but not without a price. Some of them – too many – have lost the battle they didn’t even know they had to fight. Choose life for yourselves and for our daughters. Get tested. Get healthy.
My Rebuttal--Susan Paley
In the March 21 issue of The Bulletin, Rabbi Moline wrote a searing critique of the Big Apple (Get Over It, New York.) Inspired, apparently, by The New York Times’ article that complained about DC’s less than muscular reaction to snow, Rabbi Moline’s article fully discloses that he has a personal dislike for New York City, and resents the implication that Washington has the “charm of the North and the efficiency of the South.”
Certainly, the good Rabbi has the right to espouse his personal opinions in his own column. I will not deprive him of that. But, as he put this critique forward in a public forum, I thought it warranted a rebuttal from a native New Yorker who pleasantly tolerates this mid-Atlantic region but loves the fact that New York has both the charm of the North and the efficiency of the North.
Rabbi Moline remarks that we should be glad that in Washington we can walk down the street and see the sky without falling over backwards. That he’d rather drive the Rock Creek parkway than the West Side Highway. And that one needs a Ph.D. in public transportation to ride the New York subway system.
I for one would rather traverse the sidewalks of New York, where looking upward brings a veritable smorgasbord of sensory experience; I’d rather drive the scenic Hutchinson Parkway or the beautiful NY Throughway than sit on the Beltway for miles without a Trans Am or oversized Cadillac in sight for visual entertainment; I’d take that class in public transportation that would qualify me to ride the NY subway system where at Least I Can Eat on the Commute.
And finally, I’d love to every day walk the sidewalks of Manhattan where 80 years earlier my Grandfather may have walked when he arrived on these shores from Minsk, risking everything to start a life in the city that would become the most culturally Jewish in the country.
If Washington, DC is the political center of our country- or, symbolically the Prime Minister, then New York is the Monarchy where our Royalty lives. And in a time when cultural divides are causing consternation the world over, perhaps the Rabbi didn’t need to draw attention to another.
If I’ve taken too seriously a column which the Rabbi intended only tongue-in-cheek, then I back away and sheepishly say ‘never mind.’ Otherwise, I stand by my declaration and say ‘Get Over It, Moline!’