Medical Ethics Program Takes Aim at BRCA 'Jewish' Gene Mutation

After Angelina Jolie's Breast Surgery, Push To Explore Issues

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By Chavie Lieber

Published October 25, 2013.
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The mortality rate varies depending on the types of cancer. The five-year survival rate for breast cancer is at 90 percent, while the five-year survival rate for ovarian ranges from 20 to 30 percent, according to Chani Wiesman Berliant, a genetic counselor with the Program for Jewish Genetic Health.

“As a woman, there is so much saturated information out there, and this topic is way too complex to get all the options from one single news article,” said Mindy Wallach, the director of continuing education at the JLI. “Right now, there is nothing really that gives Jewish women answers: do I have to get tested if I’m an Ashkenazi Jew, regardless of my family history with breast cancer? What about if I’m tested positive, am I automatically going to have to get surgery?”

The first JLI session on BRCA will be free to the public in commemoration of National Breast Cancer Awareness month. Co-sponsored by the Susan B. Komen Foundation, representatives from Komen will attend the programs in several cities to answer questions and provide options for cancer treatments. The other 5 sessions in the course cover topics of abortion, end-of-life care, organ donations, autopsies, and uterus transplants.

“We create programs based on the needs of the community, and this is a severe topic circulating within Jewish homes,” said Rabbi Mordechai Dinerman, the course’s editor. “This course will help people think about what it really means to be an Ashkenazi woman facing the BRCA gene— as well as Ashkenazi men, since men, while not as common as women, are disposed to the BRCA gene as well.”

Sitting at large conference table with JLI representatives in their Crown Heights headquarters one fall afternoon, Dinerman said his team spent many months consulting with professional genetic counselors to ensure the content of the course was factual, expansive, and up-to-date.

The program fuses commentary of Jewish sources like the Talmud and Maimonides with scientific research and statistics from sources including the Journal of the National Cancer Institute, the New England Journal of Medicine, and the Journal of Clinical Oncology.

“Given the unique fact this gene is strongly associated with the Jewish community, it behooves us to know what our own tradition has to say about the matter,” said Dr Edward Reichman, a professor of clinical emergency medicine at the Albert Einstein College of Medicine. Reichman assisted JLI in editing the course. “There’s a great deal of commentary within Jewish law that helps us address health issues, like what we can and can’t do to our bodies. For some, its comforting to return to their faith for answers.”

Some of the questions addressed in the JLI BRCA course might appear to have obvious answers, but the topic of medical necessities within the Jewish community— especially the Orthodox community— is a rather sensitive issue.

The case for testing for BRCA within the Ashkenazi Jewish community comes with debate. Mary Claire King— the woman who first found the BRCA mutation in 1990— holds the position that all Ashkenazi Jews should be tested. Opinions like those from the National Comprehensive Cancer Network, on the other hand, suggest women should be tested if the BRCA gene already runs in the family.


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