In the worldwide battle against cancer, Angelina Jolie’s decision to have a risk-reducing double mastectomy in 2013 was a hugely significant milestone. In particular, it removed much of the stigma surrounding genetic testing for a BRCA mutation, as well as helped many with the difficult dilemmas involved in undergoing prophylactic treatment.
A significant number of those who chose to undergo testing or surgery now felt that they had a role model in Jolie, who declared, “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.”
But the specific battle to raise awareness about BRCA1 and BRCA2 genetic mutations did not end with Jolie’s announcement, vital though it was. In fact, it was just a beginning. Since then, many initiatives have been introduced to help raise awareness about cancer risk and enable people to make informed choices.
Within the Jewish community, this has involved innovative sixth-form educational programmes, “Pink Shabbat” campaigns and excellent outreach work spearheaded by the remarkable organisation Jnetics .
Yet, there is always more work to be done. And nowhere is this more so than in the context of the BRCA gene. Jewish people of Ashkenazi descent are 10 times more likely to be carriers of a mutation of this gene, which dramatically increases not only the risk of breast and ovarian cancer in women, but also prostate cancer in men. So, the recent launch by the charity Ovarian Cancer Action of an excellent online tool, designed to assess cancer risk, is a vital addition to the arsenal of initiatives that already exist.
I was privileged to participate in a recent presentation of the tool and subsequent panel discussion by Ovarian Cancer Action at JW3. I was deeply inspired by the charity’s dedication to the cause, as well as its vision in developing a resource which is simple and straightforward enough for anyone to use, yet provides significant, and possibly life-changing, guidance.
The tool, which is suitable for both men and women, essentially gathers data regarding family history of cancer, including the ages at which close relatives were diagnosed. It then uses this information to provide advice regarding the possibility of being at a higher risk of developing cancer. Although it does not assess the risk of all possible genetic mutations, it does assess the risk of being a carrier of faulty BRCA1 and BRCA2 genes, as well as Lynch Syndrome, a form of colorectal cancer. Both are particularly relevant to the Jewish community.
From the perspective of Jewish law, it is important to point out that many leading rabbinic authorities agree that a decision to undergo testing for a dominant genetic mutation, such as BRCA, is an intensely complex and personal one. Yet BRCA testing unquestionably saves lives, and while not a formal obligation, is certainly permitted in Jewish law, particularly if one has a family history of certain cancers. Today, preventative measures can dramatically reduce the risk of cancer for both the carrier and their families.
It is true that the tool itself is no more than an indicator of risk. It obviously cannot diagnose, or provide any firm conclusions, in its outcomes. But what it does do is provide the critical gift of awareness. Spending just a few minutes completing it online enables a user to make an informed decision as to whether it would be wise to initiate a conversation with a GP or other medical professional regarding cancer risk. It ensures we are more knowledgeable regarding our future choices, and that can only be a good thing.
As a community, we should be deeply grateful to Ovarian Cancer Action not only for developing this vital tool, but for reaching out to the Jewish community to ensure that we are aware of its existence. Thankfully, genetic testing for recessive gene problems, such as Tay-Sachs, has become more widespread across all sectors of the community during recent years. With the heightened presence of the BRCA gene mutation in our collective genetic heritage, we should now rightly spread the word — and link— about this new tool as much as we can.
There was a time when people were afraid to mention the ‘C’ word. But we are fortunate to live in an age when more than ever before can be done to fight the scourge of cancer. As Jews, our tradition empowers us to take action wherever and in whatever manner we can in order to protect our health.
Yoni Birnbaum is the rabbi of Hadley Wood Synagogue
