Cancer is scary. Delving into the realities of genetic predispositions for cancer can also be scary, especially if, like many Ashkenazi Jews, you have a higher-than-average likelihood of carrying certain cancer-linked genes.

Talking about these things shouldn’t be – at least it wasn’t supposed to be at Congregation Beth Israel’s panel discussion, What Every Jewish Person Should Know, held Wednesday, Aug. 19.

“This evening is not about creating fear,” moderator Dr. Barbra Fisher explained. “It’s meant to provide knowledge when we understand our personal and family health history and recognize what questions to ask and know where to turn for support so we’re better equipped to make informed decisions and advocate for others and the people we love.”

Ashkenazi Jews are more likely than the general population to carry the BRCA1 and BRCA2 gene mutations, which are linked with increased risk of breast and ovarian cancer. They also are more likely to develop colon cancer, particularly early-onset cases associated with the A636P gene mutation, according to medical journal database EBSCO. However, cancer genetics is still a new field, and just like having a genetic mutation doesn’t mean you’ll get a certain cancer, the absence of generic markers isn’t a guarantee the other way.

Dr. Dafna Lohr, a panelist who practices obstetrics and gynecology in Portland and comes from a family with a history of cancer diagnoses, learned this when she went in for her own genetic testing after finding a benign lump in her breast.

“There was not a known gene mutation that explained the cancer in my family,” she said, “and I remember very clearly that, ‘There probably is a gene mutation in your family. We just don’t know what to look for yet.’”

Lohr was later diagnosed with breast cancer.

Having information about genetic history can prompt more intensive screenings for certain cancers, guide treatment decisions if a cancer is found or even inform decisions on elective treatments like fallopian tube removal – a procedure which has been found to reduce the risk of ovarian cancer, a disease for which Lore explained there is not currently an effective screening.

Michelle Caplan, a cancer survivor and womens health advocate, explained that she ended up not testing positive for either BRCA mutation, despite a lengthy family history of breast cancer. She still elected for a double mastectomy when she was diagnosed.

“It’s asking, it’s being an advocate, it’s asking a lot of questions. It is relying on people who know the answers and not being afraid to reach out to them,” she said of the process of going through genetic testing and cancer treatment. “Sometimes we’re scared to ask for help. I’m one of those people who does not like to ask for help because I think I can do it all myself. But I learned that I needed to ask for help.”

Many organizations exist to help; Sharsheret, a Jewish women’s health group, Breast Friends, Fighting Pretty, Pink Phoenix and a number of local genetic medicine practices were among those with tables at the event’s information fair.

A great resource, of course, is your primary care provider.

“A big part of our job is to be someone’s partner in their health journey and decide whether to worry with them or not,” explained panelist and internist Dr. Denise Bilbao, discussing when someone should talk to a doctor about something they may notice on a breast self-exam. “I don’t really have a ‘If this is a symptom, come see us, but otherwise, don’t bother us.’ I think if you have a worry, it’s a good idea to talk to somebody about it.”

That this event was held early in the Hebrew month of Elul was no mere coincidence, Beth Israel’s Senior Rabbi Designate Rabbi Rachel Joseph explained. She spoke wearing, as she does every day, the kippah of her close friend Rabbi Aimee Gerace, z”l, who passed away in 2023 due to breast cancer.

“We often think about it as internal spiritual work... but our tradition has always also taught us that our that our physical is just as important,” Rabbi Joseph said. “That caring for our bodies is also really important work in this preparatory time of Elul, and that our health, our physical health, is not separate from our spiritual health. It’s all intertwined. It’s all connected.”

Learn more about breast and ovarian cancers and other women’s health issues in the Jewish community at Sharsheret.org.

PHOTO: Rockne Roll/The Jewish Review