(JTA) – On the way home from the hospital where I received my diagnosis of grade 2 invasive lobular breast cancer, I directed my husband, through my tears, to stop at the kosher shop.
“I don’t want to see anyone right now,” I said, knowing the inevitability of meeting someone we knew in the small Jewish community where we live, “so can you come in?” He pulled into the parking lot. “We need challah,” I reminded him. After all, it was Thursday. The next night was Shabbat. Time does not stand still for cancer.
My hospital appointment came two days after the front page of the New York Times declared, “When Women Should Get Regular Mammograms: At Age 40, US Panel Now Says.” I was 48 years old. Breast cancer has always been the second most common cancer among women, after skin cancer. It is also the deadliest after lung cancer. Statistically, though, most affected women are postmenopausal, so unless there was a specific reason to get tested early, women were regularly screened from age 50 onwards. Now the advice has changed. Breast cancer is increasing in younger women. For women in their 40s, the rate of increase between 2015 and 2019 doubled from the previous decade to 2% per year.
Why is this happening? Air pollution? Microplastics? Chemicals in our food? We do not know.
In the days following my appointment, there has been a proliferation of articles on the subject. Importantly, doctors explained that cancer diagnosed in women in their 40s tends to be a more aggressive type of cancer. Cancers in premenopausal women grow faster; many breast cancers, like mine, are hormone sensitive. (Does it have estrogen? Bad luck for you.)
When I posted the news of my diagnosis—on Facebook, because I’m the oversharing type—I was amazed at how many friends my age, more private about their lives, messaged me that they’d recently gone through the same thing. Everyone had advice. “If you can have a mastectomy, you are very lucky. It is not a major operation and you will preserve your breast. “Cut everything! Immediately! Get rid of it all and never worry again! Do you want to spend the rest of your life with mammogram anxiety? “Ask plastic surgeons for photos and choose the cutest breasts out there. You will not regret.” “Radiation burns – that’s something no one ever tells you. Take some Lubriderm and Lidocaine, mix it into a paste, put it in a pad and put it in your sports bra.
I don’t know why I thought I was immune. Or maybe not – maybe I just never thought about it much. Even when I found the lump in my breast, I was dismissive. I went to the doctor and she asked if anyone in my family had breast cancer. “Oh, who knows? They were all murdered,” I said happily. His eyes bulged. “In the Holocaust,” I added. “Your mother? Grandmother? Sisters?” Oh! No, no history of breast cancer in my immediate family.
Add to that, both my mom and sister tested negative for BRCA gene mutations, and that’s the Ashkenazi side of me. The problem is that most women who test positive for breast cancer no her family history.
But also, I had done everything right! If you look at the preventive measures, I took all of them. I had three children by age 35 and I breastfed them. I have a healthy, mostly plant-based diet; I walk and cycle everywhere. I am not a drinker or smoker. I eat so many blueberries!
Several of the articles that have been published in recent days emphasize the particular danger for black women, for good reason: they have twice the death rate of white women. But in doing my research, I realized that Jewish women should also be on high alert. We have long known that one in forty Ashkenazi women have the BRCA gene mutation, significantly increasing their risk of breast cancer (50% of women with the gene mutation will have breast cancer), as well as ovarian cancer, which is much more difficult to detect and much more deadly. Then many of my friends who have reached out to tell me about their experiences with breast cancer are Jewish; interestingly, none of them have the BRCA mutation. Are these high numbers indicative or anecdotal? Are Jewish women generally more susceptible to breast cancer? This appears to be an important area of future research.
For me, this research will come too late – and so will the orientation. For now, I have to accept that this cancer diagnosis is part of my life, that just as I’m going to get challah every Thursday, I’m going to wake up every morning and take my hormone blocker Tamoxifen. I’m going to lose sleep every night thinking about which surgery to do until I have the surgery, and then I’m going to lose sleep every night wondering if it was completely successful. And there’s so much more in store for me that isn’t pretty; so it goes.
But here’s one good thing that already came out of that diagnosis: When responses to my Facebook post flooded in, they weren’t just along the lines of “Refuah shleimah” and “I just went through this too,” but also, “Thanks for sharing I’m scheduling my mammogram right now!”
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