Knowledge is Power: Learning more about BRCA-related cancer risk
On Thursday night, March 28, Congregation Beth El in Berkeley will partner with The Basser Center for BRCA to host a panel discussion entitled “Knowledge is Power: Understanding and Managing BRCA-Related Cancer Risk.” The Basser Center is located at the Abramson Cancer Center at the University of Pennsylvania. It is the first comprehensive center for the research, treatment, and prevention of BRCA related cancers. The Basser Center has an overarching mission to decrease the number of BRCA gene mutations in the general population, and a unique model where they fund both collaborative research and education programs.
In advance of the event, Federation interviewed Beth Stearman, the Administrative Director of the Basser Center, about BRCA mutations, who they effect, and what we can all do to protect ourselves.
What is a BRCA mutation?
BRCA1 and BRCA2 are genes that we all have and when they work properly, they suppress the formation of tumors. But, when somebody inherits a mutation in one of these genes from their mother or father, the genes don’t work properly. That’s why people that have BRCA1 or BRCA2 mutations have a higher incidence of developing a number of types of cancers. The largest cancer risks are in breast cancer for both men and women, ovarian cancer, pancreatic cancer, prostate cancer, and melanoma.
Why is this issue important?
While so many issues of our health are beyond our control, understanding what the BRCA mutations are and how they might affect you and your family can have a meaningful impact on preventing illness down the line. Knowledge really is power in this case and there are choices that BRCA carriers can make to manage their risk and provide peace of mind.
Why is this especially important in the Jewish community?
While BRCA mutations are found in every population, these mutations occur at a much higher rate in the Ashkenazi Jewish community. In the general population, BRCA mutations occur in about one in 300 people. There are three common mutations that occur in the Ashkenazi Jewish community at a rate of 1 in 40 people. These mutations are called “founder mutations”, and they occur because of a high rate of in-marriage within the community over many generations.
BRCA mutations effect men and women equally. A lot of people think it’s a women’s health problem, but that is not the whole story. For example, men with BRCA-related prostate cancer tend to have more aggressive prostate cancers.
So that’s why we do so much of this outreach focused on the Jewish community. And that’s why one of the most important things that we’re doing is encouraging Ashkenazi Jewish people to have genetic testing for these mutations.
What happens once someone is tested for the mutations?
If someone tests positive for a BRCA mutation, there are screening and surveillance options, as well as preventive surgery options. We generally don’t recommend testing people until at least the age of 25. Only after that age would the information be ‘medically actionable’ where an individual has options for managing their risk.
For example, if a woman is found to carry a BRCA mutation, the general guidelines include much more aggressive surveillance for breast cancer including mammograms and breast MRI’s alternating every six months. For families with a mutation that also have prostate cancer as part of the constellations of cancers in their family, we recommend that men start prostate cancer screening at a younger age.
So those are some examples of the sort of screening and surveillance options that people have, and then there are other options that become major decisions for people, particularly women, that involve things like prophylactic (preventive) mastectomy.
These are big, difficult decisions, but ones that save lives.
What will I hear at the panel?
At the event, there will be a panel of experts in the field to discuss genetic counseling and testing, preventive care, and navigating through the challenging decision-making and medical management options faced by mutation carriers.
In addition to physicians, there will be two members of Beth El on the panel who have personally been impacted by these issues. We like to have patients on the panel as they bring a really important voice to this conversation.
Physicians can talk about it and say ‘here’s what the research shows’ and ‘here’s what this looks like in our community’, but really, you have to hear from an actual person who has been through it to understand what it means to an individual or a family.
There’s lots of complexity to these decisions, but it all starts with information. That’s why we do these events. And that’s why we call it ‘Knowledge is Power’ because that’s one of the things that we do have control over. If you have this information, then there are things you can do to decrease your risk of developing a BRCA-related cancer. They’re not great options at the moment, but they’re certainly better than a cancer diagnosis and treatment. And reducing the risk of these cancers really does save lives and can give families a lifetime of joy and better health.
Interested to hear more? Join us at “Knowledge is Power: Understanding and Managing BRCA-Related Cancer Risk” at Congregation Beth El in Berkeley on Thursday, March 28, 7:30 – 9:30 pm. The event is free with advanced registration. More information here.
Thank you to all of the event partners: