An Open Letter to Berkeley Lab: Thanks for the Funny Research About Squeezing Breasts and Cancer

Dear Daniel Fletcher, Gautham Venugopalan and Sarah Yang, Media Relations,

Thank you for your release reporting the FASCINATING detail on the research  Dr. Fletcher and Mr. Venugopalan presented at at the American Society for Cell Biology in San Francisco.

Who knew that mechanical pressure alone apparently can revert and stop the out-of-control growth of cancer cells?

“Compression, in and of itself, is not likely to be a therapy,” cautioned Daniel Fletcher, professor of bioengineering at Berkeley and faculty scientist at the Berkeley Lab, in the statement. “But this does give us new clues to track down the molecules and structures that could eventually be targeted for therapies.”

For the experiment, scientists grew gelatin-encased malignant breast epithelial cells in flexible silicone chambers. The squishy housing allowed researchers to apply compression in the early stages of cell growth, the university said. The compressed malignant cells grew more organized and healthy-looking compared with the uncompressed malignant cells.”

Interesting! Novel!

But the true stroke of genius was the excellent word choice: SQUEEZE!

Yes! Because otherwise who would care? So thank you for the headline:

“Squeezing Malignant Breast Cancer Cells Could Help Them Return To Normal, Study Says”

…and the first sentence:

Researchers at the UC Berkeley and the Lawrence Berkeley National Laboratory have put the squeeze — literally — on malignant mammary cells to guide them back into a normal growth pattern.

Who would have thought to work in “squeeze” with a news item about breast cancer research. It’s as if the Algonquin Round Table has launched a California franchise. Awesome, just awesome.

Some news outlets went with a “straight” account:

http://www.huffingtonpost.com/2012/12/18/squeezing-breast-cancer-cells-compression_n_2323376.html

However, many other outlets could not resist. Do a simple Google search to see how your research has now been reduced to the level of a bunch of sixth grade boys looking at Playboy.  For your reference, here is a screen grab from my Facebook page.

Science marches on…

Metastatic breast cancer claims 40,000 lives annually in the U.S. As one of 155,000 U.S. people living with MBC, I have a vested interest in educating people about this incurable disease and urging them to support research that helps people with advanced breast cancer live longer.

For the last 20 years, NCI’s Dr. Patricia Steeg has been researching how cancer cells from the primary tumor in the breast travel to vital organs, in particular the brain. Dr. Steeg identified the first cancer suppressor gene and has done pioneering work on brain metastasis.

Do you think we’ll be seeing ha-ha, funny, funny Facebook posts citing Dr. Steeg’s work?

This past fall, Dr. Steeg spoke to about 150 people with metasatic breast cancer at the Metastatic Breast Cancer Network’s annual conference in Chicago. In her presentation on “Research on Treatment to Contain Metastatic Growth,” she made a case for redesigning clinical trials to do what she termed “phase II randomized metastasis-prevention trials.” Currently, phase I and phase II clinical trials are done in patients with advanced, refractory metastatic cancer, patients who have had many therapies. In phase II trials, researchers typically are trying to determine if a drug shrinks metastases.

“But a drug that prevents metastasis may not shrink a large, refractory tumor,” said Steeg. “It has a different mechanism of action that is not picked up by the clinical trial system.” (Steeg referenced a perspective piece, “The Right Trials,” she wrote for Nature this past May: http://www.nature.com/nature/journal/v485/n7400_supp/full/485S58a.html)

After Dr. Steeg finshed speaking, every single person in that auditorium stood up and offered a thundering ovation. That’s how important her work is.

Have you heard about it? Would you share it with a friend?

If only Dr. Steeg had made some reference to squeezing breasts, second base, boobies, ta tas, and, God help us, sweater kittens. Because that seems to be the only way to capture the general American public’s interest in a terrible disease.

You may say you have no control over how the news is reported or repurposed. That’s true. And I acknowledge in some respects you are truly blameless. Two decades of dedicated pinking–from chicken buckets to perfume for “The Cause” have somehow taken breast cancer from the Big C to the boffo laugh.

But, even a boilerplate statement acknowledging the stark reality that metastatic breast cancer is incurable and remains woefully underfunded  and statement from Dr. Fletcher or Mr. Venugopalan   asking reporters to avoid the easy jokes, the temptation to turn this into a ha-ha. funny news story of the day would be something.

It’s not too late. Get your head out of your petri dish and issue a follow-up press release.

Tell them breast cancer is not funny.

Help Wanted: Where is Our Metastatic Breast Cancer Celebrity Spokesperson?

You know what’s weird about metastatic breast cancer? It has no celebrity spokespeople.

Well, we sort of have one. Actress Marcia Strassman, best known for playing Gabe Kaplan’s wife on “Welcome Back Kotter,” has spoken about having metastatic breast cancer. Strassman presented with bone mets in 2007. Just as a First Lady or a Miss America Pageant contestant advances a particular cause or platform, so, too, does Marcia Strassman. She encourages medical compliance–specifically Novartis pays Strassman to talk about her experience with Zometa and why it is important to get these bisphosphonate infusions every 28 days (or as one oncologist recommends).

Those who don’t have metastatic breast cancer may be more familiar with another bisphosphonate: Boniva. You’ve probably seen the commercial starring Gidget aka Sally Field.  As Consumer Reports says, “Great Spokeswoman, Misleading Ad: … [the convenience Field touts] comes at a price—it can set you back about 10 times the cost of the similar drug alendronate (the generic version of Fosamax). No wonder Boniva’s backers, Roche and GlaxoSmithKline can afford to invest in a big-name celebrity to pitch it. Interestingly, studies don’t show that Boniva is any more effective than other bisphosphonates.”

You can see why we metsers might feel a little slighted. Everyone else get Sally Field urging them to get their bone boosters. And we get….Mrs. Kotter.

Beyond Marcia Strassman, who concedes she is not “a huge celebrity,” we don’t have any nationally known people with metastatic breast cancer speaking on our behalf.

Maybe we should count our blessings.

Sheryl Crowe had a lumpectomy and 7 weeks of radiation. She says her cancer was caught in the “earliest of stages…I am a walking advertisement for early detection. ” On a national television appearance Crowe implied there’s a connection between drinking water in plastic bottles left in a car and exposed to the sun’s heat and getting breast cancer. Although Crowe didn’t specifically suggest that’s why she herself got cancer, many viewers made that assumption. But as this report notes:  Dr. Rolf Halden of the Johns Hopkins Bloomberg School of Public Health [says] consumers face a much greater risk from potential exposure to microbial contaminants in bottled water — germs, to you and me — than from chemical ones. For that reason, most experts suggest not refilling or reusing empty bottles.

In 2012, Crowe announced she had a noncancerous brain tumor (i.e, a meningioma ). Crowe theorized her cell phone may have led to the tumor. Science writer Benjamin Radford refutes this notion: “While concern over the potential harm of cell phones is widespread, the vast majority of scientific research does not support the idea that cell phones are dangerous,”says Radford. “Repeated scientific studies have failed to find good evidence supporting the position that EMFs or cell phones damage human health.”

Crowe has shown her power to reach millions. But she doesn’t seem to be the best informed spokesperson.

In 2008, actress Christina Applegate, then 36 years old, had a double mastectomy after testing positive for the BRCA1 mutation. Applegate, the daughter of a breast cancer survivor, had been getting mammograms since she was 30 years old.  “My doctor said that the mammograms weren’t enough for me because of the denseness of my breasts,” Applegate told Oprah Winfrey in 2008. “He suggested that I get an MRI.”

According to this article: [Applegate] learned early detection may not come from a mammogram. Christina says she will fight for women to have access to MRIs and genetic testing, which many insurance companies won’t pay for.

This is certainly a worthy message and one that is championed at www.areyoudense.org and FORCE (“fighting heridiatry breast and ovarian cancer”).
So far, so good. But Applegate also said she was cured: “[I’m] absolutely 100 per cent clear and clean,” Applegate said on a 2008 GMA appearance. “It did not spread. They got everything out, so I’m definitely not going to die from breast cancer.”

Ooops. . . ACS’ Dr. Len Lichtenfeld noted we don’t know the specifics of  Applegate’s disease. “Breast cancer, in fact, is a life long disease,” wrote Dr. Lichtenfeld. “That’s what many women live with every day…The medical facts are that bilateral mastectomies as a treatment for breast cancer are not a cure, especially in BRCA positive women.   They are the best strategy we have to reduce the risk of another breast cancer in the opposite breast, but they don’t remove risk completely.  Even in the hands of the best surgeons, bilateral mastectomies in a BRCA positive woman who has not had breast cancer reduces the risk of a new primary breast cancer to about 10%.  That’s because even in the best surgical hands, there is still some breast tissue left behind after these procedures.”

In 2004, singer Melissa Etheridge was diagnosed with Stage 2 breast cancer. Etheridge had a lumpectomy, but the surgeons also had to remove 15 lymph nodes to make sure the cancer hadn’t spread. She then went through five rounds of chemotherapy and radiation.

More magazine recently asked Etheridge what about the key to a breast cancer cure–what needs to happen?  “I have a very strong belief that this cure that we’re looking for is inside us,” Etheridge responded. “That cancer is just a symptom of our bodies being out of balance and the cure is to understand health. It’s to understand our bodies and our spirits—our souls—better. That’s the cure.”

Thank you, Melissa, don’t call us. We’ll call you…

 

Highlights from MBCN’s 2012 Chicago Conference on Metastatic Breast Cancer

Canadian friends Penny Overes, Catherine Spencer and
Danielle Smith were among the 200+ attendees. Alberta represent!

MBCN’s 6th Annual National Conference (“Moving Forward With Metastatic Breast Cancer,”) took place Oct. 13, 2012 at Northwestern’s Lurie Cancer Center in Chicago. In a few weeks, videos and presentation handouts will be posted at MBCN.org. In the interim, here are some highlights from selected breakout sessions, from attendee Pam Breakey. Pam is a long-time participant on the BC.Mets.org site and, as you will see, takes wonderful notes.
Part One: General Sessions

Part Two: Selected Breakout Sessions

We were honored to have Medical Lessons blogger and Atlantic correspondent  Elaine Schattner join us. Dr. Schattner is a trained oncol­ogist, hema­tol­ogist, medical edu­cator and jour­nalist who writes and speaks on med­icine. Her views on health care are informed by her expe­ri­ences as a patient with sco­l­iosis since childhood and other con­di­tions including breast cancer. Her work has appeared in Slate, the New York Times, Sci­en­tific American, Cure Mag­azine and the New York Observer. Read  her great article for the Atlantic here.

MBCN Honors Dr. Pat Steeg’s Dedication to Metastatic Research With the Ellen Moskowitz and Suzanne Hebert Leadership Grant Award

MBCN board member Shirley Mertz presented the award to Dr. Pat Steeg.

In other conference news, MBCN presented Dr. Patricia Steeg with the Ellen Moskowitz and Suzanne Hebert Leadership Grant Award. “For the last 20 years, in her laboratory at the National Cancer Institute, in Bethesda, Maryland, Dr. Patricia Steeg has been researching how cancer cells from the primary tumor in the breast travel to vital organs, in particular the brain,” said Shirley Mertz, MBCN board member and prominent patient advocate. “Dr. Steeg identified the first cancer suppressor gene and has done pioneering work on brain metastasis. Although metastatic research is difficult and involves long and complex experiments, Dr. Steeg remains undeterred. She exerts strong leadership in the research community nationally and internationally.”

Prior to accepting the award, Steeg gave a presentation on “Research on Treatment to Contain Metastatic Growth.” The researcher made a case for redesigning clinical trials to do what she termed “phase II randomized metastasis-prevention trials.” Currently, phase I and phase II clinical trials are done in patients with advanced, refractory metastatic cancer, patients who have had many therapies. In phase II trials,
researchers typically are trying to determine if a drug shrinks metastases.
“But a drug that prevents metastasis may not shrink a large, refractory tumor,” said Steeg. “It has a different mechanism of action that is not picked up by the clinical trial system.” Steeg referenced a
perspective piece, “The Right Trials,” she wrote for Nature this past May.

“The proposal I’ve put forth should apply to a number of different cancers, particularly those where the majority of patients are diagnosed before they have full-blown metastatic disease, or if they have limited, treatable metastatic disease,” Steeg told NCI Cancer Bulletin this past June. “One could imagine applying this to prostate, bladder, and colon cancers.”

Don’t Miss These Awesome Photos:

But wait! There’s more! Awesome conference photographs, courtesy of Ellen Averick Schor are Here.

Calcium: It Does a Body Good (Supposedly)

Sorry for the long lapses between posts. I am fine–just busy!

One of my secondary motives for starting this blog was to improve my online skills. I prepared my first resume on a typewriter–which I suppose puts me only slightly ahead of Laura Ingalls Wilder who wrote hers in pencil on a Big Chief  Tablet. So I try to keep up.

I’ve noticed just about every news/entertainment website features slide shows, like this one:

Gettysburg Adress as a Powerpoint Presentation

With a little online help from Jesse P. Luna, I learned how to create my own photo slide show: “Calcium Supplements Can Be FUN for the Whole Family! 6 Great Ideas!

This slideshow requires JavaScript.

Can’t See the Metastatic Forest for the Breast Cancer Screening Trees

Others can speak far more knowledgeably and eloquently about the recent pink ribbon funding controversy. My concern is that we are missing the forest for the trees. Setting aside the funding issue, let’s consider the truth worth of these exams. Screening and self exams can be helpful. But let’s not kid ourselves. These tests are frankly not that great.

“Women are regularly told that screening mammograms save lives,” says the National Breast Cancer Coalition. “Evidence of actual mortality reduction is, in fact, conflicting and continues to be questioned by scientists, policy makers and members of the public. Since evidence does not currently significantly support, nor disprove the effectiveness of this test, receiving a screening mammogram should be a personal choice, not a medical mandate.”*

Essentially, we have better imaging technologies. The  average size lump found by first mammogram is about the size of a dime (~1.5 cm) but even tumors as small as pencil erasers can be seen.

The real problem is we don’t know WHAT we are looking at.

We don’t know  WHY some tumors spread beyond the breast.

We don’t know HOW to stop metastatic growth.

We are seeing more and more breast cancers earlier and earlier. In some cases, people are overtreated: It’s the oncological equivalent of using a shotgun to kill an ant. Many women may be diagnosed and treated for a cancer growing so slowly it might never have caused any symptoms or threatened their lives.

As surgeon/scientist/blogger David Gorski, explains, “… for mammographically-detected small tumors, almost always those detected by screening mammography, it’s not so clear whether all of these need to be treated. Overdiagnosis is being increasingly appreciated as a significant problem, and, indeed, may account for as many as 1 in 3 breast cancers detected by screening mammography (although more common estimates are on the order of 20%). There is even evidence–not bulletproof by any means, but intriguing evidence–that as many as 20% of mammographically detected tumors may actually spontaneously regress.”

Screening is just one tool. We need to look at the bigger picture. Unfortunately, the under treated are always with us:

“If we did what we already know, at least 37% of cancer deaths in people between the ages of 27 and 64 could be avoided right now,” writes ACS’s Dr. Len Lichtenfeld. “Where is the national conversation about the fact that poverty is a carcinogen? Are you talking about it? Is the media talking about it? If the silence is deafening, then perhaps you have your answer. “

Finally, as much as I have a vested interest in breast cancer research, it shouldn’t come at the expense of addressing other diseases. I concur with ACS’s Dr. Otis Brawley:  “The wisest advocacy for cancer science is support for more money for cancer research in general and support for funding the best science and encouraging scientific investigators to maintain an open mind,” says Brawley.  “Scientists must look for additional applications of findings beyond just their cancer of interest.”

You’ve probably heard of the chemotherapy drug Herceptin, which is used to treat about 25% of breast cancer patients. It was developed to treat neuroblastomas and gliomas, both cancers of the nervous system, but it didn’t work for those cancers.
Another example, cisplatin, was first developed as a treatment for testicular cancer.  It is now the most commonly used chemotherapy in the treatment of lung cancer and ovarian cancer. It is also used in some breast cancer treatments. The drug oxalaplatin used in colon cancer therapy was developed from cisplatin.  So testicular cancer research benefited a number of other cancers.
Similarly, the drug leuprolide was developed in the mid-1980s as a hormonal treatment for metastatic prostate cancer. This drug has since been FDA-approved for not only treatment of metastatic prostate cancer, but also premenopausal breast cancer, endometriosis, and precocious puberty.

The number of drugs that were developed for one disease but ended up being useful in others  is legendary and goes beyond cancer.

*Women age 40 and older should have mammograms every 1 to 2 years. Women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

Stuff People Say to People With Metastatic Breast Cancer

Pundit Molly Ivins died of inflammatory breast cancer at age 62 in 2007.

“One of the first things you notice is that people treat you differently when they know you have [breast cancer],” she wrote. “The hushed tone in which they inquire, “How are you?” is unnerving. If I had answered honestly during 90% of the nine months I spent in treatment, I would have said, ‘If it weren’t for being constipated, I’d be fine.'”

In a similar vein, actress, writer and early stage breast cancer survivor Jenny Saldana recently teamed with Linda Nieves-Powell to create “Sh*t Girls Say to Girls With Breast Cancer.” It’s funny because it’s true…if you have breast cancer, you will have heard at least one of these clueless comments. That being said, I am sure that prior to my own diagnosis I made some of these same comments to others. Well, as Dear Abby used to say, 40 lashes with a wet noodle.

I should stress that in talking to other cancer patients, a spirit of tolerance and understanding  prevails. It’s not easy to know what to say and in most cases, the responses are truly heartfelt if often unintentionally hilarious.

Saldana and Nieves-Powell show great comic skill and creativity in this clip. As in similarly titled efforts, the actress is shown in various settings (getting something from the fridge, at the wheel of her car,) as she recites comments  such as “You’ll be fine,” and “It’s because you don’t have children.”

Don’t be put off by the title. It’s just a play on “Sh*t My Dad Says,” there is no cussing–it’s very funny!

I hope they will consider doing a similar piece specifically for people with metastatic breast cancer. My suggestions would include:

• Well, you never know. You could get hit by a bus.
• They don’t seem to be doing much for you.
• Sheryl Crowe says it’s from drinking out of plastic water bottles, especially if they have been sitting in the sun.
• Have you tried mistletoe?

Dr. Stephen Baylin: Rock Star of Science and Epigenetic Genius

I volunteer with the Metastatic Breast Cancer Network. At the group’s annual conference, someone living with MBC introduces every expert speaker. Prior to introducing the medical expert, each patient shares his or her story.

I had the honor of introducing Johns Hopkins’ Dr. Stephen Baylin. In addition to being a Rock Star of Science, he is on the Stand Up 2 Cancer Dream Team.

Here is my introduction:

http://mbcn.org/special-events/video-file/2011-national-conference-md-katherine-obrien/

Hello everyone.

My name is Katherine O’Brien. My breast cancer story began on July 6, 2009. I was 43 years old. According to my Microsoft Outlook calendar, my mammogram was 1095 days overdue. Yes, I put off having a mammogram for three years.

The mammogram technician seemed to think we were doing a fashion shoot: “Now try it this way, that’s right, lean into the machine a little more, hold it right there.”

There are Playboy Bunnies who don’t have as many pictures of their breasts as I do.

Finally, I was sent across the hall for an ultrasound.  The technician tapped away at her keyboard. Then she left, saying she would be back soon.

When you have a good mammogram, you never see the radiologist. When you have a bad mammogram, you get the Publishers Clearing House Sweepstakes Prize Patrol, only without the balloons and the oversized check.

It took three people to give me the bad news: The silent technician who hovered near her machine, the radiologist and the patient navigator.

The radiologist looked hungover or maybe that’s just how you look when you sit in a dark room all day emerging only to tell people they have cancer and they should see a surgeon.

The patient navigator was stroking my leg as the doctor spoke. I could only think: “This woman feels sorry for me, this must be really bad.”

How could I have breast cancer?

I was practically flat chested. In my flawed logic, it seemed reasonable that if you had big breasts you had a big chance of having breast cancer and if you had almost no breasts like me, you would have almost no chance of having breast cancer.

Everyone knows that most lumps aren’t cancer. And although my mom died from breast cancer, everyone knows most cancer isn’t hereditary.  Plus my mom had inflammatory breast cancer which is pretty rare.

So how could I have breast cancer?

A few days after I saw the radiologist, a breast surgeon did a fine needle biopsy. It is called a “fine needle biopsy” because if they actually told us “Look I am going to jam this thing that looks like a harpoon gun into your breast” we would all make a dash for the parking lot, never to be seen again.

The breast surgeon told me that I probably had Stage III breast cancer. She recommended a mastectomy. After we had talked awhile, she asked if I had any additional questions.

“Just one,” I said. “We’re Jewish. What about genetic testing?”

“Oh,” said the surgeon. She stopped just short of saying “I didn’t realize O’Brien was a Jewish name.”

My mother was Jewish—and like most U.S. Jews I am of Ashkenazi or Eastern European descent. Ashkenazi Jews have a higher risk for a genetic mutation which in turn carries a higher risk for breast and/or ovarian cancer. Testing showed I do not have the BRCA mutation.

Before I had the mastectomy, I was sent for the usual tests: MRI, CT and a bone scan. I knew I was in trouble when the bone scan technician asked me if my back hurt.

A bone biopsy revealed a low volume of mets to my lumbar and thoracic spine.

My surgery was canceled.

Learning I had Stage IV breast cancer was devastating. I assumed that I would soon be dead. Thankfully that hasn’t happened. So far.

The Metastatic Breast Cancer Network’s publications gave me a lot of help and a lot of hope as did  Lillie Shockney’s book,  “100 Questions & Answers About Advanced and Metastatic Breast Cancer.”

I have been stable on an antihormonal treatment: a pill plus ovarian suppression and a monthly bone booster.

Although surgery isn’t standard of care, there is thought to be some benefit. Last year I had unilateral mastectomy followed by radiation.

Someone asked me something I thought was pretty inane.

But in a broader sense, it’s actually a great question, one that relates very much to Dr. Stephen Baylin’s topic. The question was:  “What does your cancer mean for your twin?”

Now, I have a twin brother.

Many people, upon learning I have a twin brother, have asked: “Are you identical?”

Well, in layman’s terms, one of us has a wee-wee and one of us does not. So there are some kind of critical differences but genetically, yes we do share some common ground.

Dr. Baylin’s specialty is epigenetics. If our DNA is like a computer’s hard drive, epigentics would be the software.

My cancer isn’t hereditary—so theoretically my hard drive is fine. But something went wrong with the software. Or to use another analogy, if my DNA were a piano, I’d have 88 keys. But epigenetic changes in my DNA would mean that certain keys would be noiseless when struck because they had been turned off.

Dr. Baylin has shown disruptions in tumor suppressor genes, which normally protect cells against cancer, are more often due to epigenetic silencing than outright mutation.

Perhaps most exciting, Dr. Baylin is working on ways to turn the silenced genes back on so they can do their jobs. I could play Chopsticks on my DNA.

Someday, maybe Dr. Baylin’s work will shed some light on how a flatchested, Jewish girl named O’Brien got cancer.

Maybe even more importantly for my nonidentical dyzgotic twin and all my siblings and their children, maybe someday Dr. Baylin’s work will help us understand cancer at a molecular level and usher in an era of highly personalized treatment.

Dr. Baylin’s topic is “Cutting Edge Research.”

Just a reminder before I tell you more about Dr. Baylin—if you have a question during this session, please write it down—there are index cards in your folders—and give the card to one of the volunteers.

Now, about Dr. Baylin:

He  is Deputy Director of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. He is the Virginia and D.K. Ludwig Professor for Cancer Research and a Professor of Oncology and Medicine. He received his MD from Duke University and also completed an Internal Medicine residency there.  He completed a fellowship in Endocrinology and Physiology at Johns Hopkins. His clinical interests include molecular markers for cancer risk assessment, early diagnosis and prognostic monitoring and the use of reversing gene silencing.

Please join me in welcoming Dr. Baylin.

I Didn’t Realize O’Brien Was a Japanese Name…

The other day I finally did something about the Hobbit-like state of my feet. The pedicurist, perhaps to distract herself from the heavy lifting before her, was making small talk. Usually these conversations run along the lines of “Do you live nearby?” or “Did you know that most of Emily Dickinson’s poems can be sung to the tune of ‘The Yellow Rose of Texas?”’

So I was a little startled when the Asian woman looked up from her scrubbing and asked: “Are you Japanese?”

This isn’t the first time I’ve been asked that question. It must be my epicanthic folds.

“No,” I said. “I’m Irish. How about yourself?”

“I’m Vietnamese,” she said, laughing to think that anyone could  look at her and not immediately cotton on to this.

In the U.S., we hate to stereotype, but we love to categorize. We’re not being nosy or culturally insensitive, we’re just seeing if we know any of the same people. We are a young country–not too far removed from those 13 original colonies. So it’s possible that if my family lives in Chicago, a city of nearly three million people and your family lives 2046 miles away in Sacramento, well, we might have some mutual friends.

My name is an icebreaker. “Katherine O’Brien,” a new acquaintance will say, often lapsing into an Irish accent that  elevates Dick Van Dyke’s efforts in “Mary Poppins”  to  Meryl Streep’s level of prize winning  linguistic proficiency. “You must be Irish.”

I usually just say yes. But despite being a proud graduate of Santa Maria del Popolo grade school and Carmel Catholic High School, I’m technically Jewish. Just to be more confusing, my mother was technically and undeniably Jewish but a very good Catholic (seven kids in five years!).

I don’t know much about my  grandmother’s family, the Mays. My  Grandpa Isaac left Frankfort  for Ellis Island in 1907. He disembarked the Kaiserin Auguste Victoria with $20 and his Chicago uncle’s address. My mother grew up in Hyde Park. She graduated from the Art Institute and earned her master’s degree from Loyola. Before she met my father in Mexico and got married, she taught art at Mather High School.

All of which is why I just say “Yes,” when people say: “Katie O’Brien! You must be Irish.”

Matrilineality in Judaism is the view that people born of a Jewish mother are themselves Jewish. Given that my knowledge of Judaism is derived almost entirely from watching Robby Benson in “The Chosen” and reading the Holiday issue of “Highlights for Children,” I won’t attempt to explain this complex and controversial topic.

We are all sons and daughters of Abraham–it’s probably best to leave it at that. Unless you have just been diagnosed with breast cancer or have a family history of breast cancer.

People of Jewish descent have a higher risk for a genetic mutation which in turn carries a higher risk for breast and/or ovarian cancer. My mother  died of inflammatory breast cancer, further increasing my breast cancer risk.

Most cancer  just happens–it’s sporadic vs. heriditary. The majority of people who develop breast cancer didn’t inherit an abnormal breast cancer gene and have no family history. But about five percent of people have a genetic mutation which predisposes  them to cancer.

[Edited to incorporate ovarian cancer information. Thanks Casey!]

Two abnormal genes BRCA1 (BReast CAncer gene one) and BRCA2 (BReast CAncer gene two) are associated with a higher lifetime risk of developing breast and/or ovarian cancer.

From the NCI FAQ: A woman who inherits a harmful mutation in BRCA1 or BRCA2 has an increased risk of developing breast and/or ovarian cancer at an early age (before menopause) and often has multiple, close family members who have been diagnosed with these diseases. Harmful BRCA1 mutations may also increase a woman’s risk of developing cervical, uterine, pancreatic, and colon cancer (1, 2). Harmful BRCA2 mutations may additionally increase the risk of pancreatic cancer, stomach cancer, gallbladder and bile duct cancer, and melanoma (3).

All of us have BRCA1 and BRCA2 genes according to  BreastCancer.org: ” The function of the BRCA genes is to repair cell damage and keep breast cells growing normally. But when these genes contain abnormalities or mutations that are passed from generation to generation, the genes don’t function normally and breast cancer risk increases. Abnormal BRCA1 and BRCA2 genes may account for up to 10% of all breast cancers, or 1 out of every 10 cases.”

Ashkenazi (Eastern European) Jews are 10 times more likely to have mutations in BRCA1 and BRCA 2 genes than the general population. Approximately 2.65 percent of the Ashkenazi Jewish population has a mutation in these genes, while only 0.2 percent of the general population carries these mutations.

Note that most U.S. Jews are  Ashkenazi (their ancestors came from Eastern Europe) vs. Sephardic  (their ancestors came from Spain, Portugal, North Africa and the Middle East).

Having an abnormal BRCA1 or BRCA2 gene doesn’t mean you will be diagnosed with breast cancer: Only seven percent of breast cancers in Ashkenazi women are caused by alterations in BRCA1 and BRCA2 (See www.genome.gov/10000507.)

When I was first diagnosed (but before my mets were discovered) I was meeting with a surgeon,  Dr. Patty O’Furniture.* It was the my first meeting with Dr. O’Furniture. She took my history and explained what would happen next: lots of tests. When she finished, she asked me if there was anything else I wanted to talk about. “Just one more thing,” I said. “I’m Jewish.”

“Oh,” said Dr. O’Furniture. “I thought– with your name…” She then ordered more tests.

BRCA testing showed I am not a carrier for this mutation. (Well, at least not for BRCA1 or BRCA2. Researchers are still stirring the genetic soup.)

Young Jewish women with breast cancer should check out Sharsheret . Founded in November 2001,  the group addresses the genetic risk of developing breast cancer in Jewish women of Ashkenazi descent, pregnancy after diagnosis, parenting, relationships and intimacy, the role of religion in daily life with cancer, and the impact of breast cancer on religious ritual and spirituality.

Shalom (and begorra)! (Not to mention sayonara!)

*Not her real name…