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Here’s a test that might just save your life

The BRCA testing service could help you to dodge cancer as I was lucky enough to do

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Researchers from the Auragen laboratory prepare the sequencing of human genomes to better identify rare diseases, in Lyon, central-estern France, on February 23, 2022. - Nearly 8,000 rare diseases have been identified to date and they affect about three million people in France, the vast majority of whom are children. (Photo by JEAN-PHILIPPE KSIAZEK / AFP) (Photo by JEAN-PHILIPPE KSIAZEK/AFP via Getty Images)

February 09, 2023 12:40

Sometimes, rabbis should listen to their own sermons. Thankfully, when one of my congregants told me this, it saved my life. Over the years I have advised members of Maidenhead shul to take pre-emptive action to avoid untoward consequences — from using condoms when having sex with anyone other than their partner (this was when the AIDS scare arose) to reporting antisemitic behaviour at school or work, lest one-off incidents develop into a pattern.

I have also urged members to take health checks when over a certain age, such as men over 50 having a prostate test. But I never did. It was only when a congregant challenged me that I reluctantly went off for one, confidant that my fitness meant that I had nothing to worry about.

Then came the phone call from the surgery, saying that they normally write but in my case speed was necessary: not only did I have prostate cancer, but it was advanced and aggressive.
I did not complain. I know how many other people get cancer, so why shouldn’t I? Life is full of dangers and random events, as well as wonderful aspects.

After a hurried meeting with the oncologist, I quickly arranged rabbinic cover for a barmitzvah the following week and went into hospital for urgent surgery.

The surgeon’s initial optimism that “we took the whole prostate out just in time, and none of the cancerous cells had spread” proved wrong. So a six-week course in radiotherapy followed.
That was successful and I am free of all cancer — though, of course, as all cancer victims know, it can return at any point elsewhere in the body — so I am well and firing on all cylinders, but not taking tomorrow for granted.

I am also very grateful to my congregant for forcing me to pay attention to my own fine words.

The larger message is that testing is never a waste of time. This will become all the more important when NHS England launches a free BRCA testing service (for both BRCA1 and BRCA2) for anyone aged 18 or over living in England with one or more Jewish grandparent.

Unfortunately, the BRCA gene fault is particularly common among Jews and can lead to a variety of BRCA-associated cancers, such as breast, ovarian, prostate and pancreatic cancers.

Until now, it has only been Jews with a strong family history of cancer who were tested. In my case, this did not apply. However, recent research has shown that family history is not a true guide to one’s vulnerability, and hence the new approach to all Jews.

A study by the Genetic Cancer Prediction through Population Screening Study (GCaPPS) revealed that only 11 per cent of individuals with a BRCA gene fault in the Jewish community were aware of their status.

This mass testing would have alerted me to my cancer before it became almost-too-late and will save thousands of Jewish lives in the future.

The tests will begin soon. Individuals found to have the gene fault will be referred to their regional genetics centre, where they will be able to explore the options available to them for cancer- risk management.

Israel has already replaced the family-history-based approach to BRCA testing with a population-based system, and England is only the second country in the world so far to follow suit.

Awareness of the testing is being supported by Jnetics, a cross-communal charity in the UK dedicated to the prevention and diagnosis of Jewish genetic disorders. Anyone high-risk who needs a test immediately, or who wants to be informed when it becomes more widely available, can apply via its website, jnetics.org.

In case you feel fine and think this may not happen to you, let me tell you about Clive (not his real name).

Two weeks ago, he was enjoying a carefree but physically hard trek through the Amazon region. “I’m in great condition,” he told me afterwards at shul last Shabbat.

On Monday I received an email from him saying he was at a leading national hospital. Not only had some routine tests the week prior shown he had cancer, but that it had spread already to many organs.

“It’s been a surreal experience,” he wrote. “I’ve moved from peak fitness to extreme ill health within days.” The hope is that he will receive treatment that may not save him, but will give him some extra time with his still-young family.

Whilst some cancers reveal themselves at an early stage through various symptoms, others are silent invaders who only come to light at a very late stage.

I urge you all to take up the BRCA test offer and avoid my near-miss experience and the sad fate of Clive.

Jonathan Romain is rabbi of Maidenhead Synagogue

February 09, 2023 12:40

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