What does the Torah say about… Breast Cancer?

With Rabbi Zvi Solomons.

AS A child in the 1970s,  my father’s friend slowly died of breast cancer. There was little chance of cure. How things have changed.

My own mum, diagnosed  some 12 years ago, received superb treatment and chose double mastectomy as the best option given her genetic inheritance. The  BRCA1 or BRCA2 genetic markers for the disease, are 10 times more common among Ashkenazi Jews, so this is about all of us. However, the new genetic tests have implications:  do you tell an insurance company? A potential partner? And if, like 2.5% of Ashkenazi women, we carry the marker, do we have a Our chances of getting the cancer would be raised to 85% if we did nothing.

There are, of course, other considerations – body image and marriageability, the latter particularly In the Orthodox community. Doctors do not recommend universal screening as spontaneous genetic mutations as that there is no certainty in this particular field.

Halacha permits preventative mastectomy, as in the recent case of a mother and her two daughters, as the BRCA genes increase the danger of a life-threatening disease. Every carrier needs to consider the issue from an educated and informed viewpoint, and should discuss it with their medical and halachic adviser. Because of the dangers of complacency and the possibility of false positive results, doctors do not suggest universal screening.

This is not the case where there is already a family member with the gene. In an fascinating responsum, Rabbi Moshe Feinstein decided that a person with a genetic defect should disclose it to a potential spouse (Iggros Moshe, Choshen Mishpat II:73). Whether to tell daughters is more tricky.

Many would say that it is a preventative measure. A person is commanded to look after their health. What about the increased risk of ovarian cancer associated with these genes? Should carriers of the gene have their ovaries removed? The Torah prohibits neutering, and this therefore should only be performed in extremis.

Advances in fertility treatment mean that such a precaution need not have the same effects any more. The risks of surgery are negligible compared to the risks of developing cancer. In the 1970s you didn’t say the word ‘breast’ in polite company, and treatment was crude and generally ineffective. Nowadays we are more open.

Jewish counselling groups such as Sharsheret help deal with these matters more sensitively and professionally. A person is no more defined by their breasts than by their toenails or nasal hair. When we wear our pink ribbons on National Breast Cancer Awareness Day this month, we should also remember that men too can develop this disease. All the more reason to be thankful that there are ways of treating it effectively.