Jewish cancer charities working with breast cancer survivors have issued new guidance around using religious baths before, during and after treatment.
It aims to raise sensitivity and awareness of the physical and emotional consequences of breast cancer for women using a Jewish ritual bath, or mikveh.
The guide was launched by Michal Mocton, 41, who had breast cancer six years ago, and identified a need to train attendants, who may be the only other person to see the woman naked.
Mocton worked with Chai Cancer Care and Naomi Marmon Grumet at the Eden Center in Jerusalem to develop the guide, having identified that breast cancer treatment and its implications were subjects that mikveh attendants were often unfamiliar with.
“It is important for all balaniot (attendants) to understand the physical and emotional impact that going to the mikveh after a cancer diagnosis can have on a woman,” Mocton said.
Many women with breast cancer may expect not to go to the mikveh during treatment, because chemotherapy can stop menstruation, but treatments affect women differently, so those with breast cancer may still visit the mikveh during diagnosis and treatment, and after treatment.
The guide tells attendants that women with cancer often feel “fear and anxiety” about using the mikveh after diagnosis, surgery or during chemotherapy.
“A woman may not have shown her scars to anyone except her doctor,” it says. “Even her husband may not have seen them. Exposing herself to the attendant may be embarrassing, frightening, or overwhelming and fraught with tension.”
One cancer survivor recalls that although she hoped that returning to the mikveh would “feel like a normalising experience, the focus on preparing my body for immersion reminded me of my feeling damaged and unattractive”.
Breast cancer is a particular concern in the Jewish community, where one in eight Jewish Ashkenazi women will develop it during the course of their lifetime – a far higher percentage than the national average.
This is because roughly one in 40 Ashkenazi Jews – men and women – carries a BRCA gene mutation, and recent studies show that Sephardi Jews may also be genetically predisposed to hereditary breast and ovarian cancer.
Increasing numbers of women are now choosing to perform prophylactic breast removal after discovering that they have the BRCA gene, to reduce their chances of breast cancer. This is when a woman has an elective mastectomy as a way of prevention.
“Extreme care is needed not to question their personal decisions,” the Chai guide explains. “It is important to make them feel welcome and cared for in the mikveh and be careful not to stare no matter what their body looks like.”
Chai chair Louise Hager praised Mocton for her “commitment and determination in raising the issue above the parapet, and sharing it with Chai in order that we can assist in bringing it to the attention of a broader audience”.