Cara Scharf knew her mother and grandmother had died from cancer when they were young, but it didn’t occur to her that this family history could be passed on directly until her father spelled it out when she graduated college.
Scharf, a Philadelphia native, soon went for a genetic screening. The results of her blood test showed she carried the BRCA1 gene mutation, meaning she was seven times more likely to be diagnosed with breast cancer before the age of 70 and 30 times more likely to have ovarian cancer than other women.
Everyone has the BRCA1 and BRCA2 gene, a tumor suppressor. When that gene is mutated, DNA damage cannot be repaired properly and cancer may occur.
Because early prevention is the best way to avoid cancer’s devastating effects, the Centers for Disease Control and Prevention on Monday launched a two-year Bring Your Brave campaign “to help inspire young women to take action and learn their risk for breast cancer,” a spokeswoman said.
Scharf, who is Jewish, is one of seven women whose cancer story is being spread through social media. Because Ashkenazi Jewish women are more likely to carry a BRCA1 or BRCA2 mutation, the CDC chose two Jewish women to tell their stories, hoping to better reach the Jewish community.
One in 40 Ashkenazi Jewish women has a BRCA gene mutation, making these women 10 times more likely to have that mutation than women in the general United States population.
Dr. Temeika Fairley, who specializes in breast cancer in young women at the CDC, said the new campaign stems from a mandate in the Affordable Care Act to educate young women about their cancer risks: “Our target audience is women ages 18 to 44.”
Women usually have their first mammogram at the age of 40, she said. The CDC, however, is reaching out to younger women who have a cancer-ridden family tree.
After learning she carried the gene mutation, Scharf met with a genetic counselor, explaining that her mother had died in her 40s, when Scharf was only 3 years old, from breast cancer and that her grandmother had died from ovarian cancer before Scharf was born.
Three years later, Scharf, who is now 30, had her first mammogram and MRI test, only to find she already had breast cancer.
At the same time she was mulling career choices, “I was being confronted with my own mortality,” she said.
She had an aggressive form of cancer, but Scharf was fortunate that it was detected early.
Early screening “saved me,” she said. She would like to help other women in her predicament, which is why she is participating in the CDC campaign as well as in several support groups in the Philadelphia area.
Scharf, a museum curator, advises those with a family history of cancer to not only have early screening done but also to study their options before they receive a diagnosis. When a doctor tells someone she has a potentially deadly disease, it’s harder to think clearly about options, explained Scharf.
“Do your research,” she said. “You should be ready to make a decision” soon after receiving a cancer diagnosis. Talk to doctors, a genetic counselor and someone who has been through the same thing, she advised.
Although Scharf’s tumor was in her right breast, she opted to have a double mastectomy, because she had the BRCA1 mutation, she said.
She has since gone through chemotherapy and reconstructive surgery. She has been cancer-free for five years.
Scharf, though, is well aware her mutation makes it more likely that she may someday have ovarian cancer. Recently engaged, Scharf now is juggling thoughts about becoming a parent and also having preventative surgery to remove her ovaries.
“I never really consider myself out of the woods,” she said. “Never, and I don’t think I ever will.”
Understanding the importance of family medical history in hereditary cancer was the theme of a Sept. 27 program at the Washington, D.C. Jewish Community Center.
Dr. Claudine Isaacs from the breast cancer program at Georgetown Lombardi Comprehensive Care Center, told an audience of almost 100 people that it is important to let “sisters, kids, cousins” know if there is a family history of BRCA gene mutation.
“You hand someone life-changing” information, she said.
Spreading the world that a gene mutation exists in one’s family carries “a ripple effect. This information touches the rest of your family,” said Judith Macon, manager of cancer outreach and education at Suburban Hospital Cancer Program in Bethesda.
Keeping everyone informed is particularly important in the Jewish community as there are so many blanks in the family tree because so many ancestors were killed during the Holocaust.
Ali Weinberg learned when she was only 20 years old that she had the BRCA 1 mutation. “On spring break, while so many girls where showing off their breasts, I was cutting mine off,” she told those attending the JCC event. “Part of me wanted to keep my breasts. We were just getting to know each other. On the other hand, I was a ticking time bomb.”
Having a mastectomy before any cancer was detected has given her “incredible peace of mind.” And, she joked, thanks to breast reconstruction, “I am going to have the best boobs in the nursing home.”