Cedars-Sinai to host symposium on inherited cancer risk


As a gynecologic oncologist at Cedars-Sinai Medical Center in the late 1980s, Dr. Beth Karlan and her colleagues noticed that cancer seems to cluster in certain families. In 1991, they established the Gilda Radner Hereditary Cancer Program to investigate the role heredity plays in cancer.

A key discovery in 1994 shed light on the relationship between heredity and cancer: Mary-Claire King, a researcher at UC Berkeley, identified an alteration on a single gene that made people more susceptible to breast and ovarian cancers. King named the gene BRCA1, for breast cancer gene. Soon afterward, a second gene alteration associated with increased cancer risk was identified and given the name BRCA2.

Discovery of these genes constituted a “seismic change to the landscape of hereditary cancers,” said Karlan, now director of the Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute at Cedars. “[It gave us] an understanding and ability to focus on some of the ways these cancers are transmitted.”

To mark the 20-year anniversary of this discovery, the Women’s Cancer Program is hosting a symposium Sept. 13 exploring advances in screening, prevention and treatment of hereditary cancers. Presenters also will discuss some of the controversies around this issue, such as prophylactic measures for preventing cancer in individuals who have tested positive for a BRCA gene.

The symposium, titled “Advances in Care for the New Millennium,” will be held at the Sofitel Los Angeles at Beverly Hills. The first portion of the day is designed for physicians, geneticists, genetic counselors, nurses and other professionals whose work concerns BRCA-related cancers. 

A free afternoon session, “Strategies for Managing Hereditary Cancer Risk,” begins at 4 p.m. and is open to the public, though registration is required. It is geared toward those with an interest in the topic, such as people who carry or are related to a carrier of a BRCA mutation, those with a strong family history of hereditary breast or ovarian cancer, those seeking strategies for lowering cancer risk and detecting it earlier, and women considering prophylactic measures to limit cancer risk. 

BRCA gene mutations account for about 5 to 10 percent of all breast cancers and about 15 percent of all ovarian cancers. Ashkenazi Jews have a higher prevalence of BRCA1 and BRCA2 mutations than the population at large.

Speakers at both portions of the symposium include Karlan; Dr. Steven A. Narod, director of the Familial Breast Cancer Research Unit of Women’s College Research Institute in Toronto; Dr. Judy E. Garber, director of the Cancer Genetics and Prevention Center at the Dana-Farber Cancer Institute in Boston; and Dr. Sue Friedman, executive director of FORCE (Facing Our Risk of Cancer Empowered).

Karlan, who is Jewish, says that the BRCA gene mutation will not manifest the same way in everyone. Researchers hope to untangle the environmental and genetic factors that determine why some carriers develop cancer and others don’t, and why those who do may develop different types of cancer. 

“There are also noncancer implications of BRCA genes,” Karlan told the Journal. “These mutations are present in every cell of the body.”

She urges women to know their family health history. 

“You can inherit the BRCA gene mutation from your mother or your father,” Karlan said. “Find out what runs in your family and see if genetic testing is appropriate for you. It could end up saving your life.”

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“Strategies for Managing Hereditary Cancer Risk,” takes place Sept. 13, from 4-5:30 p.m. at Sofitel Los Angeles at Beverly Hills. Registration is required. Contact Fay Shapiro at (310) 423-5800 or fay.shapiro@cshs.org. To register for the afternoon public session, contact Fay Shapiro at (310) 423-5800 or fay.shapiro@cshs.org.

Calendar: October 26-November 1


SAT | OCT 26

“A CELEBRATION OF HAROLD PINTER”

John Malkovich and Julian Sands collaborate on a personal and unusual tribute to one of the most influential British dramatists of the 20th century. The Nobel Prize-winning playwright is responsible for “Betrayal,” “The French Lieutenant’s Woman,” “Sleuth” and much more. Sands, who knew Pinter personally, captures the opinionated and enigmatic author in this intimately directed portrait. Sat. 7:30 p.m. $47-$75. The Broad Stage, 1310 11th St., Santa Monica. (310) 434-3200. SUN | OCT 27

BALABOOSTA: POP-UP DINNER WITH CHEF ADMONY

One word: Yum. Join renowned Israeli-born chef and author Einat Admony, owner of New York’s acclaimed Balaboosta restaurant, as she cooks a Middle East-inspired pop-up dinner at the ultra-cool downtown grocer Urban Radish. You’ll get a casual family-style dinner with dishes inspired by Admony’s Israeli heritage (Yemenite and Persian) from her new cookbook “Balaboosta,” seamlessly blended with the fresh, sophisticated Mediterranean palate she honed while working in some of New York City’s most beloved kitchens. Sun. 6-8 p.m.  $65 (limited tickets). Urban Radish, 661 Imperial St., Los Angeles. (213) 892-1570. ” target=”_blank”>aju.edu.

“SILENT WITNESSES”

It’s closing night and your last chance to see this moving piece of theater. Time can be just as revealing as it is healing for a group of women who all, in their own way, survived the Holocaust. When they meet each other in a group therapy session, it is used as an opportunity to share. Decades since their respective escapes, these women finally speak about vanished loved ones, privation and sorrow, but also compassionate Christian families and triumphs. Sun. 7:30 p.m. $20. The Whitefire Theatre, 13500 Ventura Blvd., Sherman Oaks. (800) 838-3006. TUE | OCT 29

“THE VISIONARY: THE LIFE OF RABBI BEN ZION MEIR HAI UZIEL”

This film biography of Israel’s first Sephardic Chief Rabbi is part of the Sephardic Education Center’s Fall Lecture Series. After the screening, Rabbi Daniel Bouskila will lead a short discussion about the film’s journey through the pre-state yishuv and Israel’s early years. Come and experience the Sephardic philosophy of tradition, modernity and unity. Refreshments will be served. Tue. 7 p.m. Free. Must RSVP. The Jewish Federation, 6505 Wilshire Blvd., Los Angeles. (323) 272-4574. WED | OCT 30

“THE 75th ANNIVERSARY OF KRISTALLNACHT”

The Whizin Center for Continuing Education presents a special program to commemorate that destructive November night 75 years ago. In addition to a docent talk about AJU’s Rare Book Center, Journal Book Editor Jonathan Kirsch will be speaking on his new book “The Short, Strange Life of Herschel Grynszpan: A Boy Avenger, A Nazi Diplomat, and a Murder in Paris.” Michael Berenbaum will moderate the program, which will also include German synagogue music and light refreshments. Wed. 7 p.m. $20. American Jewish University, 15600 Mulholland Drive, Los Angeles. (310) 476-9777. ” target=”_blank”>mutantdiaries.com/la.

“LIFE IN BALANCE”

How much right do we have to our body? And where do the Torah, the Talmud and modern medicine meet? The Rohr Jewish Learning Institute and the Beverly Hills Jewish Academy are organizing a community awareness workshop series on how Jewish law views the modern-day medical dilemma. Tonight’s first class, “Safeguarding Our Health,” looks at issues surrounding the BRCA genetic mutation in honor of National Breast Cancer Awareness Month. Wed. 8 p.m. Free. 9401 Wilshire Blvd., Suite 1250, Beverly Hills. (310) 734-9070. FRI | NOV 1

“SAY THE WORD: GET IT TOGETHER”

Beth Lapides hosts a night of comedy writers and comedians as they share stories of weddings, funerals, graduations, birthday parties and those special events that aren’t as easily categorized. Tim Bagley, Kevin Nealon, Merrill Markoe, Dan Levy, Carlos Kotkin and Wendy Liebman gather to flesh out all the juicy details. Cocktails and snacks available for purchase. Fri. 8 p.m. $15 (general), $10 (members), $8 (students). Skirball Cultural Center, 2701 N. Sepulveda Blvd., Los Angeles. (310) 440-4500.

Turning Knowledge into Power


The connection between Jewish women and cancer is unsettling, even terrifying, yet undeniably real. Too many have been diagnosed to be simple coincidence. What’s happening to Jewish women? What can we do about it?

On December 9, 1999, the University of Southern California/Norris Comprehensive Cancer Center, the Jewish Federation and Hadassah hosted the conference “Cancer Genetics: Health, Hope and the Jewish Family.” The conference brought a group of physicians and experts to the Skirball Cultural Center in Los Angeles to explore those questions and try to provide some answers. “We care that our community get the facts that can make the difference in their lives,” said Federation President John Fishel.

The problem, according to conference speakers, is in our genes. In 1994, two genes were discovered — BRCA1 and BRCA2 — that significantly increase a woman’s risk of breast and ovarian cancer. And, unfortunately, Jewish women are about 10 times more likely to carry one of these mutations than the general population. “If the individual is an Ashkenazi Jew,” says Alexandra Levine, M.D., medical director of the USC/Norris Cancer Hospital and chief of USC School of Medicine’s Division of Hematology, “the chances of carrying one of those genes is about one in 40, or two-and-a-half percent.”

And the effects of those genes are profound. According to Levine, the lifetime risk of getting breast cancer for a carrier of BRCA1 is 50 to 85 percent. The risk of ovarian cancer is somewhere between 15 and 45 percent. And the lifetime risk of getting a second primary cancer if you’ve already had one is 40 to 60 percent. The risks associated with BRCA2 are about the same.

But the idea conference speakers stressed most was that although the numbers are frightening, they are also empowering. Because knowing that these genes exist means we can test for them, and when they’re found in an individual, we can act.

“If we know that the gene is there, we might allow early detection,” says Dr. Levine. And there is now a host of preventive measures women can take, everything from birth control pills, to drugs like tamoxifen, to prophylactic surgery. While none of these measures eliminates the risk of cancer, they can reduce it significantly. And knowing you’re a BRCA carrier means you can discuss those options before cancer ever appears.

So how do you know if you should be tested for the BRCA genes? The most telling signal is family history. “If you have two or more relatives on the same side of the family with cancer, as a geneticist, I would look at that person more carefully,” says Dr. Levine. “Breast cancer normally occurs when you’re 50 or 60, but here’s someone who develops it at the age of 30, that’s another indication.” Other indicators are people with multiple cancers. And, as Beth Karlan, M.D., director of Gynecologic Oncology at Cedars-Sinai Medical Center, points out, “your father’s family history is just as important as your mother’s.”

Of course, testing presents its own risks. Just because someone doesn’t carry a BRCA gene doesn’t mean they’ll never get cancer. The knowledge of being a carrier may cause undue stress and fear. And, in a larger context, genetic testing is so new that government hasn’t caught up, and a positive test could create insurance or employment problems. But even with pitfalls like these to navigate, knowing you’re a carrier empowers you to act, a principle message of the conference. “If you’ve been tested and you find out you’re positive, you don’t have to sit there and just feel victimized by it,” says Dr. Karlan. “You can be proactive. You can do something about it.”