Researchers stop biological clock during chemo


Girls as young as 14 who are exposed to chemotherapy for treating breast cancer, Hodgkin’s disease, and other non-malignant diseases such as lupus, put their reproductive system at risk. The chemotherapy can trigger premature menopause and leave women infertile.

New research by an Israeli team of doctors, led by professor Zeev Blumenfeld from the Rambam Medical Center and the Technion Faculty of Medicine in Haifa, has found an effective new treatment that helps keep a woman’s reproductive health intact while undergoing aggressive chemotherapy treatment.

Blumenfeld and his colleagues have found that a monthly injection of a gonadotropin-releasing hormone (GnRH) agonist before and throughout chemotherapy treatment can reduce the risk of premature menopause from 50 percent to less than 8 percent.

Blumenfeld and his colleagues compared ovarian function in a group of women with Hodgkin’s lymphoma receiving a monthly injection of a GnRH agonist. The women were given the injection before the start of chemotherapy until its end. Researchers compared these women who were treated with a similar dose of chemotherapy against Hodgkin’s, but without the GnRH agonist.

As reported in the journal Fertility and Sterility in January, only 3.1 percent of women in the GnRH agonist group developed premature ovarian failure. In contrast, 37 percent of the patients who did not take the GnRH agonist developed premature ovarian failure.

The researchers also found the treatment works in women with breast cancer and leukemia.

“We’ve just published a unique report of a young Israeli woman who had two bone marrow transplantations. She underwent a very aggressive chemotherapy treatment,” Blumenfeld said.

“With only one bone marrow transplantation, there is more than a 96 percent chance she would become menopausal and unable to have children. We put her on a GnRH agonist and now we were lucky to find that she is pregnant again with her second child. This is an exceptional case and probably the first worldwide of spontaneous conceptions after two bone marrow transplantations in the same patient.”

A GnRH agonist is a synthetic peptide modeled after a brain neurohormone that stimulates the pituitary gland to release hormones. The peptide has been used in a number of ways from delaying puberty in very young children to managing female disorders such as menorrhagia and uterine fibroids. It is also used in in-vitro fertilization treatment.

Doctors have long speculated that women who have been pretreated with GnRH agonists could be spared from suffering the lasting effects of premature menopause. The recent Israeli study strengthens the scientific argument.

Given to women from the reproductive age of 14 to 40 years, the GnRH agonist was able to suppress the menstrual cycle and temporarily create “a pre-pubertal hormonal milieu,” Blumenfeld said.

Due to a decreased count of platelets, a side effect of chemotherapy, the GnRH agonist injection also prevented the severe menstrual bleeding associated with chemotherapy, Blumenfeld found.

Currently, there are three other methods for preserving fertility in women exposed to chemotherapy and include preserving both unfertilized and fertilized ova. None are extremely successful. This new treatment developed by Israeli scientists could increase the likelihood that a sick woman will one day be able to conceive when she recovers.

Fertility and health is an important focus for Israeli scientists. Last year an Israeli team from Hadassah University Hospital in Jerusalem were the first who succeeded in removing eggs from pre-pubescent cancer patients — some as young as 5 — and bringing them to maturity before freezing them, giving the girls a better chance to one day have children.

According to Dr. Ariel Revel, from the in vitro department at Hadassah, until now scientists had thought viable eggs could only be obtained from girls who had undergone puberty.

Blumenfeld is a friend of Revel’s, and acknowledges that Israel is a worldwide leader in the field of fertility. He says that Israeli fertility clinics see in comparison to the population size more IVF cycles than any other country in the world — about 1,500 cycles per one million people.

“We think we are the leader,” Blumenfeld said. “Both the Israeli Jewish and Arab Israeli population are faced with social pressures to have more children. Maybe for this reason our reproductive technology and research is very developed.”

Karin Kloosterman is the associate editorial director of ISRAEL21c, a media organization focusing on 21st century Israel.

Blood Brothers: How a gift of lifesaving bone marrow united two strangers


Although they live more than 12,000 miles apart, Yosef Eliezrie and Moshe Price have a lot in common. Eliezrie, 21, is a Los Angeles yeshiva student preparing to become rabbi, like his father. Price, 24, studies in a Jerusalem yeshiva. His father is also a rabbi. The two are not related, and until this year, they had never met. Yet the same blood runs through their veins.

In October 2006, Eliezrie received a bone marrow transplant provided by Price. It was his only hope for survival after a recurrence of acute myelogenous leukemia (AML), a fast-growing cancer of the blood and bone marrow. This month, Eliezrie got the chance to meet Price in person, thank him for his lifesaving gift and embark on a unique new friendship.

At the time of the transplant, however, neither man knew how much they had in common. Bone marrow registry protocols prevent donors and recipients from learning anything about one another beyond age and gender. After a year, the donor or recipient can request contact information, but the other must agree before any information is released.

After the prescribed period, both Eliezrie and Price independently contacted their registries to initiate contact. The two were united first by phone, then met face-to-face in a private gathering April 7.

“It was amazing,” Eliezrie said. “It was one of the greatest days of my life.”

The following day, the pair visited the physicians and medical staff at Children’s Hospital of Orange County (CHOC), where Eliezrie’s transplant had been performed.

“As staff, we get caught up in day-to-day demands,” said Dr. Steven Neudorf, one of Eliezrie’s principal physicians. “Seeing Yosef and his donor together puts things in perspective and reminds us of why we do this work.”

Dr. Leonard Sender, Eliezrie’s doctor and the medical director for both UC Irvine’s Chao Family Comprehensive Cancer Center and the Cancer Institute at CHOC, showed Price where his bone marrow cells had been delivered and the small oncology intensive-care unit where Eliezrie spent almost a year.

“He’s someone who did something selfless in a selfish age,” Sender said.

After the hospital event, Price, Eliezrie, physicians, family and friends participated in a seudat hodaa, a meal of thanksgiving, hosted by Eliezrie’s parents, Stella and Rabbi Dovid Eliezrie. The senior Eliezrie is director of the North County Chabad Center in Yorba Linda.

“Judaism considers doctors to be agents of God,” Rabbi Eliezrie had said earlier at CHOC. “This hospital was an agent of God. May the bone marrow transplant team see tremendous success and have the fortitude to continue this lifesaving work.”

Yosef Eliezrie’s odyssey began in the summer of 2005. At the time a Yeshiva student in Morristown, N.J., he was anticipating a trip to Lithuania to assist with Chabad’s outreach to the Jewish community of Vilnius. Eliezrie had felt “fluish” for about a month prior to his departure and visited a doctor in New York just before leaving. The doctor said Eliezrie had bronchitis. So despite his fever, Eliezrie went ahead with his trip.

But he grew sicker and weaker with each day and soon went to a clinic, where doctors suspected — but couldn’t confirm — that he had leukemia. Eliezrie flew home and went straight from the airport to the UC Irvine Medical Center to see Sender, the pediatric hematologist/oncologist who had successfully treated his brother for cancer seven years earlier.

Within an hour, Sender had diagnosed Eliezrie with AML. Less then two days later, Eliezrie’s condition severely deteriorated, and he was put on a ventilator to control his breathing.

“He was extremely ill,” Sender said. “We weren’t sure if he would make it.”

Doctors eventually stabilized Eliezrie, and in the following months, he endured five rounds of chemotherapy and countless infections, but by Passover, Eliezrie was considered to be in remission.

During Eliezrie’s chemotherapy, Sender wanted to identify a potential bone marrow donor in the event that the cancer recurred. Family members have a 30 percent chance of being compatible donors, but neither Eliezrie’s parents nor any of his five siblings were a match.

Sender contacted the National Marrow Donor Program, but none of the program’s 7 million potential donors were compatible, either. However, through the program’s partnership with registries around the world, two possible donors were identified by Ezer Mizion, the national bone marrow registry of Israel: Moshe Price and his sister.

The largest Jewish bone marrow registry in the world, Ezer Mizion lists more than 338,000 potential donors. The organization’s registry has grown dramatically in recent years as a result of nationwide donor drives and voluntary testing routinely offered to new Israel Defense Forces recruits. However, only about 60 percent of those who contact the registry find a potential match, according to Ofra Konikoff, chief bone marrow transplant coordinator for Ezer Mizion, who traveled to the United States to facilitate Eliezrie and Price’s meeting.

Sender’s fear came to pass in August, when he discovered that Eliezrie’s cancer had recurred. Bone marrow transplantation was Eliezrie’s only option.

Ezer Mizion contacted Price, who underwent additional tests that confirmed his compatibility as a donor. Eliezrie then began 10 days of conditioning chemotherapy and radiation, a brutal regimen designed to destroy his bone marrow and prepare the body to receive foreign cells.

On Oct. 18, physicians extracted bone marrow from Price’s hip bone during a two-and-a half-hour surgery. The procedure can sometimes be done through the process of aphaeresis, where the donor’s blood is removed through a needle in one arm, passed through a machine that removes certain cells and is returned through the other arm. The donor first undergoes five daily injections of a drug that increases the production of blood-forming cells.

A courier took the package of Price’s cells directly to the airport and flew to California to deliver it to CHOC.

Eliezrie received the transplant on Oct. 19; he then he spent 55 days in isolation, where only a few family members could visit.

Jewish women change their destinies by testing for genetic mutation


Erika Taylor didn't want to know whether she had the breast cancer gene.

“My thinking was I would never get a prophylactic mastectomy,” Taylor, 44, said of the idea of removing her breasts as a preventive measure. “I just thought it was horrible thing to do to myself, and if I was unwilling to do that, why bother finding out?”

[RELATED: Women support each other in navigating genetic risk]

Her grandmother died of breast cancer at 56, and her mother battled and beat the disease in her 30s. Taylor, who is single and the mother of a 14-year-old boy, always suspected cancer was in her future, but taking steps to confirm that was not something she wanted to do. Until she got her own diagnosis.

A routine mammogram last November revealed early stage noninvasive cancer cells in Taylor's milk ducts, making information about her genetic status vital for determining her treatment.

“All of a sudden, the idea of 'I would never do such a thing' goes out the window,” she said. “It's astonishing how quickly you go, 'OK, OK, what do I need to do? I'll do it.'” Taylor's mother tested first, and when she was identified as a carrier of the BRCA 2 genetic mutation common in Ashkenazi Jews, Taylor tested next. In January, she found out she, too, carries the gene that makes it likely that even if she were to rid herself of her diagnosed cancer, it would probably recur.

Like a growing number of women, Taylor faced both the gift and the terror of knowledge.

One in 40 Ashkenazi Jews — compared to one in 500 in the general population — carries a mutation that gives women a 50 percent to 85 percent chance of getting breast cancer by the time they are 80. The genetic mutation, discovered in 1994, also increases the likelihood of melanoma and ovarian, prostate or pancreatic cancer. While within the general population about 5 percent of cancers can be attributed to a hereditary syndrome, in the Jewish community, that number is closer to 30 percent.

Her bag of tricks helps patients conquer chemo


Shortly after Janet Halbert completed treatment for breast cancer in 2005, a friend was diagnosed with the disease. The friend asked Halbert if she had any tips for easing the chemotherapy experience.

“I told her I had some products and some ideas and things that might be helpful,” Halbert said.

During her own therapy, Halbert spent her dwindling energy tracking down over-the-counter products to relieve the side effects of her treatment. She couldn’t understand why doctors and nurses didn’t just hand out a kit to their patients if they knew the typical side effects and what products helped. Halbert assembled a goodie bag for her friend, which included a toothbrush designed to be gentle on the gums, lotion, a humor book and a list of suggestions.

After putting together several more kits for other acquaintances diagnosed with various forms of cancer, Halbert decided to create 50 bags to give away to friends and friends of friends.

Earlier this year, the Jewish Community Foundation of Los Angeles awarded a $10,000 grant to Halbert’s nonprofit, Hurdle Jumpers, which has enabled her to assemble and distribute an additional 2,000 bags.

“I’m honored to have been recognized by such a well-regarded foundation,” said Halbert, who added that the Foundation’s acknowledgement was instrumental in helping her obtain two additional grants.

In 2006, Halbert formed Hurdle Jumpers, which provides the kits to help patients “soar over the obstacles of cancer treatment.” Like Sharsheret, Gilda’s Club and the Wellness Community, the nonprofit exists to provide support to ease cancer treatment’s physical and emotional toll.

Halbert hopes to secure additional funding to further expand the Hurdle Jumpers operation by taking her efforts nationwide. The American Cancer Society expects 1.4 million new cancer cases to be diagnosed this year, and Hurdle Jumpers is hoping to meet part of that need in the future by creating and shipping 700,000 kits annually.

In the beginning, Halbert started out by contacting companies and asking them to donate health and beauty products. Before long a second bedroom in her home was stacked with boxes.

The project took on a life of its own as family, friends and colleagues provided their talents, contacts and enthusiasm. A business associate, impressed with her efforts, donated the initial seed capital to get the larger-scale operation running.

Halbert, a CPA who operates her own management-consulting firm, realized she could no longer run the Hurdle Jumpers out of her home when a truck arrived carrying eight palettes of personal care products from the pharmaceutical company Novartis. She rented warehouse space to store the inventory, and recruited students from area schools to help assemble the kits. (A local business now provides her with free warehouse space, and the kits, which include items donated by 15 different companies, continue to be put together and delivered by volunteers.)

Psychotherapist and Journal contributor Anne Brener, who was diagnosed with leiomyosarcoma, a rare form of cancer, received an early version of Halbert’s kit from a colleague.

“The individual items were wonderful, but even more wonderful was the acknowledgement of what chemo is like and the nuances of it,” Brener said.

In addition to 12 personal care products, each chemo care kit includes the book “A Blue Day Book — A Lesson in Cheering Yourself Up” by B.T.Greive, a relaxation CD, a list of Halbert’s personal survival tips and a note explaining that the kit was “lovingly assembled by volunteers.” There is a smaller version of the kit for those undergoing radiation, and both kits are provided free of charge. A kit request form is available via the Hurdle Jumper Web site.

“When [a patient’s] autonomy, happiness, and coping skills are maximally taxed, along comes this delightful collection of non-medicinal remedies which focus on the baby steps it takes to get over each hurdle on the way to wellness,” said Dr. Marjorie B. Fine, chief of surgery at St. Johns Health Center and a member of Hurdle Jumpers’ board of health care advisers.

A Southern California native, Halbert describes herself as “a product of the Los Angeles organized Jewish community.” She grew up at and is still a member of Temple Beth Am, and participated in Young Judaea, Los Angeles Hebrew High School and the Brandeis Collegiate Institute.

“I grew up in a family where we always talked about politics, community, communal responsibilities and Jewish values,” Halbert said.

Later, she chaired the Jewish Federation’s Young Leadership Program, and served on the boards of Jewish Family Service, Camp JCA and the Progressive Jewish Alliance, among others. She has been active in political campaigns at the local, state and federal levels.

Her mother died of breast cancer at the age of 49, when Halbert was 11, so she learned at a young age about cancer and the importance of early detection. When Halbert felt a lump during a routine breast self-examination, she knew to take immediate action.

Her yearlong treatment included surgeries, four months of intensive chemotherapy and seven weeks of radiation.

“The whole thing is so overwhelming and exhausting,” Halbert said. She created the Hurdle Jumper kits so that “someone who is scared about the uncertainties of cancer treatment will know I made it through and they will also make it through.”

Early in her cancer odyssey, “My surgeon told me something good will come from this,” Halbert recalled. “She was right.”

For more information about Hurdle Jumpers, visit http://www.hurdlejumpers.org

First Person – God Laughs?


This column first ran on July 26, 2002, and is one of a series that the beloved former managing editor of The Journal wrote about her life and her battle with cancer. She died on Sept. 5, 2002. She was 54.

My girlfriend “E” was the first to declare what others had been observing for a while.

“God sure is having a good laugh,” she said. “You write a column called ‘A Woman’s Voice.’ And yet you have no voice.”

The irony had crossed my mind.

Lance Armstrong, the bicyclist, had testicular cancer. Beverly Sills, the opera singer, has two daughters who are deaf. Is there “meaning” in the fact that I, who have for some years traveled the country public speaking, and whose professional identity is hung up on the moniker of this column, cannot be heard?

I haven’t had a speaking voice in more than a month. I whisper, a frog croaking through the bulrushes.

My right vocal cord is paralyzed. While speaking, which I assure you doesn’t hurt, I puff like I’m running a marathon. I take an hour to eat scrambled eggs.

Still, if you ask me, God has nothing to do with it.

The loss of a voice carries a surprising spiritual threat: friends act as if some crucial part of me were gone. Inside my head, I still yammer away, brilliant on the topics of WorldCom, ImClone and Israel. But when I open my mouth, I become like Hannah before the Tabernacle. My every chortle and grimace is subject to misinterpretation.

The phone rings. The caller is disoriented: Who am I? I rush to reassure them: I’m OK. I feel fine. When I had chemotherapy, I continued to sound like myself. I would call my parents in New York right after treatment ended. Sitting tall, I was convincingly strong and congruent.

These days, without a voice, identity is not so much gone as taken on faith. I have faith that the situation is only temporary. My community has faith that I’ll be restored to myself, New York accent and all.

We are known by how we sound. Sound — our laugh, our cry, the song we hum — is the beginning of identity.

We know that God stands watch at night by the natural and unnatural sounds of the universe: the roar of the wind, the bray of the ass, the bark of a dog, the sound of a baby’s cry.

I listen for God’s comfort at night, and offer the silence of praise.

But is God laughing?

Judaism has struggled since the Holocaust to remove God from the nation’s “Most Wanted” list — the “intervening punisher God” with a wicked sense of humor.

As for you and me, the good people that bad things happen to, we’re our own worst enemy: We keep asking “Why?” as if there’s an answer. We remain committed to a God who can’t wait to pull the tablecloth out from under us.

We seek out “God the sadistic entertainer” when all other explanations fail. Lacking all other reasons, we fall back to a punitive concept, that we deserve punishment; that perhaps God never liked us to begin with.

But illness has shown me another God, one of comfort. The “loathsome trickster God” offers nothing, not even to say, “I don’t know.”

There is no reason why this has happened. Life is inherently unpredictable. Diseases, like lung cancer, have more ups and downs than a soap opera. Like “Anna Karenina” you laugh or cry, and sometimes both.

It’s funny, at least to me, that since losing my voice, I can’t interrupt anyone, not even to tell a joke. I have learned to listen to news reports rather than comment on the haircut of the newscaster. Now that I listen to conversation, I’m no longer the smartest person in any room, so far as you could tell.

The condition won’t last forever. Soon, I’ll have a silicon implant that has nothing to do with breast enhancement. I’m told it will smooth out my vocal cord and will restore my voice to normal. I’m saving my best repartee until then.

“Man plans and God laughs,” is what we say in difficult times, as if God were Henny Youngman.

If so, God can find me right here.

 

First Person – My Upfsherin


The upfsherin (hair cutting ceremony) took place on the last day of Shevat — an auspicious time for a healing ritual. The day before Rosh Chodesh (first day of the month) is observed, in the medieval mystical practice of Yom Kippur katan (little Yom Kippur) — a day for cleansing, purification, and preparation — just what shaving my head represented, as I began my fifth week of chemotherapy.

The upfsherin fell on the cusp of the months of Shevat and Adar — also propitious. The landscape of Shevat, in which we celebrate the rebirth of the trees, is a vegetative mirror of a bald head. Yet inside those leafless trees the sap is rising, life-giving elixirs watering it back to life. While we know that spring will come, the trees of Shevat often look like brittle sticks. Healing seems unlikely. This same feeling is hard to escape amidst chemotherapy’s limitations.

But Adar comes, with its joy and celebration. Lifting the weight of winter and of the fluids that run through the trees, swelling the buds and propelling green shoots in preparation for spring, Adar is the month of reversals. In Megillat Esther, stories of gloom and doom surprise us with happy endings. Destruction that seemed determined is overturned. The Jewish people survive and flourish. I embrace these metaphors for my healing journey, linking my bodily resurrection to that of the sycamore tree in my garden.

This is not the first time I have turned to that tree for guidance. In 1995, for the year after my father died, I retreated to the company of the tree. I sat for long periods, looking at the tree, thinking about my father. Looking through the skylight in my office, the seasons’ changes in color and texture against the California sky reflected my internal changes. The tree’s efforts to hold onto its leaves, as the autumn winds pulled, became my own resistance to letting go of my father and facing the starkness of winter without his protection. The hole in the trunk, where a branch had been cut away many years before, became my early wounds, reopened with this new loss. The burst of green, that appeared overnight to propel my tree into springtime, expressed my own rebirth of energy. By the summer, I was ready to leave my tree companion to teach and to study.

Once again my tree teaches me of the paradox of constancy and change that is the grace of the seasons. Embracing my tree as a companion weds me to life — and to the life-affirming progression of the seasons. It carries me forward, on the wings of time, beckoning me to use time as a healer.

For the upfsherin, I decorated a chair with ribbons in purple, green and gold — Mardi Gras colors — to mark the mutual healing for my beloved hometown and my own body as we confront the floods of toxic chemicals. I put a sheet on the floor to catch the falling hair. I explained the ritual’s intention and plan and introduced a prayer, affirming my vision for healing, encouraging others to join in:

Dear God:
Gimme a head with hair
Long beautiful hair
Shining, gleaming,
Streaming, flaxen, waxen
Give me down to there
Shoulder length or longer
Here baby, there mama
Everywhere daddy daddy
Hair, hair, hair,
Flow it, show it
Long as God can grow it
My hair

Then the cutting began. People held a lock, made a snip and gave a blessing. I received my blessing and asked each person to cut a length of ribbon for themselves, requesting that each sight of the ribbon move them to pray for my healing, the healing of New Orleans, the planet and all those who suffer.

The blessings ran from heart-rending pleas for my safety to humor. One friend told me, that he had just purchased a tree and was going to mulch it with my cut hair. My ex-husband reminded me of my mother’s dictum, “There’s nothing more temporary than a haircut.” Between blessings, my guests chanted the short healing prayer of Moses when his sister was stricken with disease: “El na rafana la (God please heal her).” I responded — to the blessings and to each crunch of the scissors — with tears and laughter. When the blessings were finished and my hair lay in piles on the floor, Peter, my hairdresser for 25 years, swooped down with electric clippers and completed the job.

Newly a woman with a buzz cut, I spoke about being a walking testimony for the disease of the planet. I prayed for the courage to not cover the truth in order to protect those uncomfortable with the anomaly of a bald woman and perhaps in denial about the state of the earth. I spoke of the link of my healing to the healing of my city of New Orleans and to all those who suffer.

Then we took the sheet out to the garden. And while we sang the “Misheberach,” we sprinkled the hair among the roots of my tree — to nourish it as it nourishes me. I hope a bird chooses some of my hair for a nest.

Anne Brener is an L.A.-based psychotherapist. She is the author of “Mourning & Mitzvah: Walking the Mourner’s Path” (Jewish Lights, 1993 and 2001), a fourth-year rabbinical student at Hebrew Union College-Jewish Institute of Religion and a faculty member of the Academy for Jewish Religion.

Spectator – ‘Time’: a Truthful Family Portrait


For Los Angeles artist Shelley Adler, the epiphany came after her second diagnosis of breast cancer and near-death from diverticulitis in 2001. Following her lumpectomy and two weeks in the hospital, she returned home and glimpsed cartons of family photographs she had collected since her parents and other relatives had died.

“The black-and-white snapshots revealed little worlds and scenes I wanted to bring alive in color,” said Adler, whose “Shades of Time: The Extended Family of Shelley Adler” runs through July 1 at the Workmen’s Circle. “I wanted to paint them the way the 16th-century Dutch genre painters had done — small portraits of ordinary people in their homes, offering glimpses into their lives.” Yet, she had put off the project until that day in 2001: “I suddenly recognized I might die, and if I was to do the series, it had to be now,” the artist said.

Adler, 69, had not painted in oils for decades; she had grown up Jewish in what she describes as a repressive small town, Minot, N.D., which she escaped to attend art school. But by 1960 she had married, had children and become a librarian in an effort to “conform, to be ‘normal.'” Fifteen years later she was so miserable that she divorced, returned to art school and became a professional illustrator.

After her 2001 epiphany, she left her job as The Jewish Journal’s art director and, between radiation and chemotherapy treatments, spent hours intensely staring at the snapshots.

“Eventually, the body language of the individuals told me things I wanted to communicate,” said Adler, who left The Journal in 2002.

Her realistic paintings include a 1944 winter portrait of her stoic, taciturn uncle Ben, who stands very still in front of his Minot jewelry store, his eyes veiled behind shadowed spectacles. In a painting of Adler’s domineering father and grandmother, his hand clutches her shoulder as if he is controlling her every move. A summer 1930s portrait of Adler’s scowling mother and aunt reveals “two women who are in conflict, yet they’re in a family,” she said.

Sherry Frumkin of the Santa Monica Art Studios, which previously displayed some of the paintings, described them as “intimate little gems, which make you feel transported to another era.”

If the portraits aren’t always positive, Adler said, “I’m a truth teller. I don’t color things with niceties…. [Rather], I hope viewers will feel they’re looking through a window, as if these people will step right out of the frame.”

For information, call (310) 552-2007.

 

Marlene Marks’ Spirit on the Web


Being treated for cancer is no one’s idea of fun. But a new Web site, www.chemochicks.com, is bringing moral support and an irreverent sense of humor to women undergoing chemotherapy. The colorful, breezy site gives female cancer patients a place to gripe, share inspiring stories and purchase products that will make life easier when their hair falls out and their self-esteem is nil.

Chemochicks.com is the brainchild of Jana Rosenblatt, a theatrical costumer and interior designer who has spent the past year fighting ovarian cancer. Much of the Chemo Chick product line comes from her own search for stylish headwraps and for eye makeup that will stay put on a hairless face.

“It’s amazing,” Rosenblatt said, “how expressionless you are without your eyebrows.”

The site also reflects Rosenblatt’s feisty spirit. When first facing chemotherapy, she dreamed up a fearless alter ego, Super Chemo Chick, who was tough enough to handle whatever might come. Now this personal coping mechanism helps empower others.

Rosenblatt’s founding partners in Five Chicks Unlimited are four local businesswomen who have been touched by cancer. They bring expertise in finance, product research, Web design and customer service to the site. But its guiding spirit is someone who did not live to see its launch: Marlene Adler Marks.

Rosenblatt had redecorated Marks’ Malibu home in 2000, shortly before The Jewish Journal’s longtime columnist and former managing editor was stricken with lung cancer. When Rosenblatt herself fell ill in June 2002, a visibly ailing Marks came to call. Marks’ courage in the face of her own mortality inspired Rosenblatt to battle back with similar grit. Two months after Marks’ death last September, the idea for chemochicks.com was hatched.

Another major morale boost came from Rosenblatt’s synagogue, Or Ami of Calabasas. Though she was relatively new to Southern California, members showered her with food baskets and friendly visits. Several, in fact, have joined the Chemo Chick team.

“I didn’t realize I was so much a part of any community, let alone a Jewish community,” Rosenblatt marveled.

Which shows that even a cancer diagnosis can lead to good things. “I like the person I am now better than the person I was before I got sick,” Rosenblatt said.

And Many More


There’s nothing like completing chemotherapy to spice up a birthday party. Last weekend, 40 of my dearest friends performed a commemorative Havdalah ceremony to mark a really great CT scan and year 53. My "re-birthday" celebration was just the ticket, restorative not only for me but also for the extended community that has seen me through my struggle with lung cancer.

In the afternoon, we painted silk squares for a healing quilt. We stuffed ourselves on smoked turkey and exotic salads. At sunset, we stood in a circle, lighting each other’s candles, saying blessings, smelling the spices that would stimulate the memory of friendship overcoming pain.

After the candles were blown out, we stood around the lemon cake lit with a single candle and sang the Birthday Song. When we got to the last line, I raised my arms like a choral director and elicited a benediction: "Hap-py Birth-day to you. And mannnnny more."

Yes, yes, make it so. Many, many more.

It is wonderful to be back among the living. During the afternoon, I walked around my garden, the summer sun dappling through mock pear trees. I eavesdropped as my friends, all Baby Boomers, complained about the ravages of age. One cries that her ear lobes are growing longer. Another says her face is sagging. Still another notes that her nose seems bigger, or that there’s no hair on her legs. How I want these problems, too.

And when I’m 90: a sturdy cane, decent hearing, a steady hand for the crossword puzzle, gums to eat corn.

Now begins yet another hard part, the reconstruction of normal time. Cancer shakes to the roots any complacency that we own our own existence. A day, a week, a month, a year. The forest of my life has separated into distinguishable trees, many of them now fallen, as if by a hurricane. Who or what owns what comes next? I am baffled. What is a worthwhile activity, and what would lead only to irrelevance or regret?

When the matriarch Sarah dies, the Torah counts her life this way: "The life of Sarah was 100 years, and 20 years and seven years." Why the triple repetition of the word "years"? The sages answer that Sarah truly lived every part of her life cycle: She was intently young, intently adult, intently old.

"One who has truly lived walks through the days," says Samson Raphael Hirsch. "He does not walk above them or below them." I will walk through the days, too.

What does this mean to me? Hirsch explains that we must bring the best of ourselves into our future. I assume he doesn’t mean my youthful love of Archie and Veronica comics, but wouldn’t mind my carrying along a sense of humor.

Can I really move on without resentment, not embittered by cancer, still resolutely me (whatever that might mean)?

The mythology of cancer is that the disease changes us in big ways. We imagine that if we survive chemo, well, naturally, we’ll quit our jobs, or go off on a junket around the world, living with an urgency and a new desire for spicy food.

But I’m not so sure. Since the diagnosis of lung cancer, the biggest change I intuit is that I drive slower.

Well, it’s true. I have a peculiar new understanding of risk, and the way unfortunate forces converge in unpredictable ways. There is danger in a sloppy left-hand turn, and what about that guy tailgating in the next lane. Having made it through lung surgery, would I want to die on Pacific Coast Highway?

To counter this caution, maybe what I need to bring with me into this next period is my insouciance. I loved being young. I gave away my years, and flaunted my energy. I crammed a lifetime into a day, reading bad books, following bad fashion, seeing bad movies without discrimination.

"Hope I die before I get old," I sang with the car radio. How close to that goal I came.

The Strongest Link


No matter how well things go in chemotherapy, the truth is, cancer always makes new demands on you. You can’t afford to be a k’nocker, pretending you know what you’re doing or what you’re ready for. It’s not as if you are in charge.

On the morning of my final course of treatment, I was ready for the long, seven-hour routine now so familiar to me. I was bringing irises for my room, pretzels filled with peanut butter for the nurses and anticipated visits from dear friends throughout the day.

It occurred to me that now, on my sixth round, maybe I was overdoing the need for support. The nurses have become like friends, and I knew I could count on them for diversion and hope, conversation about their art projects, pets and outside interests. Why ask others to interrupt their lives when by rights I could (should?) handle this last treatment alone?

My portacath was easily accessed. The intravenous drip of steroids and kidney stabilizers was set in motion. Emily, Joyce and I were discussing the career prospects of our adult children. At 2 p.m. the doorway filled; my oncologist and the staff brought a chocolate cake and sang "Happy Last Chemo to You!"

Yes, my last chemo day proceeded naturally, dull with the drip of healing.

At 6 p.m., we caught the mistake. The IV pump had a glitch, and I had not yet begun Taxol, the first and longest part of chemo treatment. For two and one half hours, while Susan, Cynthia and Rona had been discussing art museums and second careers, I’d been getting nothing from a blocked port.

And so I was back at the beginning. Not just the beginning of the day, but, my thoughts sent spiraling, the beginning of my life. Fear took over, my blood pressure rising into the stratosphere. And I knew, with a certainty only six months of lung cancer could produce, that this was bad news. My grandmother, who died before I was born, had had high blood pressure, followed by a stroke. She’d gone blind. All my life seemed pointed at this moment, this awful dark joke. Maybe cancer wouldn’t kill me, but blood pressure might.

"Can you meditate?" nurse Stephanie asked as she turned down the light.

Yes, of course. I had practiced 20 years of meditation, plus visualization. Plus prayer. Not to mention yoga.

"Om," I began. And "Shalom."

I started the slow counting of the breath, in and out. I saw myself on a sandy beach of a tropical island at sunset. I breathed God in, and tried to breathe fear out.

Nothing worked. The slower I breathed, the worse my fear became. I was the proverbial speck, a victim of a senseless universe, with the terror of my grandmother’s legacy whispering in the wind.

And my blood press stayed high.

Then I heard the rustle of leaves. I wasn’t alone, of course. Cynthia and Rona were bringing back soup and sandwiches. But Susan was there, flipping through the newspaper nearby.

"Hold my hand?" I asked her. Within minutes, I was breathing normally. My blood pressure stabilized.

So on the very last day of chemotherapy, one valve of an IV tube was constricted, but another valve, that of the heart, opened up.

I know nothing about bravery. I know only about need. Reb Nachman of Bratslov calls prayer the cry of the brokenhearted to a father who is far away. Maybe so. But prayer can also be reaching out, to friends who are close at hand.

Alone, I am the weakest link. Together, there are soup and sandwiches for all.

Back From The Dead


I am determined to learn nothing from my cancer. Last month, I had lung surgery known as a thoracotomy. A cancerous tumor in my lower left lobe is gone. I’ll have chemotherapy, and pretty soon I’ll be bald. That’s all I care to know about this completely hideous, unprovoked and unpredictable disease until the CT scan says that the cancer on my chest wall is under control.

I don’t have a prayer of realizing this goal, do I? One way or another, I am destined to meander through the bramble of "meaning" we impose on any affliction. If I don’t do it for myself, you’ll do it for me. That’s the way we humans are built. We are "meaning makers," genetically inclined to connect the dots between disparate events. And Jews, I think, are the best at it.

A friend came over today, in the spirit of bikur cholim (visiting the sick), just to tell me he envied my grand moment, the make-or-break confrontation with reality. Forget it. I want my cancer to be just a disease blip that, given the best medical attention in the world, will soon be over and out. I don’t want it to be poetry, adventure, a journey. I don’t want my life to become, God forbid, heroic metaphor, sermon or midrash. I don’t want to look into cause and effect, stress and the mind-body connection. Fat chance.

It began seconds after surgery; my impulsive, chaotic pursuit of "understanding." The wheels of my gurney kerplunkt down the long hallway, and then a strong voice calling to me.

"Marlene! Refuah shleymah — speedy recovery!"

I opened my eyes to see my dear friend, Cantor Chayim Frenkel of Kehillat Israel, standing by my side. Chayim’s voice, both buoyant and grave, penetrated right through the anesthesia and warmed me. In my stupor, he clung to me, praying for my welfare. My heart lifted.

But why was Chayim there? My mind, frenzied from post-surgery, hunted and pecked for meaning.

The Frenkels, Chayim and his wife Marsi, had just had their second baby, Molly, in the same hospital. I was thrilled for the Frenkels, but now a vague, lint-like terror floated by. First, my mind replayed the sight and sound of Chayim waving at me. Then I went back in time and recalled the cantor as he had stood at the bimah officiating at my daughter’s Bat Mitzvah six years ago. Then a fast forward, to the Saturday before during Torah study. He had embraced me, offering prayers and blessings, before I’d gone into the hospital. No cantorial voice could be more comforting, but for that reason his was also more terrifying.

Putting these events together, my warped, drug-soaked brain worried: Was Chayim a messenger? Was he somehow an angel, ushering his new baby in, while I, with such a similar first name, was moving out? Was this the famous exchange of souls at the borderline of life? For hours I could not settle down.

That was my first post-surgical confrontation with ancient superstition, though certainly not my last. Worse yet, after the ancient bubbemeisers (grandmother’s tales), came the modern ones — created by those with learning.

The gist of these theories is that nothing happens by accident, that everything is as God plans it, including, I suppose, my cancer.

Rubbish. These literary devices can be heartwarming as one takes the plunge into marriage or child-rearing. But for random, life-threatening situations, they can be debilitating or worse. Must I fight my own tradition by thinking that I’m not only getting chemo but crossing a "narrow bridge;" that I am not only killing deadly cells, but being tested by God?

The idea that God tests us is deep within Jewish reading, and I’m not only talking about Job. The patriarch Abraham endured 10 tests to prove himself worthy of founding the Jewish people.

Jacob, of course, was tested spiritually and physically, finally winning a brutal battle (with himself or an angel) in which his name was changed to Israel. Joseph’s whole life was deemed a test, sold into slavery by his brothers, back and forth into prison. When he had his brothers are united he says, "You meant it for evil, but God meant it for good."

But it isn’t so. God does not really "mean" something evil for good. Nor is all the world and its difficulties to be summarized as "Egypt" — "mitzrayim" in Hebrew, meaning "narrow birth canal."

My cancer isn’t "my Egypt"? It’s my contact with the best of American medicine. I’m not praying for freedom, for reasons or for literary symbols, but for access to the best clinical drug trial I can find.

"There’s room for both you and Molly to live a full life," Chayim told me. "One day, we’ll dance at your daughter’s wedding!"

That’s why I’m committed to learning as little as possible from my cancer. Stay with me.