Our Voices: A Blog by Links, Callers and Volunteers

Adopting a Patient Perspective

When Karin Charnoff-Katz, MD, was diagnosed with breast cancer, she entered the patient experience and left a changed physician.

On my way to work as a general radiologist in Memphis, I detoured to stop for a routine screening mammogram. I was 41 and a few months late for my second annual screening. I was not overly anxious. My white attending physician coat provided me with an illusory protective shield. I believed the coat granted me a special immunity of sorts. I did not even wait for an official read after the imaging, as I was in too much of a rush to get to work. It seemed at that phase in my life, I was always multi-tasking and perennially in a hurry. Between working, losing my mother and mother-in-law to ovarian cancer deaths at young ages, and having three small children at home, every moment was teeming with activity and responsibility. I often put on makeup in the mornings while stopped at red lights in my car. Maybe that explained my less than stellar driving record.

To read Dr. Katz's complete story from the American College of Radiology Bulletin, click here.

Sharsheret Survivorship Program Continues to Thrive

“I was thrilled to receive your breast cancer survivor kit. It literally made my day. The cookbook is fantastic, and the information provided will definitely help me during my survivorship journey. I keep my kit in the great tote bag and refer to it often. It is usually the first thing I look at if a question occurs to me. You all do wonderful work and this was so supportive to me. I will share it with other survivors as well as those beginning their journey.”
- Joanne, Baton Rouge, LA

In September 2011, Sharsheret received a three-year grant from the Centers for Disease Control and Prevention to develop a comprehensive survivorship program for young Jewish breast cancer survivors like Joanne.  Three years later, after distributing more than 1,300 survivorship kits, conducting nearly 750 care plan navigation sessions, and hosting 5 national teleconferences, Sharsheret’s survivorship program, Thriving Again, is doing just that – thriving.

Throughout the process of developing and implementing Thriving Again, Sharsheret conducted a series of evaluations on the needs and concerns of young Jewish breast cancer survivors. Sharsheret clinicians engaged in a comprehensive review of the literature regarding young adult cancer survivors and relevant support programs, surveyed more than 1,400 young breast cancer survivors to better understand their unique and unmet needs, and conducted four national focus groups of breast cancer survivors to collect feedback and identify priority concerns. Sharsheret presented this program development model and findings from the Thriving Again program at healthcare conferences across the country, including the Centers for Disease Control and Prevention Business Meeting and the Academy of Oncology Nurse Navigators Annual Conference, where Sharsheret was presented with an award for our poster presentation in the “Original Research on Survivorship Programs” category. Through sharing our program model and data, Sharsheret advances survivorship care for all groups, and informs the development of new programs for survivors of breast and other cancers.

Looking toward the future, Sharsheret now offers consulting services and co-branding opportunities for healthcare professionals and those at medical centers nationwide who wish to develop similar culturally-relevant support programs for cancer survivors, and continues to provide survivorship kits and navigation services for the women of Sharsheret, like Joanne, who seek survivorship information and support.  

To learn more about Sharsheret’s consulting and co-branding services, contact Support Program Coordinator Sharon Stahl, LMSW or call 866.474.2774.

My Children and Hereditary Breast and Ovarian Cancer

A diagnosis of ovarian cancer earlier this year was a life changing event.  Fear, anxiety, sadness, body image issues, and short and long term effects of chemotherapy, only begin to touch on the myriad of worries which confronted me.  Still, one of the most difficult things to deal with has been the not-so-surprising presence of a genetic predisposition (due to a BRCA2 mutation) to cancer.   The thought that each of my four young adult children had a 50% chance of inheriting this gene was almost more than I could bear.  

How does one deal with the guilt?  How does one speak with her children about such an inheritance?  Does one inform female and male children at the same time and in the same fashion?  Does one give married and still unmarried children the same details?  Does one advise her children to be tested as soon as possible?  Will a positive BRCA2 test with all its implications interfere with a developing or even presently stable relationship?  Can one avoid adding pressure to the lives of adult children when discussing the issues of marrying early and having babies as quickly as possible so that they may take advantage of risk reduction therapy at a young enough age to reduce the chances of ovarian cancer and breast cancer?

There are no standard answers to any of these questions; indeed the approach will surely differ for each family based on the individuals and the family dynamics.   Several interactions have guided my thinking regarding these issues. 

Firstly, I cannot say enough positive things about resources available through Sharsheret.  Sharsheret’s genetic counselor made herself available to me within a few minutes of my initial call and kept closely in touch.  She pointed out several important concepts to me, including the ideas that: 1) I am not the only source of information for my children; 2) Each individual on the receiving end of the information must decide for him or herself how to proceed; 3) All of the information does not have to be discussed in one sitting– indeed the important thing is to keep the lines of communication open; 4) Difficult as this discussion must be, knowledge is empowering as it allows positive actions to be taken.

Secondly, a wise and spiritual friend focused my attention on the positive implications associated with this difficult discussion, namely: truth, trust, potential for decreasing uncertainty, and potential for risk reduction actions.
Finally, one of my children, aware of the pending issue, asked me straight out about the results of my testing, before I was ready to have the big discussion.  When I made the result known to her and spoke with her about some of my concerns, I was amazed at the strength she imparted to me by her personal views. 

I have yet to work through all the details, but I have gained understanding through learning as much as possible about the implications of the BRCA gene mutation, and through speaking with wise and trusted professionals and friends.

May We All Go From Strength to Strength

When my youngest daughter was four months old, I was diagnosed with stage two breast cancer. With my newborn, I would go to chemo treatments followed by daily radiation. After radiation we would go to Gymboree because life needed to remain normal. It was a new normal, but just the same, it was my normal. I would then go and pick up my other three children from school and continue on with the day.

After surgery, chemo, and radiation, there was no evidence of cancer. The doctors thought we were home free. But as anyone with cancer knows, it can sometimes be a very tricky disease. After three and a half years of remission, we found that the cancer had returned. The cancer had spread to my liver and bones. I now had stage four metastatic cancer. The diagnosis and prognosis was confirmed with two doctors. That was eight years ago. There has been no evidence of disease for 2 years and 4 months! Yes, I have metastatic breast cancer but I am living with it. I have a wonderful full life with my husband and four kids. Three are now in college and the youngest is in 7th grade.

I have had 11 types of treatment and achieved success with some and failure with others. One thing I do know is that research is key to giving us all a fighting chance. The more treatments we have in our arsenal, the more chance for one to work.  I also am not going to take my treatment lightly. I have blood work every 3 weeks and scans are done every three months. I fit cancer into my life. It works around my busy schedule. It is in the background of my mind but living is in the forefront of it. I believe in carpe diem every day. We were given this incredible blessing of life and I plan on living it for a very long time!

Colored Beads of Sharsheret

I arrived at Sharsheret for my first day of work, ready and willing to embrace my inevitable role as coffee-delivery girl, file organizer, data enterer, and performer of all such tasks typically delegated to the summer intern. However, as I dived into spreadsheets and media archives, a world began to unfurl before me. Now on the inside, I learned about navigating the inner-workings of a professionally run non-profit organization, while never losing sight of the target audience--the women we try our best to serve.  I witnessed daily the fierce power, fueled by Rochelle’s first brave initiative, of our network of women, staff, donors, and volunteers. Sharsheret’s beauty is in its “chain,” formed not by uniform links, but by thousands of diversely colored beads thoughtfully threaded together. Our dedicated staff cares passionately for women of all Jewish affiliations, stages of cancer diagnosis, and phases of life by offering cutting-edge support tailored to the individual needs of each woman, always deeply sensitive to the reality of living with a serious illness. Our mission is contagious, permeating the cubicles of Suite 2G on Teaneck Road to reach women and organizations nationwide.

Although my tasks consisted mainly of data entry, fundraising, filing, and research, I was privileged to interact with every member of the staff, each offering a particular skills-set and area of expertise.  At the annual retreat, I spent time with the team outside of work and enjoyed a front-row seat as they outlined their vision for the organization’s future. Powered by the commitment of a personally-founded non-profit and directed with the efficiency and strategy of Corporate America, Sharsheret holds a unique place amongst the many organizations in the Jewish and cancer communities. I am so thankful to the women and men of Sharsheret, both inside of the office and out, for the excellent learning opportunity and urgent call to action that will stay with me long after the leaves begin to fall.

Anything You Do That Is Small Is Not Small At All

“Anything you do that is small is not small at all,” was the message of a breast cancer survivor who spoke at the annual Sharsheret Cake Wars event at Yeshiva University. This was my introduction to Sharsheret.

After Cake Wars, I attended Sharsheret walks, speaking engagements, and other events throughout my college experience.  Since I learned how to help my father when he was facing cancer, I had a strong desire to help others in similar situations. Sharsheret’s mission, to help Jewish women and families affected by breast or ovarian cancer, seemed like a great cause to help advocate for and support.  Last fall, I began my Masters in Social Work degree at Columbia University, and I wanted to find something meaningful and stimulating to do for the summer.

When I was accepted as the Sema Heller – Netivot Shalom Summer Intern, I was excited to meet the staff that was responsible for this growing and successful organization.   Over the summer, I worked on various projects that helped analyze and enhance the programs at Sharsheret. The most interesting project was working on the health care symposia.  Reading through past transcripts and planning for upcoming symposia helped me gain a greater understanding of the current research and information available to women facing cancer and the many challenges they face when diagnosed.

I was also fortunate to meet Sam Heller.  Mr. Heller, along with friends and family, established this internship in memory of his late wife, Sema, who passed away from breast cancer. Learning about Sema’s strength and her desire to help others as she battled cancer was very inspiring and I am humbled to have had this internship in her memory.

I know that I will take the skills and information I have learned from Sharsheret and bring them with me in my career as a social worker.  It has been an enjoyable and memorable summer experience working at Sharsheret and I look forward to hearing about continuous growth and progress in its future.

Ovarian Cancer: Let’s Talk About It

Inspiring, brave, passionate.  All words one can use to describe the women and caregivers I met at the Ovarian Cancer National Alliance Conference in Washington, D.C. this July.  One such woman is Carey, a Sharsheret peer supporter and founder of Teal Toes, an ovarian cancer organization that encourages groups to paint their nails teal to spread awareness about ovarian cancer. Women like Carey know that the first step in the fight against ovarian cancer is a simple one: talk about it. Over 20,000 women are diagnosed with ovarian cancer each year, according to the National Cancer Institute, and many cases are not diagnosed until later stages of the disease.  Regular screenings for ovarian cancer are uncommon, and the signs and symptoms of ovarian cancer, such as back pain, bloating, and feeling full too quickly after eating, can be often overlooked.

Individually, knowing the signs and symptoms will allow us to be proactive about our health.  As a group, discussing ovarian cancer on major public health and advocacy stages can lead to earlier detection and treatment advances.  1 in 40 Ashkenazi Jews carries a BRCA mutation, and women with a BRCA gene mutation have 40% – 60% lifetime risk of developing ovarian cancer, making discussions about ovarian cancer even more important in our community. 

As the summer begins to wind down, we are busy preparing for National Ovarian Cancer Awareness Month in September.  September is the perfect time for you and your family to have conversations about your risk, and to raise awareness.  Click here to order Sharsheret’s free educational resources about ovarian cancer to share with others, or call 866.474.2774 to learn more about our Ovarian Cancer Program and ways to get involved at Sharsheret.

Time Flies When You’re Having Fun

It’s true when they say time flies when you’re having fun.

This summer I had the privilege of interning at Sharsheret. I cannot believe that it has already been nine weeks, and my time at Sharsheret is almost over!

When I first heard about Sharsheret, I did not understand how breast and ovarian cancer were Jewish concerns. I did not understand genetic risk or culturally relevant support. However, over the past nine weeks, I have watched Sharsheret staff with inspiration as they provided individualized support to callers, matched peer supporters, worked with healthcare professionals to provide culturally relevant support to patients, worked on national outreach programs, attended conferences, organized teleconferences, webinars, and medical symposia as resources for survivors and tools to educate others about the most up to date cancer research, and worked with athletes and volunteers to raise awareness about Sharsheret’s mission.

Sharsheret is an extremely welcoming place. I remember how nervous I was my first day as an intern. However, Sharsheret staff went out of their way to make me feel welcome as a member of their team, even on my first day. The passion, dedication, and kindness of Sharsheret staff is contagious, as one cannot help but smile in awe when walking into the Sharsheret office. The office is always bustling with volunteers, students, and staff. The phone is constantly ringing in the clinical office, and the fulfillment center is always bustling with activity as Thriving Again kits, Busy Boxes, and Best Face Forward kits are being sent out to women.

Each day I am more and more amazed by Sharsheret. The callers, the volunteers, the impact, and the energy the organization has is unmatchable. But I am most inspired by the women. The links that keep Sharsheret’s chain growing. The women who debate undergoing genetic testing. The mother newly diagnosed who is already looking to serve as a resource for others. The wife who just finished her first round of chemo. Women at all different stages in their cancer journeys, diagnosed at various stages. The woman who called Sharsheret right before surgery to thank us for our support. We must thank these women for their bravery, courage, and constant inspiration because without them Sharsheret would not exist.

As I near the end of my time at Sharsheret, I want to thank all the women, volunteers, staff, and Sharsheret supporters that help make Sharsheret the incredible organization that it is. I am sad to be leaving, but I look forward to continuing to support Sharsheret and spreading the word about this amazing organization!

Reporting From ASCO: Obesity and Breast Cancer

A study presented this week at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting suggests that in younger women with early stage estrogen-receptor positive (ER+) breast cancer, obesity is associated with poorer outcomes. The research comes from a review of 70 clinical drug trials enrolling 80,000 women. It further supports an increasing body of data suggesting worse overall outcomes related to breast cancer for women who are overweight or obese compared with women who stay at a healthy weight.

About two-thirds of all breast cancers are hormone receptor positive, meaning estrogen and/or progesterone fuel their growth. Fat cells help make and store hormones including estrogen. Therefore, carrying excess fat tissue may increase breast cancer risk by increasing the body’s exposure to circulating estrogen. Previous research has shown overweight and obesity increase risk for breast cancer development in post-menopausal women, as does weight gain in adulthood. In fact, women who gained 60 pounds after the age of 18 had twice the risk of post-menopausal breast cancer versus women who maintained their same weight. To date, however, negative effects of overweight and obesity with regard to breast cancer were demonstrated only in older women, not pre-menopausal women with ovarian function.

Preventing excess weight gain in the first place is the best way to reduce risk for certain cancers and many other illnesses. It isn’t clear yet whether weight loss in adulthood reduces risk of cancer diagnosis or mortality. However, we do know that even a modest sustained weight loss (5%-10%) in people who are overweight or obese decreases risks for heart disease and diabetes. Given the potential relationships between these types of systemic and metabolic diseases and cancer growth, it is certainly possible that weight reduction could have even more benefits than those we already know.

Many risk factors for breast cancer, such as family history, are not modifiable. The good news is, avoiding excess weight gain – both for women at risk for breast cancer and those already diagnosed with breast cancer – is largely controllable. The following points are helpful in weight reduction and management over time:

  • Choose a mostly plant-based diet with a variety of whole foods.
  • Limit processed foods and fast foods.
  • Decrease added and refined sugars.
  • Monitor portion sizes.
  • Eat mindfully and pay attention to physical hunger and satiety cues.
  • Eat meals more slowly.
  • Keep a written food diary.
  • Engage the support of friends and family.
  • Exercise for at least 30 minutes most days of the week.
  • Get enough sleep.

Meet with a Registered Dietitian Nutritionist (RD/RDN) to discuss a nutrition plan that is personalized, practical, and sustainable over a lifetime. You can find a local RD/RDN who specializes in weight management and/or cancer nutrition at www.eatright.org.

Sharsheret and the CDC “Know: BRCA” – Do You?

Sharsheret is proud to have been awarded a grant from the Centers for Disease Control and Prevention to develop and implement our program for young Jewish breast cancer survivors, Thriving Again®.  This grant was part of a larger CDC initiative to address breast cancer in young women.  Since 2011, Sharsheret’s Founder and Executive Director, Rochelle Shoretz, has served on the Federal Advisory Committee on Breast Cancer in Young Women, along with representatives from other major breast cancer organizations, supporting the development of national resources and awareness of the Jewish population’s unique role in the conversation about breast cancer.

The CDC recently announced the launch of Know: BRCA, an initiative and web-based resource designed to promote BRCA gene mutation awareness in young women.  1 in 40 Ashkenazi Jews carries a BRCA gene mutation, compared to 1 in 345 in the general population, making Jewish families 10 times more likely to develop hereditary breast cancer, ovarian cancer, and related cancers.  This CDC initiative brings Sharsheret another step closer to achieving our goals of enhancing awareness about the impact of BRCA gene mutations, the elevated risk of developing hereditary cancer among Jewish families, and the need for tailored support for the more than 250,000 women under 40 living with breast cancer in the United States today.

If you have a family history of cancer, or a BRCA gene mutation, call Sharsheret at 866.474.2774 or email info@sharsheret.org to speak with a member of our clinical staff and join our Genetics for Life® program.

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