October’s Arrived, So I’m on My Soapbox

Credit: benefits.com

I didn’t know how I was going to write about Breast Cancer Awareness Month this year, and then I saw this message on Facebook, posted by a guy I knew in high school:

Lost my mother, grandmother (and both her sisters) and great grandmother to breast cancer. I get checked every year by my doctor.

#getchecked

#protectthetattas

I immediately sent him a private message: “Have you had genetic testing for BRCA and other mutations?”

Guy: “My brother has since he had daughters. Was negative. But he and I are vastly diff makeups. He’s def from my father’s DNA. And I’m sure I’m more my mother’s. Never got tested since I only had boys.”

I couldn’t have asked for a better set-up!

Me: “You should consider consulting with a genetic counselor because men, not only women, can pass mutations on to their children. So, if you carry a hereditary cancer mutation, each of your sons has a 50% chance of carrying it—and a 50% chance of passing it on to their own kids, both sons and daughters. Happy to discuss further if that would be helpful. I’ve learned all of this the hard way, and I work hard to make sure other families don’t have the experiences that mine did. Also, some of these mutations are much more prevalent among Ashkenazi Jews than they are in the general population. I’ll also butt out if you think this is none of my business.” 

Guy: “I appreciate it! I will pursue it further.”

Me: “Excellent! Please keep me posted.”  

If, in fact, Guy or either of his sons turns out to be a BRCA mutation carrier (pfth, pfth, pfth), they’re at increased risk of male breast cancer, prostate cancer, pancreatic cancer, and melanoma. So, I hope he follows through, gets genetic counseling, and does whatever might be necessary to protect his own health and that of his sons.

To learn more about hereditary cancer, visit FORCE: Facing Our Risk of Cancer Empowered, a national non-profit organization solely devoted to providing resources and support to the hereditary cancer community. To find a genetic counselor in your area, visit the National Society of Genetic Counselors. Visit JScreen.org to learn how you can test for hereditary cancer mutations from home and consult with a genetic counselor about the results.

Shechinah at #FORCE17

Last Friday afternoon, as I do each week, I texted a few friends a Shabbat shalom message: “Shabbat shalom from Orlando and #FORCE17 – annual hereditary cancer conference. 🌞”

One of them responded with this: “Shabbat shalom to you, too, in sunny Florida. Will there be a Shabbat service?”

Our conversation continued.

Me: “The place is crawling with M.O.T.s, but Friday night is reserved for “show and tell,” a different kind of ‘service’ for those facing tough decisions.”

My friend: “HaShem is found in many places and in many ways.”

Me: “She (Shechinah, the feminine divine presence of God) definitely is here. There’s something that feels very sacred about empowered women and pikuach nefesh (saving a life).”

My friend: “It will be a wonderful Shabbat, even if you are not in temple."

Me. “Indeed.”

#FORCE17 was this year’s annual hereditary cancer conference organized by FORCE: Facing Our Risk of Cancer Empowered , a grass-roots, non-profit organization devoted to providing support, research, resources, and advocacy to those affected by hereditary cancer. Approximately one in 400 people in the general population carries a BRCA mutation, significantly increasing their lifetime risk of breast and ovarian cancer (in women) and male breast cancer and prostate cancer (in men), as well as raising the likelihood for others, including pancreatic cancer and melanoma. Hereditary mutations can be transmitted from either parent to both sons and daughters. Among Ashkenazi Jews, the prevalence of BRCA mutations is 10 times greater than in the general population; approximately one in 40 individuals carries a mutation, and most are unaware of their status as carriers.

#BlogExodus: Join

Back in January, I started working with my fellow FORCE group leader to plan a spring fundraising event for the organization that means so much to us because it was there when we needed information and support in dealing with our hereditary cancer mutations.

Although we volunteer, giving generously and caringly of our own time and knowledge to those following in our footsteps – planning and facilitating group meetings and providing one-on-one support to members – it still takes money to run a non-profit organization. There are brochures and business cards to print, conference calls to connect volunteers, salaries to pay, an annual conference to organize, and so much more that goes into making sure no one travels the hereditary cancer journey alone.

With that in mind, I invite you (or your friends and family in New York City) to join us for a terrific evening to support FORCE and its work on behalf of the hereditary cancer community:

Monday, May 1, 2017 

6-8 p.m.

SideBAR

118 East 15th Street and Irving Place

New York City

Purchase tickets or donate today.

$65 per person includes appetizers, two drinks, and your chance to be chosen as the evening's model for a make-up or guy brow demo, done by celebrity make-up artist and brow expert Ramy Gafni. 

The best-selling author of How to Fake Real Beauty: Tricks of the Trade to Master Your Makeup, Ramy will inspire you with his personal story, professional experiences, “minimum make-up, maximum impact” application techniques, and the guy brow, his trademarked eyebrow sculpting for men.

There also will be chance drawings for fabulous prizes, including samples of Ramy's cosmetics, lots of great books, a professional massage, an acupuncture session, two tickets to Broadway's Phantom of the Opera, including a signed Playbill, and guided backstage tour....and more!

We look forward to seeing you (or your NYC friends and family) on May 1! 

#BlogExodus 2: Honor

Studying at a long-ago UAHC Kallah at Brandeis University 

One of the selections preceding the Mourner’s Kaddish in the Reform Movement’s prayer book says, in part, this:

We do best homage to our dead when we live our lives more fully,
even in the shadow of our loss.
For each of our lives is worth the life of the whole world;
in each one is the breath of the Ultimate One.
In affirming the One, we affirm the worth of each one
whose life, now ended, brought us closer to the Source of life,
in whose unity no one is alone and every life finds purpose

Whether I have lived it more fully or not, I definitely have lived each of the last nearly six years in the shadow of the loss of my mother. I best honor her memory (and feel closest to her) when I:

1. Work to raise awareness about BRCA mutations and hereditary cancer.
2. Study Torah, especially Lech L’cha (her favorite) and Pinchas, which includes the story of the daughters of Zelophehad.
3. Speak my mind, which I don’t do often enough, but I’m getting better…
4. Vote.
5. Use the library.
6. Nix a Marriott for a different hotel chain.
7. Drink Dunkin’s coconut iced coffee (with a French cruller on the side, annually on Bastille Day, July 14).
8. Root for the Yankees, even though I don’t follow baseball.
9. Assuage irritability with a hefty “Feh,” or “A pox on her house!”
10. Encourage friends to “Go with the right foot” to interviews, new jobs, and adventures of all kinds
11. Gaze out on the Statue of Liberty and remember how lucky she and the rest of us are that her parents and my other grandfather, too, had the foresight, vision, courage, and moxie to leave eastern Europe in a timely way for the goldene medina.

Inspired by Ima on (and off) the Bima, this post is one in a series marking the days of the Jewish month of Nisan leading up to Passover, which begins at sundown on Friday, April 22, corresponding to 15 Nisan. If you want to play along, check out this year's  #BlogExodus and #ExodusGram prompts. Once again, this series of posts also is priming my heart, mind, and spirit to participate in Beyond Walls: Spiritual Writing at Kenyon, a six-day summer writing seminar that is an initiative of the Kenyon Institute at Kenyon College in Gambier, OH.

Four Key Reasons the American Cancer Society's New Breast Cancer Screening Guidelines Aren't Up to Snuff

Earlier this week, the American Cancer Society changed its guidelines about breast cancer screening for women. The ACS now recommends starting annual mammography at 45 instead of 40, and decreasing the screening to once every two years for women over 55. The organization also would have physicians forego clinical breast exams.

These recommendations are problematic for four key reasons:

1. Among women who are at average risk of breast cancer, the biggest risk factor is age. Why, then, would you increase the age at which you begin screening for the disease? Indeed, the incidence of breast cancer increases among women in their 40s, accounting for one in six cases of the disease among women in this demographic.  Additionally, mammograms can be a tool for early detection, which studies have shown results in less invasive therapies, increased quality of life, increased years of life, better prognoses, and overall better outcomes.
2. Although the ACS screening guidelines for women at high risk for cancer have not changed, the reality is that the vast majority of these women have no family history of breast cancer and as a result they are totally unaware that they are at increased risk. For this population especially, -- even if they don't know who they are -- annual screening beginning at age 40 is critically important
3. Having so many different sets of screening guidelines from various cancer and medical organizations -- especially because they're not consistent with one another -- is confusing for both patients and their doctors. What's more, although none of the guidelines is binding, they can be used by insurance companies to restrict accessibility and coverage for mammography, erecting barriers where fewer existed before
4. Clinical breast exams are quick, easy, and non-invasive, and there's no reason not to do them. In fact, for younger women and those in remote and rural parts of the country, they may be the only screening option readily available.

For these reasons and so many others it's important that women be strong advocates for their own health and avail themselves of resources and guidance to help them develop an individual breast cancer screening plan that works best for them.

Why I Keep Telling My BRCA Story

Recently, I was invited to write about my BRCA journey for Invitae, a genetic information company, as part of a campaign to inform and inspire people to understand the impact of hereditary breast cancer. The hope is that these stories will jump-start a Facebook conversation about hereditary cancer.

In recognition of Hereditary Breast and Ovarian Cancer (HBOC) Week, which bridges ovarian cancer awareness month in September with breast cancer awareness month in October, I am pleased to share the piece I wrote for Invitae.

Although I tell my BRCA story again and again, it never seems to get old. There are always new people to hear it, and its potential to change the trajectory of just one person’s life makes the telling and the retelling – and all the sharing – worth it.

Last Tuesday marked the fourth anniversary of my prophylactic bilateral mastectomy (PBM) and reconstruction.  It was surgery that I believe saved my life.  FORCE: Facing Our Risk of Cancer Empowered has been equally life-saving in my BRCA journey.  If you're the least bit inclined to support this incredible organization during its annual fundraising campaign, I'd be grateful. The letter below provides addition information about this year's campaign and my ongoing involvement with the organization.  

July 21, 2015

Dear Friends and Family,

Thank you for visiting my FORCE fundraising page!  

Four years ago today, I underwent life-saving, life-changing, and life-affirming surgery that kept me in the hospital for five nights, including one in intensive care, and then at home recovering for more than eight weeks.  As tough as it was, I'd do it all again in a heartbeat.

A Glimpse Into History: An Anecdote from One Family's BRCA Story

Kate, Karen's grandmother

As depicted in Joanna Rudnick’s documentary In the Family and Decoding Annie Parker, a feature film directed by Steve Bernstein and starring Helen Hunt and Samantha Morton, every BRCA family has a story.

Switching Sneakers

As I was helping my sister get out of her clothes into the standard-issue hospital gown and robe, I commented on her sneakers -- cobalt blue Under Armours with florescent salmon laces and trim.

#BlogExodus: Bitter

I just finished reading Jennifer Weiner’s article in today's paper about seders past and present, and how she’s the one in her family now in charge of the annual event.

In 2010, at 77, my mom was still the one in charge of our seders.  She’d been having some health issues so I went out to New Jersey the day before, Sunday, March 28, to help finish the preparations.  When I arrived, the table was already set, the soup and the matzah balls were made, and the brisket was in the crockpot.  I assembled some relish trays, chopped apples for charoset, and followed a recipe she’d clipped from the newspaper for a tri-colored gefilte fish loaf.  Before long, that, too, was covered with Saran and squished in the overflowing fridge, in the kitchen that smelled – as it did every year at this season – like Pesach.

Ten Good Things About Today

10. It was sunny all day.

9.  Even with oversleeping, I made it to the office by 9:10 a.m.

8.  I didn't have time for breakfast at home, so I'm planning on oatmeal for dinner.

7.  There was a check in the mail. (Thanks, Mellon.  Too bad I wasn't visiting you tonight.  We'd have had a great time watching the game at the CONSOL Energy Center.)

The Shiva Orchid

Nearly five years ago, when we were sitting shiva for my mother, one of my sister's friends from The Frick Collection came by with a beautiful orchid.

Learning to be a Friend is a Lifelong Endeavor

Although I have not read Letty Cottin Pogrebin's book about being a good friend to someone who is ill, I've learned a few dos and don'ts in the last few months.  In no particular order, here are some of them:

Chemo's Silver Linings

Even though I'm not the one with cancer (pu, pu, pu), I can tell you that there's not much to like about chemotherapy.  In fact, it epitomizes "#cancersucks."

And yet, Amy and I have managed to find a few silver linings in the chemo routine we've established in recent weeks:

1. Java Girl, a wonderfully cozy and comfortable coffee shop that's quickly becoming our standard "I'll meet you there" spot.  Where else can you get brewed chocolate pretzel flavored coffee?  Yum!
2. The opportunity to shut out the world for a while -- just because we can.  
3. The hard-working chemo nurses, ever willing to answer questions and kibitz, even as they carry out their serious (and lifesaving) work.
4. Panera  Bread's comfort food-filled, "Pick Two" lunch that we sandwich (pun intended!) between the chemo session and our hunkering down for an afternoon of quiet togetherness -- reading, chatting, and answering friends' emails and texts, all from the comfort of the couch.

When they're finally over, sometime in March, I doubt that either of us will miss the chemo sessions themselves.  We may, however, miss some of the simple pleasures and human connections -- the silver linings -- that we've made a part of the process.

Plowing Through to a Better Self

November 1, 2014

Dear The Mums,

Today was Shabbat Lech L’cha, your favorite parashah.  I’m sure Cantor Dubinsky didn’t know that when, during the hakafah at minyan, she asked me to recite the Torah blessings, but it seemed like an appropriate coincidence, so I nodded my agreement. 

It seemed appropriate, too, that following minyan and Torah study, I'd arranged to meet Lil’ Zigs at a (highly recommended) wig store near Columbus Circle, setting us off on a journey to ChemoLand, a place we do not know.

I think I need to back up, though, and fill you in.  In mid-August, just a few days before her birthday, her annual sonogram (which, in addition to a mammogram, she's been having since you died, even though she pays out-of-pocket because her insurance doesn't cover the cost) picked up something that, although it didn't show up on the mammogram turned out to be breast cancer.  Needless to say, she was blindsided, and I was stunned by the absolute irony of the diagnosis, given that I’m the one with the BRCA mutation.  In fact, to ensure that this was truly “sporadic” breast cancer and not the result of a hereditary mutation, we met with a genetic counselor, and LZ had genetic testing beyond the Multisite 3 BRACAnalysis we'd both had in 2010, which tests for only the three Ashkenazi founder mutations.  (When my results turned up positive for the BRCA2 Ashkenazi founder mutation, and LZ was negative, no further testing was done.)  Thankfully, her more recent comprehensive BRCA analysis and BART test both came back negative.  A cruel roll of the dice, gave her this cancer, and lumped her together (no pun intended) with the 12% of women across the board that randomly get breast cancer within their lifetimes, although some might suggest that she was at increased risk given her family history.

In early September, she met with the same surgeon who did my mastectomy and we learned that the tumor was small (1.6 cm) and that it was estrogen receptor and progestin receptor positive, as well as positive for the HER2 protein.  This last characteristic made it more aggressive than other types of breast cancer.  By the end of that appointment, there was a lumpectomy on the calendar for September 25 – which was Rosh Hashanah this year – the first date that worked for both the surgeon and Lil’ Zigs, given the crazy travel schedule she maintains for her wildly successful business.

Two weeks after the lumpectomy, we met with the surgeon again and learned that the tumor was totally contained, that the tissue surrounding it was clear of cancer, and that the lymph nodes were not involved.  The upcoming chemo is insurance against any microscopic spread in light of the tumor's HER2+ profile.  The first session is scheduled for a week from today and the A-C-T regimen looks like this: 

• Adriamycin and Cytoxan once every other week for four cycles (eight weeks)
• Taxol once a week for 12 weeks
• Herceptin and Perjeta – which are antibody therapies and have no side effects – every third week during the 12 weeks of Taxol, and continuing every third week for a year.  These two drugs are specifically used as insurance against the return of HER2+ tumors and are especially effective when used in combination with chemotherapy.

She's got appointments scheduled in January with a plastic surgeon and a radiation oncologist so that she can figure out next steps -- mastectomy or radiation.  That decision is hers to make, but in the the meantime, she's got plenty of time to ponder the pros and cons of each.

As I’m sure you can imagine, Lil’ Zigs wants no part of anything pink, no support groups, no coddling, and no fussing over her.  She's planning to plow through all "this nonsense" as she says, so she can get on with the rest of her life. 

Nonetheless, she has cut back on her travel significantly beginning in mid-November, but in the meantime, she’s front-loaded a ton of business into this coming week (and the week following her first chemo session) and will be on 10 flights and in six cities during the next seven days.  Only when she returns from all that travel will we begin our journey to a place we do not know.

But, like Abraham, we are blessed on this journey. You are with us each day -- in our hearts and in our minds -- as we travel into ChemoLand.  We’re lucky, too, to have an abundance of friends – some we know and others we have not yet met – who already are sharing their time, their talents, and their expertise, so that Lil’ Zigs and I can go forth from all “this nonsense” to our new and better selves.

Miss you…love you,

~ Boo! 

#BlogElul: Can You Hear Me? We Don't Back Down From Cancer

My sister and I spent a lot of time today listening to medical professionals. 

Here is what we heard:

1. Amy's small tumor is estrogen-receptor-positive (ER+) and progesterone-receptor positive (PR+), which means that the cells are trying to behave like normal breast tissue cells, but they're not quite hitting the mark. The good news is that this isn't our mother's triple negative breast cancer, and there are very effective chemotherapy drugs to which this type of tumor will respond.  It is totally treatable and curable.
2. The tumor also is positive for the protein human epidermal growth factor receptor 2 (HER2+), which means it is somewhat more aggressive than other types of breast cancer, but again, there are very effective drugs (Herceptin and Perjeta, among others) to which the tumor will respond.

Based on what we heard and the constraints of the business she runs singlehandedly, this is the strategy she and the doctors have mapped out for the next few months:

1. She's scheduled to have a lumpectomy (a same-day procedure) on Thursday, September 25, which is the first day of Rosh Hashana, and, I believe, a good omen.  Even as the world is being born, so, too, will she have an opportunity to begin again...healthy, strong, and whole.
2. In mid to late October, she'll begin chemotherapy, the specific "cocktail" to be determined based on information gleaned from the lumpectomy.  Its frequency likely will be once a week either every other week or every third week, depending on the specific drugs selected for her.  At the same time she'll also be treated with Herceptin or Perjeta.  The chemotherapy will last for about four months, the other drugs for 12 months.  She may lose her hair, but again, that depends on the specific mix of drugs that are selected for her.
3. Once she's finished with chemotherapy (probably sometime in February), she'll have a window of opportunity of about three weeks to decide about next steps after which she'll either have radiation or a mastectomy.  Not wanting a repeat of the last few weeks, she's leaning toward the latter and I can't say I blame her.  But we'll cross that bridge when we come to it.
4. In the meantime, she'll also schedule additional genetic counseling and testing (beyond what she and I both had in 2010) to rule out the possibility that this tumor was caused by hereditary factors.  Based on the information available at this point, neither the surgeon nor the medical oncologist believes that it was, but the testing will confirm their hunch (or not...).

We heard a lot today, and it was exhausting.  However, we're good listeners and we've got a pretty good handle on things.  Most of all, we're strong, we're a family, we're in this together, and we're buckling up for the ride.  

Can you hear me?  We don't back down from cancer.

Inspired by Ima on (and off) the Bima, this #BlogElul post is one in a series marking the days of the Hebrew month of Elul, which precedes the Jewish High Holidays and traditionally serves as a time of reflection and spiritual preparation for the new year. 

#BlogElul: We Have Every Reason to Believe...

In the last few weeks, I've written and spoken these words countless times about my sister, who recently was diagnosed with breast cancer:

She's going to see my breast surgeon in two weeks.  In the meantime, we're trying to be strong for each other...and we have every reason to believe that she will be fine.

Ken yehi ratzon.

Inspired by Ima on (and off) the Bima, this #BlogElul post is one in a series marking the days of the Hebrew month of Elul, which precedes the Jewish High Holidays and traditionally serves as a time of reflection and spiritual preparation for the new year. 

#BlogElul: To Know or Not to Know

When I lived in Los Angeles more than a decade ago, the father of one of my colleagues had breast cancer.  In light of the diagnosis, his doctors suggested that my colleague have genetic counseling and possible testing for a BRCA gene mutation.

"No, I don't want to know," she told them.  "Whatever will be will be."

By contrast, more than two years ago, on the day after this blog post about BRCA awareness went live, a different former colleague wrote to say, "I just wanted to tell you that I found your blog so inspirational."

A few weeks ago, she wrote again:  "Hey Jane.  I wanted to tell you that

my father and I met with a genetic counselor to assess my risk of getting breast cancer  My dad was tested for the BRCA gene and it ended up being negative.  Thanks so much for talking about your experiences in a public manner.  It really inspired me to check out my own health."

I responded with this:  "Plonit -- thanks so much for your message!  I'm thrilled that your dad's test was negative and that my experience prompted you to get tested.  That's exactly why I do it!  Thank you!!"

Needless to say, I'm pleased to know that my efforts to raise awareness about BRCA mutations, especially within the Ashkenazi Jewish population are meeting with some success.  I'm glad to know, too, that my friend's father tested negative for a mutation and that she and her siblings are not at any greater risk for cancer (breast, ovarian, prostate, pancreatic and melanoma) than people in the general population.

As for my friend in Los Angeles, I hope she knows that even though she's opted not to test for a known BRCA gene mutation, she (and her daughter, beginning at age 25) should be doing surveillance as though they had, in fact, tested positive.  The regimen includes a mammogram once a year and an MRI six months later, meaning that they'd be getting each mode of testing no more than once a year (so insurance will cover the costs), but also getting two chances in one calendar year to be checked, increasing the likelihood of finding disease, if any, in its earliest, most curable stage.

Whether or not individuals want to know their BRCA mutation status, it's critically important that they know and understand the risks associated with these mutations and that they use that knowledge to make decisions about testing that are right for them and their families.

For more information about hereditary breast and ovarian cancer (HBOC) syndrome or to locate a certified genetic counselor who can help your family assess its risk, check out the website of FORCE: Facing Our Risk of Cancer Empowered.

In the year ahead, may we all have access to the knowledge and resources necessary to make the best possible decisions for ourselves, our families, and our loved ones.  Amen.


Inspired by Ima on (and off) the Bima, this #BlogElul post is one in a series marking the days of the Hebrew month of Elul, which precedes the Jewish High Holidays and traditionally serves as a time of reflection and spiritual preparation for the new year. 

My Sister, the F***ing Warrior!

One day when my sister was in fifth or sixth grade, she returned home from school very upset.  Several classmates -- Linda, Lori, and Lisa -- had given her a hard time when she told them that, like them, her Hebrew name was Leah.

No, they told her, that couldn't be.  Her English name was Amy and therefore, according to them, there was no way her Hebrew name could possibly be Leah.

In fact, Amy's Hebrew name is Leah -- Leah Meryl -- in memory of our father's maternal grandfather, "Grandpa Louie" and a maternal cousin, who always was known to our mother and Aunt Claire as Tante Mina.

Here's what Kolatch -- in his Complete Dictionary of English and Hebrew First Names -- has to say about Leah:

From the Hebrew meaning "to be weary."  Also, from the Assyrian meaning "mistress, ruler."  In the Bible (Genesis 29:17), the daughter of Laban and the first of Jacob's four wives.  Lea is a variant spelling and also a French form.  Leia is the Hebrew form  Lia is an Italian form.  Lea and Lee are pet forms.

When I spoke with her earlier today, she told me that she was "moving slowly." Although that's uncharacteristic behavior for her, it's no surprise that she would "be weary."  After all, she's trying -- as are we all -- to wrap her head around the breast cancer diagnosis she received on Thursday, after a routine annual mammogram on Tuesday that was followed by a biopsy on Wednesday.

Once she processes this information, I hope she will ditch her weariness, embracing instead the Assyrian meaning of Leah so that she can be the "ruler" over this disease.  More to the point, I hope that going forward she will take on the persona suggested by one of her friends and prove herself to be a "F***ing Warrior" in the weeks and months ahead.

I Got All My Sisters With Me

Kara DiGuardio, my BRCA sister

A generation ago at this season, I attended a number of sorority semi-formals at my alma mater.  At the time, the school was heavily Greek, with nearly 20 fraternities and five sororities. Invariably, each of these spring events--no matter the sorority--closed with the DJ "spinning" Sister Sledge's "We Are Family" as all the young women, in various states of intoxication, gathered on the dance floor, linking arms and singing along as a gaggle of young men watched from the sidelines.

I was reminded of this scene last Wednesday evening at FORCE's NYC Spring Celebration 2014: Live Life Empowered at Hudson Terrace.  The organization's inaugural benefit event, which was sponsored by Quest Diagnostics, featured two of my BRCA sisters, Stacey Sager and Kara DiGuardio, in a joyful celebration of the organization that is the unequivocal voice of the hereditary breast and ovarian cancer (HBOC) community.  In addition to providing resources, education, and support to individuals and families at risk for hereditary cancer, FORCE, comprising a staff of 11 and a tremendous corps of dedicated volunteers throughout the country, advocates on our behalf within the medical, pharmaceutical, and policy arenas, helping to ensure that we don't encounter discrimination, insurance snafus, or other obstacles as we--individually and collectively--deal with the inevitable roller coaster ride that comes along with our attempts to ensure, to the extent possible, that our genetics don't dictate our destiny.

Throughout the evening, we cheered Sue Friedman, FORCE's founder, celebrated Stacey's survival of both breast and ovarian cancer, and marveled at the serendipity that propelled Kara, who shared her songs and her story, to get tested.

As regular readers of this blog know, I am one of thousands of FORCE members who will be ever grateful to the organization for its strong, supportive, knowledgeable, powerful, and empowering voice.  Most of all, I appreciate my countless FORCE sisters (and one brother, who sports a New Jersey license plate that reads "BRCA1") who are ever ready and willing--as am I--to answer questions, share experiences, recommend doctors, dry tears, commiserate, or just listen.  Help from our BRCA sisters empowers so many of us to make tough decisions, undergo surveillance and surgeries, deal with both expected and unexpected consequences, and move on in our forever-changed lives, all in the hopes that cancer won't steal us the way it already has stolen far too many of our mothers, grandmothers, sisters, aunts, and cousins.

Indeed, Sister Sledge's "We Are Family" is the perfect soundtrack for my BRCA family.  Had a DJ and a dance floor been in the room on Wednesday night, I am quite sure that as our partners, spouses, friends, and supporters stood on the sidelines and watched, we all would have been out there, linking arms and singing along with Sister Sledge:

We are family
I got all my sisters with me
We are family
Get up ev'rybody and sing

Ev'ryone can see we're together
As we walk on by
(FLY!) and we fly just like birds of a feather
I won't tell no lie
(ALL!) all of the people around us they say
Can they be that close
Just let me state for the record
We're giving love in a family dose

We are family
I got all my sisters with me
We are family
Get up ev'rybody and sing

Living life is fun and we've just begun
To get our share of the world's delights
(HIGH!) high hopes we have for the future
And our goal isnt in sight
(WE!) no we don't get depressed
Here's what we call our golden rule
Have faith in you and the things you do
You won't go wrong
This is our family Jewel

We are family
I got all my sisters with me
We are family
Get up ev'rybody and sing