Health & Fitness

ON THE COVER

Staff photo by Armando Rios

A Matter Of Choice

E

Hen Grumeretz, a Birmingham psychologist, whose mother died of
breast cancer at age 39, had genetic testing within two weeks of find-
ing a lump in her breast earlier this year.
By the time the 42-year-old Superior Township wife and mother learned she
was positive for the gene, she had already decided on a bilateral mastectomy
with reconstructive surgery and a later hysterectomy, from which she is cur-
rently recovering.
"I believe it's a personal thing and that it's really important to know your-
self," Grumeretz said. "Everything is a choice. I didn't want to go for MRIs for
the rest of my life" and mammography had not detected her cancer. "I wouldn't
do well with that pressure."
Grumeretz has not seen the ads for genetic testing. But she wishes someone
had made her consider it more seriously. "The most important thing is getting
the information out in a responsible way," she said.
"The general view of the genetics community is we don't support direct con-
sumer advertising," Zakalik said. "The more people who meet the criteria who
are tested the better. But we recommend they see a trained professional."
That was dittoed by Nancie Petrucelli, a certified genetic counselor at
Karmanos Cancer Institute, Detroit. "Myriad is encouraging women to talk to
their doctors and encouraging the physicians to work directly with them.
"Family history can be very complicated," Petrucelli said. "We don't recom-
mend testing for everyone with a family history. That requires some degree of
assessment.
"The element that is missing" she said, "is meeting with a genetic coun-
selor." I

Ellen Grumeretz, an ovarian cancer survivor, sits on the back
patio of her Superior Township home. Next to her is her friend and
good companion Tammie, a yellow Lab.

Gene Alert from page 43

either breast or ovarian cancer, "a very com-
mon misunderstanding is that you don't
need to test until you have the cancel.," she
stressed.
Possible insurance and/or job discrimina-
tion scare off some who might benefit from
the test. Currently, federal and some state
laws prohibit group health insurance dis-
crimination based on genetic information.
Congress is expected to extend that to
private health insurance and life insur-
ance plans and to the workplace. The
House has passed the Genetic Information
Nondiscrimination Act (GINA) of 2007;
it is now in a Senate committee. President
George W. Bush has urged its passage.
"Genetic tests results are strictly confi-
dential',' Zakalik said. "Even when insurance
plans pay for testing, the insurer does not
receive the results."

Preventive Surgery
For those who test positive, "the magnitude
of risk is so high, for them and future gen-
erations. Many elect to have some kind of
prophylactic mastectomy, which is 95 per-
cent effective in eliminating breast cancer.
It's amazing, she said, "how many women

44

October 4 • 2007

are very comfortable doing it." She attributes
that to encouragement from spouses, better
breast reconstruction techniques and the
peace of mind that comes from no longer
worrying about contracting the disease.
Even more women opt for having their
ovaries and fallopian tubes removed, she
said, particularly after they have had their
families.
That's because screening for ovarian
cancer is less than perfect and it's a surgery
that now can be done laparocaply, without
resorting to abdominal surgery.
Removing the ovaries reduces the risk of
ovarian cancer by 97 percent. And in women
younger than 50, it also reduces their chance
of breast cancer. That strong link between
breast and ovarian cancers is not always
emphasized, Zakalik said.

Other Options
For those who don't choose surgery, alterna-
tives include increased surveillance with
mammograms alternating with MRIs every
six months and the anti-breast cancer
drug, Tamoxifin, where indicated. The latter

Gene Alert on page 45

Taking Strides Against Breast Cancer

You don't have to sit out
October, which is Breast
Cancer Awareness Month:

• Join a discussion of
breast cancer, "What's Being
Jewish Got to Do With It?"
9:30-11 a.m. Sunday, Oct. 21,
• Join thousands of women
part of Hadassah's weekend
and men across Metro Detroit
Central States Region Fall
who will unite in their fight
Conference at the Dahlman
Ruth Lerman
against breast cancer in the
Campus Inn in Ann Arbor.
10th annual Metro Detroit Making
Ruth Lerman, M.D., a West
Strides Against Breast Cancer walk at
Bloomfield resident, who provides
9 a.m. Saturday, Oct.13, at Belle Isle
services to high-risk breast cancer
Park in Detroit.
patients at Beaumont Hospital, will
Last year, 8,500 Metro Detroiters
teach breast awareness techniques.
raised more than $725,000 at the
Whitney Ducaine, M.G.C., genetic
walk, sponsored by the American
counselor for the Beaumont Cancer
Cancer Society.
Genetics Program, will discuss heredi-
Registration for the five-mile, non-
tary breast cancer.
competitive walk begins at 7:30 a.m.
Cost for the Sunday session of the
Donations will be collected at the walk conference is $60 including lunch.
or may be made online at
For more information, contact Eileen
www.cancer.org/stridesonline.
Thacker, Hadassah conference chair-
woman, at (734) 302-1810 or
tethacker@yahoo.com .