JUDI'S JOURNAL 01/05/2013: Pekuach Nefesh — the saving of a life

This is the first in a series of articles on Jewish values.

One of the most important mitzvot, commandments, in the Jewish religion is the saving of human life. The concept for this commandment comes from my oft-quoted Leviticus 19, known as the Holiness Code: “Neither should you stand by the blood of your neighbor.” (Lev. 19: 16) If a human being’s life is in danger, one is obligated to do everything possible for the preservation of that life.

One may violate the Sabbath, Yom Kippur, the holiest day of the year, and even eat unkosher food if this will save a life. One may also travel on the Sabbath if this would help save a person’s life. The donation of organs after death or from a living donor is also recognized by Judaism because of its life-saving measures. The chief Sephardic rabbi of Israel, Ovaday Yosef, has ruled that one can be a living donor, as in the case of a kidney donation, as long as the donor’s life is not put into jeopardy. This comes from the Jewish maxim that one life cannot be compromised for another.

The famous and revered Rabbi Akiva ruled that when faced with such a dilemma, it is permissible to save one’s one life based on the verse: “Let him live by your side as your kinsman.” Your life takes precedence over another’s. This situation is the difference one would find in a Jewish hospital. If a mother and child were in danger, all would be done to save the mother. In a Catholic hospital, the child would be saved. In the Jewish faith, one cannot be a martyr except in cases where one would be forced to commit adultery, incest, murder or idolatry.

The preservation of human life transcends all the other commandments of Judaism. One cannot observe the other mitzvot without the blessing of life and health. Therefore, Jews are commanded to preserve life in any way they can so that they may live by the commandments and not die by them.
 

The obligation to save a life can take the form of saving someone from immediate danger, such as drowning, or saving someone from a situation that might prove life-threatening in the future. I have taken upon myself the mitzvah of “pekuach nefesh” because I wish to raise awareness of a virulent type of breast cancer that is often misdiagnosed and is not usually presented with a lump or a calcification on a mammogram.
 

The cancer I am referring to is called Inflammatory Breast Cancer (IBC), and the campaign for its awareness is called Check for IBC. It strikes men , as well as women and is the most aggressive (fast-growing) and deadly form of the disease. Though more rare than other forms, accounting for only 5 percent of breast cancers, speed in diagnosis and awareness of this form would make for “pekuach nefesh,” saving of a life.
 

Symptoms of IBC include: Increase in breast size; redness, rash or blotchiness resembling a bruise on the breast; lump or thickening or dimpling of the skin on the breast; warmth or tenderness of the breast; lymph node swelling under the arm or above the collarbone; flattening of the nipple or discharge from the nipple.

Contrary to what most women have been taught, IBC can be painful, and a single lump in the breast is not usually how this form of the disease presents itself. If you or a loved one witness any of these symptons, get medical attention immediately to rule out IBC. Many doctors misdiagnose this form of cancer, so being proactive is essential.
 

IBC does its malevolence by traveling through the lymph system. IBC cells block the lymph vessels in the skin of the breast, thereby causing the signature redness and inflamed areas, which give the disease its name. Unlike other forms of breast cancer, this variety grows in nests or sheets instead of a confined solid tumor, making detection on a mammogram unreliable. A doctor’s clinical exam or biopsy or breast ultrasound are also used in diagnosis.
 

I am making my readers aware of this insidious form of cancer because it is so often misdiagnosed. It can appear like a breast infection, but if one experiences five days of treatment with no improvement, IBC should be looked into. It can come on quickly, often overnight. By the time it is finally recognized, the disease has advanced to stage IIIB, with a five-year survival rate of 40 percent.
 

IBC is treated with chemotherapy, surgery (usually a mastectomy) and radiation. Depending on the composition of the tumor, hormonal therapy using Herceptin may be employed. Every person is an individual, and success of treatment varies with individuals. New treatments and drugs have turned breast cancer in general into a chronic disease, no longer the death sentence of 30 years ago. Still, the public needs to be made aware so that lives can be saved.

In the Talmud it says that whoever saves a life, it is as if they have saved a world. If I have made one person aware of this disease, I may have saved a life — maybe even my own.
 

For further information on IBC, contact the Inflammatory Breast Cancer Foundation at 1-866-944-4223 or online at www.eraseibc.com.

Judi Siegal is a retired teacher and Jewish educator. She lives in Ocala with her husband, Phil. She can be reached at niejudis@yahoo.com.