When women are diagnosed with breast cancer, their life as they knew it comes to an end, and from that moment on, they require all the help they can get. But what happens when members of their innermost circle of support also get sick?
This is what happened to Yael Dahari of Ashkelon, a breast cancer survivor who lost her mother, sister and niece – all to the disease.
Today, at the age of 77 and during October’s Breast Cancer Awareness month, she is doing everything in her power to increase awareness and educate women about cancer prevention. “My family has three generations of women who carry the BRCA1 gene,” explains Yael. “The women in my family have an 80% chance of contracting breast cancer, and so we all must get checked regularly and remain vigilant. We live with this knowledge, and do our best to stay ahead of the game. I personally have chosen to live with a positive attitude, and to spend my time engaging with other women so that they have a better chance of noticing the signs early on.”
Yael’s mom died from breast cancer at the age of 37, her sister Dorit at 60, and her niece Rinat, Dorit’s daughter, at 42. Yael herself was first diagnosed with breast cancer at the age of 52, and was able to achieve full remission due to regular checkups and early detection.
Yael was just 10 when her mother became ill. The family lived on Kibbutz Neot Mordechai at the time. “We didn’t know anything about a hereditary gene back then,” Yael recalls. “No one did mammograms and the only treatment was radiation and mastectomy.
“No one was encouraging women to engage in early detection. My mother had a lump, but didn’t get it checked out because she hadn’t ever heard about lumps being problematic. My sister and I were just little girls, so we didn’t know much either. My mother was the only woman on the kibbutz who was sick.”
“Years later,” she reveals, “I asked the kibbutz nurse about my mother’s case and she told me she’d tried to convince my mother to get it checked out, but she had refused. When she finally went to a doctor, it was too late. My mother had a mastectomy and underwent radiation but died less than a year later, leaving three young girls behind without a mother. I was the eldest, and my sisters were 8 and 6.”
After her mother passed, Yael began writing in a diary as a way to deal with her grief. She found it difficult to get along with her new stepmother, and writing in her diary was the only outlet she had for expressing her feelings and sadness, since in those days on kibbutz, any expression of emotion was considered a weakness. Nowadays, when Yael gives cancer awareness lectures, she often shares entries she wrote as a child.
“When you’re only 10, you can’t imagine that something so awful can happen to you,” Yael shares. “Back then, people expected us to just accept the fact that our mother had died from a serious illness, and to get over it and move on with our lives. Today, we know so much more about early detection and the hereditary nature of the illness. In my diary, I wrote things like, ‘We are strong and don’t cry about it because that is how we were taught to behave.’”
“I didn’t want to go to the funeral, because then everyone would see me crying. It was so difficult trying to keep my face straight and not show any emotion. When I finally found a place where no one could see me, I broke down in heart-wrenching sobs, and afterward I felt a bit of relief.
“Other mothers on the kibbutz felt sorry for me, and this bothered me so much. I wanted to prove to everyone that I was strong and didn’t need anyone. But in reality, I was feeling so much pain and loneliness. I didn’t write in my diary about the disease, and to this day I don’t associate breast cancer with my pain. Over the years, I’ve learned acceptance.”
Did you and your sisters begin getting checked for signs of the disease?
“Yes, when we were in our 20s, we learned that we needed to be extra vigilant. Since I’m a nurse, I knew this was important, and we all started having mammograms. I’ve had 25 mammograms and 21 MRIs over the years, and the three of us would constantly be in touch with each other about these types of things. We were all hypersensitive to any changes in our bodies that might be a sign of disease. Also, technology has improved greatly over the years.”
All three sisters got married and started families of their own. The first one to find a lump was Dorit, the youngest sister. “Dorit was living in Zichron Ya’akov and we were in constant touch with each other,” Yael continues. “One day, she told me she’d found a lump, but the doctor had said it was enough to perform a lumpectomy, and that there was no rush. She ended up waiting six months for the surgery, during which they found that the cancer had metastasized. They removed 30 lymph nodes during that surgery.
“This was a big screwup by the medical system. They had done a biopsy, but apparently, they’d extracted cells from a place that didn’t have any cancerous cells, and that’s why they were so complacent and didn’t hurry to do the surgery. Dorit underwent intensive chemotherapy, and I would go spend time with her twice a week.”
Not long after, Yael herself discovered a lump in her breast, and the two sisters simultaneously underwent treatment. “I am extremely strict about my monthly self-checks, so I was able to catch it right at the beginning and didn’t need to undergo any chemo treatments – just radiation.
“I had to fight so hard until they agreed to do an MRI, but just on one side. ‘What about the other breast?’ I questioned. They finally agreed to scan both sides, but told me not to tell anyone. But of course I refused to keep quiet about this, and I told everyone they needed to go get checked, and to have both sides checked. I began preaching early detection and breast cancer awareness with all my heart and soul.
“Dorit and I would go together to Hadassah University Medical Center for treatments. This of course piqued the curiosity of the staff, since research into the hereditary nature of cancer was just beginning. They were excited to take advantage of our case for research purposes. They used us for testing their hypotheses, but asked us not to tell anyone about it. Then, they asked if our daughters would be willing to be part of the study, too. Thankfully, neither of my daughters tested positive for the BRCA1 gene. Rinat, Dorit’s daughter, refused to be tested.”
Yael and her sister both went into remission after undergoing surgery and radiation. Since Yael had discovered her cancer early on, her treatment ended after just five months. Dorit’s cancer had spread, and her treatment lasted for over a year. And just four years later, Dorit’s cancer returned. “Her cancer had spread to her bones, and it took them a long time until they were able to note decisively that cancer had originated in her breasts,” Yael explains. “At her 60th birthday party, Dorit was in pretty bad shape. She could barely walk and was in so much pain. Then her daughter Rinat was also diagnosed with breast cancer. It was just too much to handle all at once.”
Rinat was in her late 30s and the mother of two girls aged 8 and 14 when she was diagnosed. “She’d done a mammogram the year before, which was clean,” Yael recounts. “She was outside of Israel for a year, and when she came back home and went for her next test, they discovered cancer in her breasts, as well as in her bones. So, both my sister and her daughter were battling cancer, with both of them undergoing treatment at Hadassah with the same doctor. We used to joke that he was our family doctor, even though he was an oncologist.
“Rinat saw how much her mother was suffering and how she was in constant pain. Because the cancer was also in her bones, she couldn’t walk well, and would just lie there. For over a year, I would go over to their house all the time to take care of both of them.”
After Dorit passed away, Rinat continued to suffer for another three years until she too passed on. “Rinat participated in a few different drug trials,” continues Yael. “Each time they tried a new drug that didn’t help, they’d move on to another one.
“After her mother died, Rinat decided she was done with conventional medicine, and began searching out alternative treatments. She wanted to go to China for a treatment, and did all the paperwork and got all the referrals she needed from her doctor. Unfortunately, she died just two days after returning from that trip. At first, we were angry at her for traveling when she was so sick, but then we realized that at least she felt good about the way she’d lived her last days.”
Were you close to Rinat?
“Yes, very. We’d talk all the time. And she was very open with her daughters about her sickness. She wanted them to be prepared for her death, and to let them know what she wanted for them in life. They would ask questions, and Rinat would spend hours talking with them, explaining about her treatments, and they would go on trips together to the beach and the forest. I’m still in very close contact with her husband and their girls.”
The Stats
According to the One in Nine organization, which strives to raise public awareness of breast cancer in Israel, 5,500 women are diagnosed with breast cancer every year in Israel. With early detection, 92% of these women can reach full remission.
Twenty-five percent of women who are diagnosed with breast cancer are in the 30s and 40s, and yet the Health Ministry recommends that women undergo mammograms only from age 50. There is a lot of work being done to lower the minimum age at which this lifesaving test is recommended. Just a few weeks ago, the topic was raised during a Knesset Labor, Welfare and Health Committee meeting. “There was discussion about the benefits of early detection, and why it was so important to lower the recommended age for beginning mammograms to 40,” notes Sigal Razin, CEO of One in Nine.
Once she was in remission, Yael decided she wanted to dedicate her life to helping women with breast cancer, and to raise awareness and fight for early detection. She joined the ranks of the volunteers at One in Nine and underwent training. “There’s so much more work to be done in our battle for early detection,” Yael asserts. “I feel like this is my mission in life. It’s a mistake to start checking only from age 50. So many women are hit with this disease when they’re just 30, and too many of them are dying, since it doesn’t occur to them to be checking and they only catch it when it’s too late.
“Catching it early saved my life, and the lives of so many other women. I’m constantly telling women to be vigilant,” Yael concludes. “Just like you go to get your nails done and your hair cut, do your breast exams regularly. You will not only save your own life, but the lives of your entire family. If the mother is not functioning, the whole family falls apart. I lost my mother when I was so young.
“I give talks all over the country; I recently gave a talk in Sderot and then a while later in Kfar Aza. After my Kfar Aza talk, a woman approached me and showed me her scar. She’d heard me talk in Sderot, which had spurred her on to get herself checked, and had subsequently had a lump removed. She wanted to thank me for saving her life.
“These kinds of stories give me the strength to continue fighting this battle.” ■
Translated by Hannah Hochner.