In the Family’s Joanna Rudnick Answers Viewer Questions

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Joanna Rudnick is the director of In the Family. After seeing the film, many viewers wrote in to ask her a question or to share their own stories. Read on as Joanna responds to some of the many questions and comments that she received:

Joanna writes:
Thanks so much to everyone who watched In the Family and posted your responses on the POV Blog, especially to all of you who shared your own stories. For those of you who commented on my courage, it was the courage of all of the women and families in the film, and groups like FORCE (facingourrisk.org) that bolstered me at every step of the way. We all did this together. Thank you for carrying on the tradition of bravely speaking openly about family disease and predictive genetic testing.
Wishing everyone health and happiness,
Joanna

Cheryl asks: Several years ago I was working on an independent film in Chicago called “If You Step on a Crack” which was an adaptation of a short story by Sharon Solwitz. It’s the story of a woman who waits to hear the results of her breast biopsy: how that period of time before the “knowing” changes her life and her relationships. It was fiction. I never thought I may have to ask myself the same questions the character I was playing in the film was wrestling with. A year after the short film appeared at numerous film festivals, my mom was diagnosed with ovarian cancer, and a very rare, untreatable, autoimmune reaction to the cancer (PCD – Paraneoplastic Cerebellar Degeneration). And that was very real. While the chemo saved her life, the PCD left her with no quality of life (unable to walk, talk, see, speak, swallow). My sisters and I became her caregivers for three years: she fought for every millisecond of life with grace, until she died in August of 2005. I am 40, single (never-married), a carbon-copy of my mom, and want to some day have children. Have you learned about PCD while doing your research? Thank you, Joanna, for your beautiful and brave documentary.

Joanna: I am sorry for all the suffering that your family has endured, and understand your fears of both being a carbon copy of your mother and your desire to have children. I have not heard of PCD. I’m sorry I cannot be of more help in that area. You may want to post on FORCE to ask the community of women represented if they’ve heard of the condition. As you know, your mother’s ovarian cancer may not be the result of a BRCA mutation, which means it could be sporadic and not hereditary, and you and your sisters would not be at risk. I would suggest you speak to a genetic counselor (there are a number of great counselors in the Chicago area at Northwestern and U. of Chicago) to find out if you are at increased risk. Lastly, your film sounds incredible. What an important and brave concept. I would love to see it one day.
I wish you children and more films in your future!
Lisa asks: I watched your film last night and it was very touching and well done. I am BRCA 1 positive and learned that a year ago. I am 35 years old and considering having my breasts removed. In your film you met with a doctor who does the one-step procedure. Is that the alloderm procedure? What was the name of the doctor you met with? Thanks again and congratulations on fantastic film.

Joanna: Thank you, Lisa. Yes, the one-step procedure profiled in the film did use Alloderm. The doctors I met with are located in Dobbs Ferry, New York (right outside of New York City). Their names are: Dr. Ashikari (breast surgeon) and Dr. Salzberg (plastic surgeon). I know many women who have had the procedure and are truly satisfied with the outcome and happy with the decision. All the best of luck in the future.
Chris writes: Joanna, Thank you so much for this film. I am not at risk for breast cancer or ovairian cancer but Huntington’s Disease is present in my family. I used to wrestle with getting tesed or not. I have lived in that fear, and uncertanty, and my heart ached watching this film. My grandmother and mother both had it and I have two brothers and a neice have it. I have not been tested but have chosen alternative means of facing “The Dis-Ease”. I have been studying Metaphysics for the past seven years, and I am beginning to understand how “Dis-Ease” begins, and how we can find permanant healing. There are two books that I work with that give me hope and direction in not manifesting Dis-Ease. Permanant Healing by Dr Daniel Condron, and The Biology of Belief, by Dr. Bruce Lipton, are both books that can give insight into Dis-Ease. We can choose to live a Dis-Ease free life, and if Dis-Ease is already present, then we can work towards perminant healing, so that it doesn’t return. Before you choose to have surgury, would you concider alternative methods of healing? Blessings to you and all the woman you have helped and to all those with genetic predisposition.

Joanna: Thank you for sharing your story. My heart goes out to your family. I am impressed with how openly you write about your family history, and your choices for how to live with the potential legacy of Huntington’s Disease. I do practice some forms of alternative healing, but I do not think of them as a substitute for surgery at this point. Having watched my mother go through ovarian cancer, I am committed to avoiding that disease one day through surgery. I truly hope we will all have better options in the future. But for right now, it is the only one proven to stave off disease. However, I respect those who choose alternative methods over surgery. I wish you the best of luck in the future, and know we will all learn a lot from your course.

Catherine Jhee
Catherine Jhee
Catherine Jhee was formerly a producer with POV Interactive.
  • http://www.advbreastcare.com Sara Fredrickson, M.D.

    FOREIGNID: 17833
    FOREIGNPARENTID:
    Joanna,
    I watched your film and very impressed with your maturity and knowledge about this subject. I am a breast surgeon and have a large number of BRCA + patients in my practice. I work very closely with a genetics nurse as well. When I watched your film, I immediately wanted to get several copies of it to let our patients borrow and watch, but one thing highlighted in the film that will keep me from doing that is the segment about the one-step mastectomy and reconstruction. The use of subcutaneous mastectomy (leaving the nipple and areola) for BRCA + patients is not recommended due to the high likelihood of breast cancer occuring in the retained nipple areolar complex. While it might be a nice cosmetic alternative to a standard prophylactic mastectomy and reconstruction with tissue expanders for non-mutation carriers, it is not an adequate risk-reducing procedure for BRCA+ patients. I watched that segment of the film three times hoping there was some mention of the more standard procedure, but there was none. I am concerned that other patients watching this film will think that the subcutaneous mastectomy is the standard of care and will pursue this, thereby having an inadequate procedure. I wish I could recommend the film to my patients because it was a magnificent film in every other way, but I’m saddened to say that I cannot because of this one issue. If you would like any other information, please don’t hesitate to contact me.
    Sincerely,
    Sara Fredrickson, M.D.