Volume 29 Number 38 Produced: Wed Aug 4 7:08:11 US/Eastern 1999 Subjects Discussed In This Issue: Cancer in Israel and Operation Refuah (2) [Carl and Adina Sherer, Robert Israel] On previous generations [Shmuel Himelstein] Operation Refuah (2) [Joel Rich, Hadassa Goldsmith] ---------------------------------------------------------------------- From: Carl and Adina Sherer <sherer@...> Date: Fri, 30 Jul 1999 17:56:08 +0300 Subject: Cancer in Israel and Operation Refuah Eliyahu Shiffman writes: > I am happy to report that I have it on good authority that Carl Sherer's > info on the incidence of cancer in Israel is quite incorrect. > > Carl wrote: > > > The incidence of > > childhood brain tumors in Eretz Yisrael is more than double the > > rate in the United States, and the incidence of breast cancer in > > middle-aged women here is somewhere between one in four and > > one in three, which is also a much higher rate than in the United > > States. <snip> the fact > > remains that at least in Eretz Yisrael there is a higher percentage > > of people suffering from these diseases than before and elsewhere. > > I asked oncologist Prof. Raffi Catan of Shaare Zedek Medical Center in > Jerusalem how Israel's rate of childhood brain tumors compares to that > of the US. His answer: "more or less the same." I asked him how Israel's > rate of breast cancer, particularly in the case of middle-aged women, > compares to that of the US. Again, his answer was "more or less the > same." Eliyahu and I have been going back and forth about this off list all week. I'd like to summarize some of my responses to this without bogging you down with a lot of numbers. On children's brain tumors, my source was Dr. Michael Cohen, a Neurologist at SUNY-Buffalo and probably one of the world's foremost statisticians when it comes to childhood brain tumors. While the word "double" may have been a guzma (exaggeration), he told us unequivocably that the rate of childhood brain tumors is much higher in Israel than it is in the United States. Three possible reasons for the discrepancy between what I was told and what Eliyahu was told are: First, in the States ALL brain tumors are classified as cancer and are tracked, whereas in Israel, only "malignant" brain tumors R"L are classified as cancer and show up in the statistics. Therefore, the official statistics in Israel might not reflect the actual incidence of brain tumors. If anything, Israel is probably under-estimating the incidence of brain tumors, and that's why a doctor could look at the two numbers and see a lower number in Israel. Another thing that you have to keep in mind is that the most recent statistics that are publicly available are 4-8 years old. Dr. Cohen was basing himself on the number of surgeries Neurosurgeons in Israel told him they are performing TODAY as compared with what he knows to be the situation in the US. Third, Eliyahu asked an oncologist. Oncologists do not see many of the brain tumor patients. Often, if the tumor is benign, surgery may be the only intervention required. By the way, what kind of oncologist is Professor Katan? Most of the oncologists we have come into contact with have a subspecialty these days.... Brain tumors now have the highest incidence of newly diagnosed childhood cancers, having taken over for leukemia (which has a higher cure rate). As to breast cancer, my original source for that was a bit less reliable. However, I have since gotten onto the Israeli Ministry of Health's web site (http://www.health.gov.il/icr/HTML_95/icd174_1_1.html) which R"L showed an increase of 9% in the incidence of breast cancer in Jewish women in Israel aged 45-59 between 1990 and 1995. He said that in general the incidence of > cancer has stayed stable over the last 70 years, with the significant > exception of lung cancer, the rate of which has risen dramatically > during that period. I personally find that very difficult to believe. Just to a few examples. According to the World Health Organization http://www-dep.iarc.fr/cgi-bin/cgisql/who2.idc, the mortality rate for women's breast cancer in the US was 24.7 per 100,000 in 1950. It broke 30 for the first time in 1977 (30.5) and was over 30 every year from 1977-96 except 1979. In Israel, http://www-dep.iarc.fr/cgi-bin/cgisql/who2.idc, the rate for Jews was only 12.7 per 100,000 in 1950. The rate in Israel broke 20 for the first time in 1960, and except for 1961 it was over 20 every year from 1960-76 (the last year for which there are data available on the WHO site). The rate for 1976 was 29.2 fairly close to the American rate. You can decide which rate is going up more quickly, and whether the rate of cancer has increased in the last 70 years. And that's the MORTALITY rate, which means there were more than twice as many people dying in Israel from breast cancer in 1976 as there were in 1950. 1990 estimates of incidence (adjusted for age) show the US in second place worldwide at 87.09 per 100,000, while Israel was in 15th place at 72.21 per 100,000 (ahead of both the UK and Australia). Anyone want to bet on what has happened in the last decade? Source: http://www-dep.iarc.fr/cgi-bin/exe/globocan/report.exe?dtype=0&option=2&vsex=1&cancer=1 Moshe Feldman writes: > I don't want to sound insensitive. Clearly, we should provide both > spiritual and physical help for those who suffer from the diseases that > Carl mentioned. Nevertheless, I question whether, when *all* diseases are > examined, whether it is correct to state, "It is no secret that every > Jewish community around the world is being hit with terrible tragedies." > Are people dying earlier now than they did 30 years ago? That's not the point. Thirty years ago, did every school have at least one child on chemotherapy or dying of cancer? Did every school have at least one family of orphans? In my entire elementary and high school career, I recall one child dying R"L (he was hit by a car) and two families being orphaned. Adina recalls one family being orphaned in her entire time in school. Yet today, teachers are routinely told that before they give a class an assignment to ask one parent or the other something, they should first make sure that all the children in the class have both parents! Every neighborhood we know has at least one family where someone is seriously ill. In our shul, one of many in this neighborhood, aside from Baruch Yosef, I know of one child who died of cancer and of an adult (in his thirties) who is a leukemia survivor in the last year. > My point is: before OR makes these statements, it should do some sort of > statistical study. Until it does, I will stick with my guess that with the > advent of e-mail and the web, we are able, more than ever before, to hear > about many Jews all over the world who are, rachmana litzlan, suffering > from illness. But I doubt that, percentagewise, there are *more* people > suffering. I think there really is more incidence, but that we also hear about it more because of the net. My impression is that there are more young people suffering. One of the big problems with this field is the age of the statistics. Go walk around some of the oncology wards and ask what their workload is like compared to even five years ago.... Yehuda Poch writes: > In the first 3-4 years of the list's operation, the listing grew from an > initial 10 names on the list to around 100 in a busy month. Today there > are in excess of 300 names on the list each and every month, sometimes > in excess of 400. I think it's important to point out that you throw out all the names once a month. -- Carl M. Sherer Please daven and learn for a Refuah Shleima for our son, Baruch Yosef ben Adina Batya among the sick of Israel. Thank you very much. ---------------------------------------------------------------------- From: Robert Israel <israel@...> Date: Sun, 1 Aug 1999 13:38:33 -0700 (PDT) Subject: Re: Cancer in Israel and Operation Refuah To expand on Moshe Feldman's point: According to the Central Bureau of Statistics (http://www.doran.co.il/general.htm): According to figures published on 6 August by the Central Bureau of Statistics, half of Israeli girls born between 1991 and 1995 can expect to reach the age of 81, and half of Israeli boys born during this period can expect to reach the age of 78. In 1995, Israeli women were expected to live an average of 79.5 years and Israeli men were expected to live an average of 75.5 years. Jews were expected to live slightly longer than Arabs, with Jewish women forecast to live 79.8 years and Jewish men some 75.9 years. In comparison with men in other countries, Israeli men have the third highest life expectancy rate in the world. Japanese men were expected to live longest at 76.5 years and Swedish men came in second at 75.5 years. In 1993, American men were expected to live 72.2 years. The 79.1 year life span of Israeli women in 1993, however, ranked 17th in the world. Japanese women were expected to live longest and reach 83.1 years, followed closely by Swedish women, who were expected to live 82.3 years. So it appears that, at least as far as life expectancy is concerned, Israelis are doing very well. Moreover, life expectancies have certainly improved over the years. As for cancer, according to the WHO Databank (http://www-dep.iarc.fr/dataava/globocan/who.htm), in 1994 Israel's age-standardized rate of mortality from all cancers was 129.2 per 100000 for males and 104.3 for females, while the US had 160.6 for males and 109.9 for females. Again, especially for males, Israel is doing very well. Of course I don't want to sound insensitive - a lot of people are suffering. But to suggest that the amount of this suffering has increased, or that there is proportionately more of it among Israelis than in the other populations, is simply incorrect. Robert Israel <israel@...> Department of Mathematics http://www.math.ubc.ca/~israel University of British Columbia Vancouver, BC, Canada V6T 1Z2 ---------------------------------------------------------------------- From: Shmuel Himelstein <shmuelh@...> Date: Sun, 1 Aug 1999 14:40:02 +0300 Subject: On previous generations Carl Sherer explains that the previous generations of American Jews were not as learned, and hence carried out certain actions which were contrary to Halachah. As opposed to this, most Frum Jews 50 years old or younger received a Frum education. While this might well be a true and logical differentiation, it does not explain the fact that the wives of certain great Roshei Yeshiva (where both husband and wife were born and educated in Europe) did not, in the 1930's and into the 1940's, cover their hair, and only began (or resume) doing so at a later time.. And that was certainly not a question of lack of education. Shmuel Himelstein ---------------------------------------------------------------------- From: Joel Rich <Joelirich@...> Date: Fri, 30 Jul 1999 08:26:37 EDT Subject: Re: Operation Refuah << I fully support the efforts of Operation Refuah, and I publicize their activities through the cholim list. There is no question in my mind, internet and greater publicity notwithstanding, that there has been an increase in the level of tragedy the Jewish nation as a whole has been suffering the past 18 months or so. >> I agree that doing more mitzvot for just about any reason is a good thing. I would have no problem with a statement such as "in my(our) estimation/anecdotal experience... there has been an increase in suffering which requires soul searching... As a practicing(till I get it right) actuary and daati Jew, I disagree with making unsupported generalizations.You lose credibility if your "perception" is later disproven . You also lose some of it up front when someone looks at your "claims" and feels there's no credible evidence behind them. Kol Tuv, Joel Rich ---------------------------------------------------------------------- From: Hadassa Goldsmith <hbgold@...> Date: Fri, 30 Jul 1999 17:15:20 -0500 (CDT) Subject: Operation Refuah In response to the recent postings on Operation Refuah, I think we can all agree that whether one does or does not believe that the number of cholim is increasing it behooves us to do whatever possible to try to bring refuah to the ill and blessings to all of Klal Yisrael. In a recent newsletter put out by a leading organization that assists families with ill children, a woman comments on a shabbos spent together with other families with ill children: "...how the barriers all came down here - how Jews from every background came together and related to one another simply as people concerned about the well-being of each other's children. It was just amazing to me, sitting in the dining room on Shabbos, seeing the men dancing around the tables wearing shtreimels and black hats and knitted yarmulkas - even no yarmulkas at all - and knowing they all cared about one another from the depths of their hearts." Yes, it is true that illness and other tragic situations always bring home the point that we are all one family, despite our differences. Now let us all work together to show Hashem that we are ready and able to act toward each other - under "every day" circumstances - like one family, with Ahavas Yisrael toward each Jew we meet, those who are like us and those who are not. If you would like to join with other Jews who are rededicating themselves to the mitzvah of V'Ahavta L'Reyacha Kamocha - Love your neighbor as yourself, please e-mail us at <OREFUAH@...> and check out our website at www.sjrassociates.com/orefuah.html Hadassa Goldsmith Operation Refuah ----------------------------------------------------------------------
End of Volume 29 Issue 38