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Dr. Saul E. Rivkin

Dr. Saul E. Rivkin. I could almost stop there with this post, because Saul is a man who may be bigger than the words used to describe him. But he deserves more – much more.

Just before I met Saul, nearly 20 years ago, his nurse warned me that when it was time for an appointment, we should call the office to find out what time we should come in. My puzzling look reminded her that this was the first visit. She explained that Saul tended to run a little late, so it was a good idea to check in.

My wife, Lori, had been diagnosed with ovarian cancer about six months earlier. Her diagnosis was followed by six months of chemotherapy and a second-look surgery. For eternity I will remember watching her surgeon walk across the lobby to tell me the results of that surgery: the cancer had spread and Lori didn’t have much time to live.

He recommended that we see Saul because he was extremely knowledgeable about ovarian cancer and might offer some guidance. Our appointment was scheduled for 5:00 p.m. I called at 5:00 p.m. and was told to come in at 8:00 p.m. With a two-year old son, a busy work schedule, and an ill wife, I was upset. My only pet peeve in life is to be kept waiting-I hate it. Trying to juggle everything wasn’t going to be easy.

We arrived at 8:00 p.m. and waited another hour before being shown to an exam room. Yes, I was steaming, and prepared to give this Dr. Rivkin a piece of my mind. Then he walked into the room and introduced himself. Thin, balding, and working two different cell phones, he had me puzzled. He took Lori’s hand and told her not to worry, we had plenty of options. He explained that we were going to treat this disease like a chronic illness and hopefully cure it over time. I sat back and watched him talk to her, examine her, answer her questions, and it was like I wasn’t in the room-because I wasn’t. When Saul Rivkin met with a patient, the world outside of him and that woman ceased to exist. He didn’t care if there was someone else he needed to see, he didn’t care if he had tickets to the opera; he just cared about that patient sitting across from him.

This went on for seven years. At times it was brutal on Lori. She had 22 surgeries, dozens of chemotherapy treatments, sometimes wasn’t able to eat, and had countless other issues. But you know what? She was always smiling, and it was because she believed in Dr. Saul Rivkin 100%. Lori died in 2003, but she beat her cancer because she didn’t let it define who she was…and she loved Saul.

Does that sound familiar? It should, because this year the Rivkin Center for Ovarian Cancer is celebrating our 20th Anniversary. This year, we’re going to hear many more stories about the great women, families, friends, events, and activities that have shaped the Rivkin Center.

But Dr. Saul Rivkin will always be the most important part of the Rivkin Center. He lost his wife, Marsha, to ovarian cancer, so he and his five daughters set out to make an impact on the lives of other women battling this disease. We have all experienced the gift that he has shared with us. When you say the name Saul Rivkin, there’s always a powerful, caring story along with it. When the Swedish SummeRun comes around every year, Saul is out pounding the pavement with posters and information cards. Everyone at the race wants their picture taken with Saul, and he has his trusty camera at the ready.

Twenty years ago, the Marsha Rivkin Center for Ovarian Cancer Research was born. Today and in the future, we will do more than just research because we are trying to put ourselves out of business. Saul is working side by side with the Rivkin Team to win this fight.

It seemed only appropriate that the Rivkin Center’s first blog post should focus on the man who made this all happen. For 20 years, I’ve been proud to call Saul my wife’s doctor, a fellow member of the Board of Directors, and my partner in crime now that I am the Rivkin Center’s Executive Director…but more importantly, I can call him my friend.

I, like so many other patients and family members, know what Saul does for our wives, sisters, daughters, grandmothers, aunts, cousins, friends, and anyone else associated with this insidious disease. We are eternally grateful and can never fully repay him.

Today I wish the Rivkin Center a happy 20th Anniversary and I will raise my glass to him, not for the first time, and say, “Congratulations, Dr. Saul Rivkin. You are a great man in a world with many like you, but none equal to you for what you’ve done for the women we love!”

Talk to your Family

Talking to your family and identifying cancer in your family tree can be a good indicator of your health risks. Download our Family Tree Worksheet here.  Be sure to include yourself, children, parents, siblings, aunts, uncles, and grandparents.

Get Educated

Know your body and be proactive about your health. Learn about your breast and ovarian health. Learn about the risk factors and signs & symptoms for breast and ovarian cancer.

Trusted Healthcare Provider

Having a relationship with a health care provider you know and trust is one of the most important decisions you’ll make about your health care. Click here to find a provider

Higher Risk in the Ashkenazi Jewish Population

In the general population, around 1 in 400 people carry a BRCA1 or BRCA2 mutation. People of Ashkenazi Jewish ancestry have a 1 in 40 chance of carrying a BRCA mutation, making them 10 times as likely to carry a BRCA mutation as someone in the general population. Whether you’re a man or a woman, if you have a BRCA mutation then there is a 50% chance of passing the mutation on to your children, whether they are boys or girls. It’s important to note that these mutations significantly increase risk, but are not a guarantee a person will get cancer.

Why is the Ashkenazi Jewish population at higher risk?

Over 90% of the BRCA mutations found in the Jewish community are one of three “founder mutations”. A founder mutation is a specific gene mutation in a population that was founded by a small group of ancestors that were geographically or culturally isolated. Because the population was isolated, the rate of founder mutations in descendants is much higher than it would be if the population were larger and co-mingling with more genetically diverse populations. A large expansion in the population caused the current high frequency of the mutations in the Ashkenazi Jewish population. If you are of Ashkenazi Jewish ancestry, the chance of carrying a BRCA gene mutation compared to the general population is increased tenfold. BRCA mutations can be passed down from either your mother’s or father’s side, and may be associated with any of the following cancers:
  • Breast cancer
  • Ovarian cancer, fallopian tube, peritoneal cancer
  • Male breast cancer
  • Prostate cancer
  • Pancreatic cancer
  • Colon Cancer

Ready to take action? Knowledge is power. Take this short quiz to be proactive about your health.

Genes 101

Our bodies are made of many tiny building blocks called cells. Our cells contain a copy of our genome – all of the DNA genetic code we inherited from our parents. Our genome is organized into 46 chromosomes, 23 inherited from mom and 23 from dad. Each chromosome has hundreds or thousands of genes. Each gene has the instructions to make a protein that may control the structure or function of cells, can determine many things including how tall we are or the color of our eyes. Genes also contain instructions for many things inside of us that we cannot see, such as how our bones are formed or how our heart works. Each gene is made up of molecules called nucleic acids (A, T, C, and G). The specific sequence of the nucleic acids holds the instructions that control all the components and their functions in cells.

If the DNA sequence is changed, like a spelling mistake, the instructions may not make sense. The technical term for this change is “mutation,” meaning there is a change to the usual genetic code that may change the instructions stored in the gene. A mutation in a gene that repairs DNA damage or controls cell growth can increase the risk of developing cancer.

Sporadic vs Hereditary Cancers:

Ovarian and breast cancer can be either sporadic or hereditary. Sporadic cancers make up the vast majority (85-90%) of ovarian and breast cancers and are not associated with family history of either cancer or inherited cancer-associated mutations. Sporadic cancers arise from genetic mutations acquired in some cells of the body by events part of normal metabolism and environmental factors. This type of cancer can happen to anyone. Most acquired gene mutations are not shared among relatives or passed on to children.

Hereditary (also known as inherited, or familial) cancers are those that occur due to genetic mutations that are inherited from mom or dad. Other blood relatives may also share these same gene mutations. Parents give one copy of each gene to their children. If a parent has a genetic mutation in a gene, each of their children have a 50% chance of inheriting that mutation. Therefore, even in families with hereditary cancer, not all family members inherit the mutation that is causing cancer, and their risk of cancer is similar to the average person in the general population. Individuals who are suspected to have a family history with high incidence of ovarian, breast, and other cancers may be offered genetic testing to try to find the specific genetic mutation that may put them at risk. Importantly, individuals who do not have a known genetic mutation but have high incidence of ovarian, breast, or other cancers in their families are still considered at higher risk for developing those cancers.

Hereditary cancers often occur at an earlier age than the sporadic form of the same cancer, so experts often recommend starting cancer screening at a younger age for individuals at high risk for hereditary cancer. Hereditary cancers can also be more aggressive than the sporadic form of the same cancer. Individuals who have inherited a gene mutation may be at a higher risk for more than one type of cancer.

BRCA 1 and BRCA 2: Most Common hereditary breast and ovarian cancer

The genes that are most commonly involved in hereditary breast and ovarian cancer (HBOC) are BRCA1 and BRCA2. These genes are named for their link to breast (BR) cancer (CA), but they are also linked to ovarian cancer risk as well as other cancers. Both women and men can inherit mutations in these HBOC genes. BRCA1 and BRCA2 are tumor suppressor genes that have a usual role in our body of providing instructions on repairing DNA damage and preventing cancer. When a family has an inherited mutation in BRCA1 or BRCA2, this leads to an increase in cancer risk. Not every man or woman who has inherited a mutation in the BRCA1 or BRCA2 gene will develop cancer, but people who have a mutation do have a significanlty increased chance of developing cancer, particularly cancer of the breasts or ovaries.

While breast and ovarian cancers are the most common cancers diagnosed in people with BRCA1 and BRCA2 mutations, the risk of some other cancers is also increased. Men with BRCA1 and BRCA2 mutations have a higher risk of early-onset prostate cancer than men without mutations in either gene. Other cancers seen at increased rates, particularly in individuals with BRCA2 mutations, include pancreatic cancer and melanoma. Researchers are continuing to find new genes that are involved in hereditary breast and/or ovarian cancer so it is important to follow up with a genetic counselor on a regular basis if hereditary breast and ovarian cancer is likely in your family.

Talk to your family about your health history and take the Assess Your Risk quiz here