Health Ministry says women may have been misled about cancer testing
Health funds and hospital to track down women who saw Dr. Zvi Borochowitz after internal probe finds he advised against gene testing when it was needed in at least one case
Sue Surkes is The Times of Israel's environment reporter
The Health Ministry has taken the unprecedented step of calling on thousands of women who sought genetic testing for cancer with a highly-regarded senior specialist to seek new advice and monitoring out of fears that some of them may have been misled.
It also instructed the health funds that insure Israelis for medical treatment and the Bnai-Zion Medical Center, Technion-Faculty of Medicine in the northern city of Haifa, where Prof. Zvi Borochowitz worked, to track down women who were advised not to undergo genetic testing, to give them immediate medical and genetic advice and to put them under supervision.
The ministry’s announcement follows a two month probe by an internal committee that found Borochowitz had not used sound medical judgement in advising that at least one woman not undergo genetic testing for cancer.
The announcement is aimed mainly at women from the north of Israel who have family histories of breast and ovarian cancer but who were advised from the early 2000’s on not to have laboratory tests which could identify a genetic mutation known as BRCA.
Identification of the mutation enables many women to have preventative surgery to remove their breasts or ovaries.
Ovarian cancer is often fatal and given the difficulty of identifying it early, genetic testing can point the way to surgery which rules out cancer in 97 percent of cases.
Shira Pridan, a lawyer representing a woman who sued Borochowitz for medical negligence in 2016, warned that other women could be “wandering around like ticking bombs” not knowing the danger they were in — danger that was preventable.
The ministry launched the probe after being approached by Pridan, who represents a 69-year-old woman from the coastal city of Hadera advised by Borochowitz through the Meuhedet health fund in 2004.
Borochowitz, a renowned specialist in the field of medical genetics, retired from the Bnai-Zion Medical Center, Technion-Faculty of Medicine three years ago.
Up until that time, he served most of the country’s health funds and advised additional hospitals, among them Assuta in Haifa, the Hillel Yaffee Medical Center in coastal Hadera and the Western Galilee Hospital in northern Nahariya.
He still volunteers for a number of organizations.
An internal report from the ministry found a surgeon had referred the 69-year-old woman to Borochowitz in 2004 in light of the death at age 60 of the woman’s mother from ovarian cancer and her Ashkenazic origin, according to Israel Hayom.
Ashkenazi Jews hail from Europe and North America and Ashkenazi women are particularly prone to certain strains of breast and ovarian cancer.
According to the report, Borochowitz decided that there was “no medical justification” for carrying out genetic tests on the woman and that any test results would not impact the medical approach taken toward her.
His opinion was adopted by medical professionals who saw the woman over the next decade.
It was only in 2014 that she sought genetic counseling at Ichilov hospital in Tel Aviv — on her daughter’s recommendation — and discovered that she indeed carried the genetic mutation characteristic of ovarian cancer.
Surgery in 2015 to remove her ovaries further revealed that she already had the disease.
She had to go undergo six cycles of chemotherapy and continues to be under tight medical supervision, according to Israel Hayom.
The internal inquiry found that Borochowitz had deviated from best medical practices in advising she not undergo testing.
His reasoning that the tests were not publicly funded at the time was also discounted by the fact that he did not apprise the woman of the option of getting private testing or that if a mutation was discovered, preventative surgery could be carried out.
In summer 2016, Pridan sued Borochowitz and the Meuhedet health fund. The parties settled for an undisclosed sum in damages.
A statement issued to Israel Hayom on behalf of Borochowitz said that from 2004-2006 he dispensed advice about breast and ovarian cancer to “a few dozen women only.”
“It should be noted that in contrast to today, counseling of this nature was less common,” the statement went on.
Borochowitz acted “in accordance with his best medical judgment and with the Ministry of Health circular on the issue that was published in 2004,” the statement said.
That circular set out the cases in which women could be tested for mutations in genes BRCA 1-2. In 2006, the regulations changed and doctors were advised to tell their patients that they could have the tests carried out privately as well.
Borochowitz was also running northern Israel’s only private medical genetic testing unit when he saw the woman, the statement added, which could have led to a conflict of interest if he advised private testing.
A statement from the Bnai-Zion Medical Center said Prof. Borochowitz had finished working there three years ago. “We operate according to the guidelines of the Ministry of Health, ” it said.
