The first comprehensive study of the incidence of cancer among Holocaust survivors has shown that Holocaust survivors were found to be 2.4 times more likely to have cancer than their peers who had not been through the Holocaust.

Cancer of the large intestine among male Holocaust survivors was found to be nine times that of men the same age who immigrated to Israel from Europe before World War II. Among women, the rate was 2.25 times higher for Holocaust survivors.

The study, carried out at the University of Haifa's School of Public Health and funded by the ICA, was based on National Cancer Registry statistics. Researcher Nami Vine Raviv, under the guidance of Dr. Micha Barchana and Prof. Shai Lin, compared the incidence of cancer among 1.8 million Israelis born in Europe between 1920 and 1945 who came to Israel after the war with 464,000 Israelis who were born between 1920 and 1939 and immigrated to Israel before 1939.

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Women Holocaust survivors were 1.5 times more likely to have breast cancer than pre-war immigrants. Five-year cancer survival rates were also found to be lower among Holocaust survivors, by between 5 percent and 13 percent, regardless of sex or age. The researchers believe this may be a result of later detection of the disease because of an unwillingness to complain or to be examined among Holocaust survivors.

The team found that the younger the Holocaust survivor was during the war, the greater their cancer risk. For example, the risk for getting breast cancer later in life was double for women who were younger than 10 during the Holocaust than those above that age. "The exposure to starvation and malnutrition during childhood and adolescence, when the body is in a period of accelerated growth, was found to amplify the risk of developing cancer," Vine Raviv says.

AMCHA, the National Israeli Center for Psychosocial Support of Survivors of the Holocaust and the Second Generation, confirms the research findings. "A day doesn't go by when I don't sign a letter that is somehow connected to a cancer patient," Tel Aviv branch director Hani Oron says. A few months ago Oron sent a German translation of the study to the 11 regional offices in Germany that deal with Holocaust reparations payments, requesting funding for psychological counseling for Holocaust survivors with cancer.

"Holocaust survivors have a different dialogue with death than people who weren't there," Oron says.

"Ironically, it is those who touched death for whom cancer is a terrible threat, and their reaction to it is very hard. They don't call the illness by its name, insisting on calling it 'the disease.' They are very upset and their coping abilities are weakened. Some even refuse treatment," he adds .

Made a life for himself
Ben-Zion Ben-Ari was 13 when World War II came to Transnistria, in the Ukraine. For three years, he evaded the transports to the work camps and death camps. His father was taken in one Aktion. When his mother was captured, he decided to stay with her. They survived the camps and immigrated to Israel after the war.

In Israel, Ben-Ari made a life for himself, putting the horrors of the war behind him until he was diagnosed with cancer at the age of 50. "For three years, I waged a daily war against death," Ben-Ari relates. "Suddenly, after all those years, I was told I had a serious illness and I had to fight death once more."

At the Israel Cancer Association (ICA), where he now volunteers, Ben-Ari found the emotional support that helped him to survive a colectomy, chemotherapy and additional surgery four years later, when his cancer was found to have metastasized.

"In some ways cancer was worse than the Holocaust, because in the Holocaust I was part of a group and here I am on my own. In the Holocaust, I was young and strong," Ben-Ari says. The disease triggered nightmares from the period of the war. "For 10 years I dreamed. Everything came from my subconscious - the shouting, the fear," Ben-Ari relates. He took a course in positive thinking and began taking antidepressants.

In the past few years he has had skin cancer. "I am very afraid of the disease, but skin cancer is treatable. If I survived both types of cancer it obviously means I am stronger," Ben-Ari says.