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---November 20, 1997---
THE TRUTH ABOUT BREAST CANCER--PART 3
As we saw in Part 1 of this series (REHW #571), perhaps 30% (a few say as much as 50%) of breast cancer can be explained by genetic inheritance or by factors in a woman's life that increase her exposure to natural estrogens in the blood stream (female sex hormones). Genetic inheritance accounts for an estimated 5% to 10% of the total.[1]
The evidence implicating natural estrogen is pretty convincing. If a woman starts having her period early in life or goes through menopause late, her chances of getting breast cancer are increased. Not having a baby at all, or having the first baby late in life, increases the likelihood of breast cancer. Having more babies is more protective against breast cancer --having more than 5 is most protective.[2] Breast feeding seems to be protective (though it is unclear exactly why). Having one's ovaries surgically removed is VERY protective; in pre-menopausal women, the ovaries are the major source of natural estrogen. In sum, for unknown reasons, under some circumstances, prolonged exposure to natural estrogen increases the likelihood of breast cancer in some women.[1]
Still, 50% to 70% (or more) of breast cancers remain unexplained. And consider this: Compared to their grandmothers, more of the current generation of women in their '50s had children, and they had their children earlier --both factors that should have reduced this generation's breast cancer risk. Yet this generation's incidence of breast cancer has been steadily increasing.[3] Clearly something else is overwhelming these protective reproduction-related "risk factors."
The "something else" is no doubt a combination of other factors including medical irradiation,[4] exposures to cancer-causing or cancer-promoting chemicals (including alcohol, cigarette smoke,[5] pharmaceuticals, pesticides, food additives such as partially hydrogenated vegetable oils,[6,7] and other industrial compounds), lack of exercise, obesity (especially among women who were thin at age 18 and seriously overweight after menopause[8]) and perhaps other (as yet unknown) factors. Most likely these various factors work together, along with natural estrogen. Furthermore, many people probably inherit a susceptibility to particular harms --for example, some people have a poorly-developed mechanism for detoxifying chemicals that they ingest. For those people, ingesting chemicals may be more dangerous than it is for other people. Thus, genetic inheritance and environmental exposures no doubt interact in complex ways to cause breast cancer and other cancers as well.
What's hopeful is this: we can't change out genetic inheritance, but we can clean up the environment and reduce exposures to known carcinogens. But first, of course, we would need to identify them. There are about 75,000 different chemicals now in use and only 1200 to 1500 of these have been tested for carcinogenicity.[9] No one knows how many of the 75,000 contribute to cancer in humans but a recent estimate concluded that we should expect 5% to 10% of these (3750 to 7500 different chemicals) to be carcinogenic in humans.[10] Currently, our government regulates fewer than 200 chemicals on the basis of their carcinogenicity. We have a ways to go yet --and we add roughly 2000 new, untested chemicals into commercial use each year now. Yes, we have a ways to go.
Medical irradiation is the most-firmly-established of all causes of breast cancer. At least 32 positive studies have shown that irradiating the female breast increases the likelihood of breast cancer.[11] (In the case of mammography, after age 50 the benefits pretty clearly outweigh the risks, but if you are younger than 50, read up on the subject before you decide. In any case, please don't take our word on this --consult a qualified physician.)
Dr. John Gofman (a physician and radiation specialist) has argued in elaborate detail that medical irradiation --IN CONJUNCTION WITH OTHER CO-FACTORS --has played a role in 65% to 75% of today's breast cancers.[11] (See REHW #443.) The latest edition of Gofman's book makes it clear that the problem of excessive radiation of girls' and women's breasts is NOT a thing of the past. Anyone who wants to learn how to prevent breast cancer needs to know what Gofman is talking about so that they can protect themselves and their loved ones from excessive medical irradiation. (See Gofman's chapter 48, pgs. 353-372).
In recent years, attention has focused on chemicals that can disrupt the hormone system. Often these chemicals mimic or block estrogen. Therefore, because breast cancer seems to be intimately associated with estrogen, it seems a reasonable question ask: are industrial chemicals that disrupt hormones contributing to breast cancer? As we have seen (REHW #571, #572), this is a question that the chemical industry is not comfortable asking.
Is it plausible that organochlorines could interfere with human hormones? Some people think it is. Some say not, arguing that organochlorines are 100 to 10,000 times less potent than natural hormones. On the other hand, organochlorines are present in human blood at levels 40 to 250 times as high as natural hormones.[12] Furthermore, only 1% to 3% of natural hormones are biologically active (and sometimes much less than 1% is active) --the remaining 97% to 99% (or more) is bound by proteins and is unavailable to the body's hormone receptors.[13] Organochlorines are not necessarily bound in this way. Lastly, natural hormones last only a short time; most have a half-life of less than 30 minutes in the blood.[14] Many organochlorines have half-lives measured in years. Therefore, the arithmetic begins to put organochlorines into the ballpark where they might compete with --and interfere with --natural hormones.
Here we will begin to review some of the evidence indicating (in some cases, NOT indicating) that exposure to certain chemicals can increase a woman's chances of getting breast cancer. No one has suggested that chemical exposures explain ALL unexplained breast cancers. Still, if 50% to 70% of breast cancers are unexplained, that means 91,000 to 127,000 new cases of breast cancer go unexplained each year. If chemical exposures accounted for just 10% to 20% of those cancers, then we would have the key to preventing between 9,000 and 25,000 cases of breast cancer each year. The possibility seems too important to ignore.
Here is some of the evidence:
** Breathing vinyl chloride fumes causes breast cancer in female rats, even at low doses.[15]
** Likewise, a study of women who breathe vinyl chloride fumes on the job showed a 36% increase in breast cancer deaths.[15]
** Some pharmaceutical preparations are associated with increased likelihood of breast cancer. For example, a study of 501,536 women who received diethylstilbestrol (DES) --a synthetic estrogen --revealed a 34% increased likelihood of getting breast cancer.[16]
** Reportedly, 85% of pharmaceutical drugs involve chlorinated chemicals in their manufacture.[17] A 1979 study by the National Cancer Institute revealed excessive breast cancer (22 observed, 12.3 expected) among 1075 white women employed in pharmaceutical manufacture.[18]
** A study in New Jersey revealed excessive breast cancer among African American female pharmaceutical workers, chemical workers, electrical equipment workers, and printing plant workers (the latter two industries being associated with exposures to chlorinated solvents).[19]
A New York state study of white women in the electrical equipment and printing industries (again, presumably exposed to chlorinated solvents) showed elevated rates of breast cancer.[20]
** Women employed for more than 5 years as beauticians have a three-fold increased likelihood of getting breast cancer.[21]
** Breast cancer is increased in 339 U.S. counties that have hazardous waste sites and groundwater contamination compared to counties without such sites. In this study of waste dumps and cancers (during 1970-1979) in U.S. counties, breast cancer was the most elevated cancer among women.[22]
** Fishermen's wives who eat organochlorine-contaminated fish from the Baltic sea (east coast of Sweden) have an elevated incidence of breast cancer compared to women eating less-contaminated fish from the west coast of Sweden.[23] Among the group of 2175 women, 38 cancers were expected and 49 were observed.
** Women occupationally exposed to trichlorophenol, 2,4,5-T (the herbicide that formed one-half of Agent Orange in Vietnam) and dioxin had an elevated incidence of breast cancer (9 observed vs. 4.2 expected)[24] even though dioxin is usually considered an anti-estrogen that may sometimes protect against estrogen-related cancers.
[To be continued.]
--Peter Montague
THE TRUTH ABOUT BREAST CANCER--PART 2
Roughly five to ten percent of cancers are caused by inherited genetic disorders, but the remaining 90 to 95 percent are caused by exposure to carcinogens (cancer-causing agents such as x-rays or certain chemicals). This is true of breast cancer,[1,pgs.237-241] and of all other cancers as well.
Some carcinogens are natural, such as cosmic rays from outer space, and cannot be avoided. But many carcinogens are synthetic (meaning 'created by humans'), such as fiber glass, x-rays, some pesticides, etc. --and exposure to them COULD be avoided. Thus, cancer is largely a preventable disease. Almost no one disputes this.[1,pgs.55,265]
When women started asking about prevention of breast cancer in the 1980s, they examined the scientific research "establishment" and found it dominated by men who had close ties to industries that produce carcinogens. For example, as recently as the late 1980s, the board of overseers of the Memorial Sloan-Kettering Cancer Center was comprised of bankers and industrialists. Before Leo Wade became the director of the Sloan-Kettering Center, he had a long career as medical director at Standard Oil of New Jersey,[1,pg.266] and he was a member of the American Petroleum Institute, the National Association of Manufacturers, and the Manufacturing Chemists Association. Under Wade's leadership, Sloan-Kettering never weighed in on the side of prevention.
In 1990 --and for several years before that --the National Cancer Institute's "National Cancer Advisory Panel" (an influential 3-member group with direct access to the President --indeed, it is now called the President's Cancer Panel) was headed by Armand Hammer who was also, at the time, chairman of Occidental Petroleum, a major polluter and manufacturer of carcinogenic chemicals. When Hammer announced a drive to add a billion dollars to the NCI's budget, the goal was "to find a cure for cancer in the next ten years" and none of the money was earmarked for prevention.[1,pg.266]
As we saw last week, Breast Cancer Awareness Month was created in 1987 by a British chemical conglomerate --Imperial Chemical Industries (ICI) --and it is now funded and exclusively controlled by an ICI spin-off, Zeneca Pharmaceuticals.[2] Breast Cancer Awareness Month is focused narrowly on early detection of breast cancer through mammography; it is not about prevention. Zeneca plays a dual role in the cancer business. On the one hand it earns $300 million each year from sales of the carcinogenic herbicide acetochlor[1,pg.257] while at the same time earning $470 million each year marketing the world's best-selling cancer therapy drug, tamoxifen citrate,[1,pg.255] and it operates a chain of 11 U.S. cancer treatment centers.[3] Clearly, cancer prevention would conflict with Zeneca's business plan.
In the early 1990s, 180 cancer advocacy groups joined together into the National Breast Cancer Coalition (NBCC). Using grass-roots organizing tactics pioneered by AIDS activists and by toxics activists, the NBCC persuaded Congress to increase breast cancer funding by $300 million,[1,pg.255] with an eye toward prevention.
The creation of the NBCC represented a real threat to the chemical industry which has been discharging millions of tons of carcinogenic chemicals into communities for years --all perfectly legal because the industry's friends in Congress have adjusted the laws to make it so.
Grass-roots action to expose the truth about cancer --that CANCER IS A POLITICAL DISEASE --was a real threat to the industry, especially because the message was bubbling up from the grass-roots and being amplified by cancer researchers like Dr. Devra Lee Davis, who was at that time an adviser to the federal Department of Health and Human Services.
If you look for a group of chemicals that is causing more than its fair share of grief, you would probably pick organochlorines. Very few organochlorines exist in nature, and then only in relatively small amounts; the vast majority of organochlorines were created by humans starting around the year 1900 but gearing up big-time after World War II.
Today there are 15,000 different organochlorines but they all tend to have three similar characteristics. First, they tend to persist in the environment (because nature does not break them down readily), so once created they stay around. Second, they are not very soluble in water but they tend to be soluble in fat --so they tend to enter food chains and bioaccumulate as they move upward toward the big predators, like eagles, polar bears, and humans. And third they tend to be toxic and in many instances carcinogenic. Recently, it has been shown that several of them interfere with hormones in wildlife --and probably in humans --causing many other problems besides cancer.
Partly in response to the formation of the National Breast Cancer Coalition, the Chemical Manufacturers Association (CMA) and its subsidiary, the Chlorine Chemistry Council (CCC), hired Mongoven, Biscoe and Duchin (MBD), a PR firm in Washington, D.C., to develop a plan for countering the "prevention" message.
MBD makes its living by spying on churches, labor unions, environmentalists, and professors and students, writing wildly inaccurate reports about them, then selling the reports to gullible corporate clients, such as CCC. In addition, MBD helps corporate clients develop strategies to resist pressures for change. In its own words, MBD "assists corporations in resolving public policy issues being driven by activist organizations and other members of the public interest community. We help clients anticipate and respond to movements for change in public policy which would affect their interests adversely.... Forces for change often include activist and public interest groups, churches, unions and/or academia.... MBD is committed to the concept that it is critical to know who the current and potential participants are in the public policy process, to understand their goals and modus operandi, and to understand their relative importance. To this end, MBD maintains extensive files on organizations and their leadership...." (See REHW #361.)
A 5-page cover memo to the Chlorine Chemistry Council dated September 7, 1994, and signed by Jack Mongoven, lists many specific steps that CCC should take to defend chlorine and undercut the breast cancer survivors: "It is obvious that the battleground for chlorine will be women's issues--reproductive health and children--and organizations with important constituencies of women opinion leaders should have priority," Mongoven writes. (See REHW #495.)
MBD's August 1994 report to CCC listed a series of conferences for breast cancer survivors scheduled by WEDO (Women's Environment & Development Organization) in New York [phone: 212/759-7982]. The report says, "Devra Lee Davis is expected to direct the Clinton Administration's policy governing breast cancer and we expect her to try to convert the breast cancer issue into a debate over the use of chlorine. As a member of the administration, Davis has unlimited access to the media while her position at the Health and Human Services (HHS) [department] helps validate her 'junk science.' Davis is scheduled to be a keynote speaker at each of the upcoming WEDO breast cancer conferences."
In his cover memo, Jack Mongoven suggests that CCC deal with Dr. Davis, the breast cancer survivors, and anti-chlorine sentiments as follows:
** Schedule through KPR [Ketchum Public Relations, in Washington, D.C.] editorial board meetings in Dayton prior to Department of Health and Human Services Devra Lee Davis['s] speech to a forum on breast cancer sponsored by Greenpeace and WEDO to be held in Dayton....
** Enlist legitimate scientists in the Dayton area who would be willing to ask pointed questions at the conference....
** Stimulate peer-reviewed articles for publication in the JAMA [Journal of the American Medical Association] on the role of chlorine chemistry in treating disease.....
** Convince through carefully crafted meetings of industry representatives (in pharmaceuticals) with organizations devoted to specific illnesses, e.g., arthritis, cystic fibrosis, etc., that the cure for their specific disease may well come through chlorine chemistry and ask them to pass resolutions endorsing chlorine chemistry and communicate those resolutions to medical societies. [End of MBD memo.]
MBD has some influential allies in the campaign to deflect attention away from the fact that cancer is caused 90% to 95% by exposure to carcinogens. For example, NEW YORK TIMES writer Gina Kolata ridicules or ignores anyone who suggests that some portion of breast cancers might be caused by exposure to carcinogenic agents in the environment.
Last month HBO aired a documentary film about breast cancer and the environment, called RACHEL'S DAUGHTERS.[4] The film centers on a group of breast cancer survivors who interview scientists who explain the nature and causes of breast cancer. Kolata reviewed the film in the TIMES October 1, 1997.
In her review, Kolata forgot to mention that any scientists or physicians appear in the film. Indeed, she gives the strong impression that the women in the film have no scientific basis for their concerns. Kolata writes, "The women [in RACHEL'S DAUGHTERS] are far removed from the universe of scientists and others who make distinctions between hypothesis and evidence, who believe that speculation is not proof, and that when evidence fails to support a hypothesis, the hypothesis should be abandoned." She ridicules the women in RACHEL'S DAUGHTERS, thus: "Are crops sprayed with pesticides? Well, then of course pesticides caused breast cancer. Do we use electricity? Well, of course electromagnetic fields caused breast cancer." In summing up, Kolata dismisses the women's concerns as "paranoid thinking."
What Kolata neglected to mention is that the following scientists and physicians (among others) appeared on-camera in the film, supporting the women's concerns about the causes of breast cancer:
** Ruth Allen, Ph.D., U.S. Environmental Protection Agency and program director of the National Cancer Institute's Long Island Breast Cancer Study Project;
** Julia Brody, Ph.D., director of the Silent Spring Institute in Massachusetts and principal investigator of the Massachusetts department of health study of breast cancer on Cape Cod;
** Devra Lee Davis, Ph.D., World Resources Institute, Washington, D.C., formerly advisor on breast cancer to the federal Department of Health and Human Services;
** John W. Gofman, Ph.D., M.D., professor emeritus of molecular and cell biology, University of California at Berkeley;
** Stefanie S. Jeffrey, chief of breast surgery, Stanford University School of Medicine;
** Donald C. Malins, Ph.D., D.Sc., Pacific Northwest Research Foundation, Seattle, Washington, and member, National Academy of Sciences;
** Marion Moses, M.D., Pesticide Education Center, San Francisco, California;
** Susan Sieber-Fabro, Ph.D., Deputy Director, Division of Cancer Epidemiology and Genetics, National Cancer Institute;
** Shelia Hoar Zahm, Deputy Chief of the Occupational Epidemiology Branch, Division of Cancer Epidemiology, National Cancer Institute.
Happily, if the TIMES should ever dismiss Gina Kolata for writing biased, inaccurate reports, she wouldn't starve. She has demonstrated all the talents needed to hold down a lucrative position with Mongoven, Biscoe, and Duchin.
[Continued next week.]
--Peter Montague
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