Wellness

Wellness: The Big C Change

Activist groups broadening their agendas to include prevention, the link between environment and cancer is going mainstream.


Thursday, October 07, 2010

When she looks at her suburban street, Geri Barish sees cancer. She believes it's under her feet, in the soil that came from a landfill and has been sprayed with pesticides. She believes it's overhead, in the electric transformers that hang from telephone poles on her quiet cul-de-sac.

"Pollution from these sources may explain the cancer that killed my mother, my son and too many of my neighbors," said Barish, of Hewlett, N.Y., a middle-income community at the heart of a dense cluster of cancer cases. "It may also explain why I've had to battle breast cancer three separate times myself."

Back in 1990, when Barish and some female neighbors founded the Long Island Breast Cancer Action Coalition, their goal—to raise awareness of the link between pollutants and high rates of cancer in their area—was considered politically fringe.

No more.

Twenty years down the line, presidential advisors, lawmakers and the largest breast cancer research group in the country are all simultaneously pulling the issue to the center of the political stage.

A big sign of this change occurred this past summer, when Susan G. Komen for the Cure—the world's largest breast cancer organization—and the Institute of Medicine, a Washington-based health policy group, conducted a joint meeting in San Francisco on environmental toxins and breast cancer.

"The public is invited to observe our upcoming meeting, which will include presentations from leading breast cancer researchers and organizations," said Dr. Amelie Ramirez of Komen's scientific advisory board at the start of the meeting, held July 6-8. "We believe this meeting is very important and expect it to generate much collaborative input."

In the advocacy realm, this represents something of a seismic shift by the Dallas-based Susan G. Komen for the Cure, which has long focused on breast cancer treatment rather than prevention.

But on May 20 the group, which has invested nearly $1.5 billion to fight breast cancer since its inception in 1982, said it was devoting $1.25 million to a year-long Institute of Medicine study on cancer and the environment.

When asked why Komen launched this initiative, Elizabeth Thompson, a spokesperson for the organization, said that concern about carcinogens has "come to the point where we need all hands on deck."

"We're delighted and think it's about time," Barish said, responding to the announcement.

News of Komen's partnership with the Institute of Medicine broke shortly after the May 6 online publication of "Reducing Environmental Cancer Risk," a landmark report by the President's Cancer Panel. The report warns that carcinogens are causing "grievous harm" to Americans and that the number of cancer deaths related to pollution has been "grossly underestimated" due to a lack of sufficient research.

Formed in 1971 to monitor national cancer policy, the President's Cancer Panel has never before made such sweeping statements, instead focusing its previous reports on issues such as health disparities, barriers to care and cancer survivorship rates.

"This report is a breakthrough because of its source—and because it's the first government document to ever summarize these issues clearly and in one place," said Janice Barlow, director of Zero Breast Cancer, an advocacy group in San Raphael, Calif.

The Safe Chemicals Act of 2010—introduced April 15 in the Senate by Sen. Frank Lautenberg (D-N.J.) and in the House by Reps. Henry Waxman (D-Calif.) and Bobby Rush (D-Ill.)—is another sign of environmental health worries gaining mainstream attention.

This legislation would revamp the Toxic Substances Control Act of 1976 and would ensure, in Lautenberg's words, that "those who make chemicals be responsible for testing them before they are released."

Under current policy, the Environmental Protection Agency can call for safety testing only after evidence surfaces to indicate that a chemical is dangerous. As a result, the agency has only been able to require testing for 200 of the 80,000 chemicals registered in its database.

To date, the Environmental Protection Agency has been able to ban five carcinogens: asbestos (used as insulation); PCBs (polychlorinated biphenyls, used in electrical transformers); hexavalent chromium (a paint additive); dioxins (byproducts of chemical manufacturing); and halogenated chlorofluoroalkanes (used in aerosol cosmetics).

To lobby for the Safe Chemicals Act, currently being reviewed by congressional committees, the Environmental Working Group, an advocacy organization in Washington, has created an online petition that the bill's supporters can send to their legislators. The Senate and House could vote on the proposed law later this year. [Editor's note: Late last month, a group of 51 investment organizations managing more than $35 billion in assets signed a letter sent to Congress endorsing the Safe Chemicals Act and urging its passage before Congress adjourns for the November election campaign break. The group argues that the current rules are obsolete and that exposure to toxic chemicals by workers and consumers has created a series of health issues that ultimately stifle economic recovery and long-term sustainability.]

"This act is revolutionary because it's built on the precautionary principle, which holds that you prove chemicals are safe before you introduce them," said Barbara Brenner, executive director of the San Francisco-based Breast Cancer Action. "Growing interest in that principle means legislation like this finally has a chance to move forward."

Grassroots activists say such legislation could have a wide impact. Forty-one percent of Americans will develop cancer at some point in their lives, according to the Silent Spring Institute in Newton, Mass.

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Six percent of all cancer deaths are linked to environmental factors, the Atlanta-based American Cancer Society estimates. Grassroots groups have long pointed to evidence, however, that indicates the true number is much higher.

One Department of Health and Human Services study, for instance, estimates that 70 percent of breast cancer cases are linked to environmental exposures.

The President's Cancer Panel report takes aim at environmental risk factors in manufacturing, agriculture, medical sources, the military and modern lifestyles.

These include benzene (in petroleum products, such as the oil currently leaking into the Gulf of Mexico); chromium trioxide (an ingredient used in pesticides); increased medical testing (which is boosting Americans' exposure to radiation); the 900 Superfund sites (areas identified by the federal government as "the nation's worst uncontrolled hazardous waste sites"); and bisphenol-A (a plastic ingredient found in food and beverage containers).

The 240-page report recommends reducing exposure to carcinogens during pregnancy (which can impair fetal development); studying vulnerable populations (such as low-income residents of polluted communities); teaching Americans to protect themselves from cancer by taking practical steps (such as microwaving food in glass containers instead of plastic ones); and creating a stronger screening system that ensures chemicals are proven safe before they are put on the market.

If the Safe Chemicals Act passes, that last recommendation—which health advocates have long said is a crucial starting point—will be met, potentially paving the way for future reforms.

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