Cancer and the Environment: A Smokescreen?

“Reducing Environmental Cancer Risk: What we can do now” is a report, April 2010,  which appraises the National Cancer Program.  The following letter was submitted to the President of the United States by the President’s Cancer Panel;

Dear Mr. President
Though overall cancer incidence and mortality have continued to decline in recent years, the disease continues to devastate the lives of far too many Americans. In 2009 alone, approximately 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. With the growing body of evidence linking environmental exposures to cancer, the public is becoming increasingly aware of the unacceptable burden of cancer resulting from environmental and occupational exposures that could have been prevented through appropriate national action…..

…..The Panel was particularly concerned to find that the true burden of environmentally induced cancer has been grossly underestimated. With nearly 80,000 chemicals on the market in the United States, many of which are used by millions of Americans in their daily lives and are understudied and largely unregulated, exposure to potential environmental carcinogens is widespread……

…..Most also are unaware that children are far more vulnerable to environmental toxins and radiation than adults. Efforts to inform the public of such harmful exposures and how to prevent them must be increased. All levels of government, from federal to local, must work to protect every American from needless disease through rigorous regulation of environmental pollutants……

….. The Panel urges you most strongly to use the power of your office to remove the carcinogens and other toxins from our food, water, and air that needlessly increase health care costs, cripple our Nation’s productivity, and devastate American lives.

Sincerely,
LaSalle D. Leffall, Jr., M.D., F.A.C.S. Chair
Margaret L. Kripke, Ph.D.

In the accompanying report it was pointed out that although mortality from childhood cancers has dropped dramatically since 1975 – due to vastly improved treatments over the same period (1975–2006) – cancer incidence in US children under 20 years of age has increased .

The causes of this increase are not known but the report emphasized these increases cannot be explained by the advent of better diagnostic techniques.(1)

Ironically, in the past two decades, improved imaging technologies, nuclear medicine examinations, and new pharmaceutical interventions have made significant strides in diagnosing and treating human disease, including cancer.

Americans now are estimated to receive nearly half of their total radiation exposure from medical imaging and other medical sources, compared with only 15 percent in the early 1980s. The increase in medical radiation has nearly doubled the total average effective radiation dose per individual in the US. Computed tomography (CT) and nuclear medicine tests alone now contribute 36 percent of the total radiation exposure and 75 percent of the medical radiation exposure of the US population.

Why is this ironic?

Through radiation, human cancers can develop, grow, and spread, by damaging DNA. This damaged DNA can result in gene mutations that permit or promote cancer development and can, in some cases, be passed on to subsequent generations.

People who receive multiple scans or other tests that require radiation may accumulate doses equal to, or exceeding, that of Hiroshima atomic bomb survivors.(2)

The report states efforts are needed to eliminate unnecessary testing and improve both equipment capability and operator skill to ensure that radiation doses are as low as reasonably achievable without sacrificing image or test data quality.

No mechanism currently exists to enable individuals to estimate their personal cumulative radiation exposure “which would help patients and physicians weigh the benefits and potential harm of contemplated imaging and nuclear medicine tests.”

The report seems a reasonable assessment of environmental dangers facing folk in the US and bringing awareness of these dangers to the President.

Not so.

The American Cancer Society says the panel’s report goes too far in ‘trashing’ established efforts to prevent cancer and that its conclusions go well beyond established facts.(3)

In an October 2009 review, the Cancer and the Environment committee of the American Cancer Society suggested that pollutants cause no more than 5% of all cancers.

The presidential panel says this greatly underestimates the problem because it does not fully account for “synergistic interactions between environmental contaminants, an increasing number and amount of pollutants, and the fact that all avoidable causes of cancer are not known.”

However, Michael Thun, MD, of the American Cancer Society (ACS), writes that this opinion:

“does not reflect scientific consensus” but “reflects one side of a scientific debate that has continued for almost 30 years.”

Richard Clapp, DSc, MPH, professor of environmental health at Boston University, praises the report for challenging,

flawed and grossly outdated methodology.

“This report … calls for action on things where we don’t yet know all the details. We shouldn’t wait until the bodies are counted to say, ‘Well, maybe people shouldn’t be exposed so much to that chemical,” he said at a news conference sponsored by the Breast Cancer Fund.

Thun, MD, says;

“Unfortunately, the perspective of the report is unbalanced by its implication that pollution is the major cause of cancer, and by its dismissal of cancer prevention efforts aimed at the major known causes of cancer (tobacco, obesity, alcohol, infections, hormones, sunlight) as ‘focused narrowly‘.

There is no doubt that environmental pollution is critically important to the health of humans and the planet.  However, it would be unfortunate if the effect of this report were to trivialize the importance of other modifiable risk factors that, at present, offer the greatest opportunity in preventing cancer.(4)

Should we be encouraging the government to introduce policy and practice that focus on all aspects of our environment that is detrimental to our health?

The American Cancer Society

Established in 1913 by a handful of physicians and business people in New York City, the ACS has grown into one of the world’s largest health organizations. It has a staff of 6,000, over 2 million volunteers, and receives financial donations from over 10 million people annually. It has assets of over $1 billion and an income of approximately $700 million per year (5)

The ACS says it has created a ‘cancer-conscious public’, pioneering research and public programs that reduce mortality through prevention and early detection.

However, the ACS has been accused by the The Cancer Prevention Coalition (CPC) of  repeatedly rejecting or ignoring opportunities and requests from Congressional committees, regulatory agencies, unions, and environmental organizations to provide scientific testimony critical to efforts to legislate and regulate a wide range of occupational and environmental carcinogens.

For example the CPS states:(6)

  • In 1977 and 1978, the ACS opposed regulations proposed for hair coloring products that contained dyes known to cause breast and liver cancer in rodents. In so doing, the ACS ignored virtually every tenet of responsible public health as these chemicals were clear-cut liver and breast carcinogens.
  • In 1992,the ACS issued a joint statement with the Chlorine Institute in support of the continued global use of organochlorine pesticides— despite clear evidence that some were known to cause breast cancer. In this statement, Society vice president Clark Heath, M. D., dismissed evidence of this risk as “preliminary and mostly based on weak and indirect association,” and the blame for increasing breast cancer rates due to better detection, ” Speculation that such exposures account for observed geographic differences in breast cancer incidence or for recent rises in breast cancer occurrence should be received with caution; more likely, much of the recent rise in incidence in the United States . . . reflects increased utilization of mammography over the past decade.”

  • In 1992, in conjunction with the NCI, the ACS aggressively launched a ‘chemoprevention’ program aimed at recruiting 16,000 healthy women at supposedly ‘high risk’ of breast cancer into a 5-year clinical trial with a highly profitable drug called tamoxifen. This drug was manufactured by one of the world’s most powerful cancer drug industries, Zeneca, an offshoot of the Imperial Chemical Industries. The women were told that the drug was essentially harmless, and that it could reduce their risk of breast cancer. What the women were not told was that tamoxifen had already been shown to be a highly potent liver carcinogen in rodent tests, and also that it was well-known to induce human uterine cancer.

That was a few years ago, how’s the ‘chemoprevention’ programe faring?

On 7th July, 2010, one headline from PharmacyEurope, an online pharmacy for hospitals and clinicians stated;

Breast cancer drug draws closer

An innovative breast cancer treatment has taken a step closer to the market as Swiss drug maker Roche Holding AG submitted it for approval with American health regulators.

Roche revealed it filed trastuzumab-DM1 (T-DM1) – aimed at people with advanced HER2-positive breast cancer who had previously received other treatments – to the US Food and Drug Administration (FDA).

The company claims that its study has demonstrated that the drug shrank tumors in a third of women who had received an average of seven prior medicines for advanced HER2-positive breast cancer.

Roche also predicts that the new drug could eventually bring in sales of over £1.24 billion ($1.88 billion).(7)

Any connections with Roche and ACS?

In 2008  The ACS received a three-year grant from Roche Brazil to expand and enhance efforts on breast cancer awareness in Brazil. Breast cancer is currently the leading cancer killer among women in that country.

The program, named Brazil Breast Cancer Action, will focus on capacity building, patient support, and breast cancer awareness in the general public. Over three years, the ACS will work with leading cancer control nongovernmental organizations (NGOs) and key cancer stakeholders in Brazil, providing grants, customized trainings for NGOs, media summits for journalists, and patient navigation and survivor support services. (8)

If predictions of profits from its new drug are correct, maybe Roche will consider giving a grant to the ACS so it can expand and enhance efforts on breast cancer awareness in the USA.  Only this time working with the President and bringing to his attention all agents in our environment that encourage the onset of breast cancer. The removal of these agents will help reduce the outbreak of the disease.

But wait a minute.

Decreased incidence of cancer means less drugs, less profit, less grants.

On second thoughts…

…………………………………………………………………………………………………………

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