I Wish I Were Far From the Madding Crowd

August 23, 2010

Sept. 15 meeting on Breast Cancer and the Environment, Washington, DC

The Institute of Medicine’s Committee on Breast Cancer and the Environment will hold its third meeting in Washington, DC, on September 15-16, 2010.  The afternoon session on the 15th will be open to the public.

The agenda for the public session includes invited presentations and a brief opportunity for public comment.  One of the invited presenters is the executive director of the Silent Spring Institute, which conducts and sponsors research on the links between the environment and breast cancer, other environmental health issues, and green chemistry.  Silent Spring maintains science review databases and other tools on the environment and breast cancer.

Its publications include the Guide to Breast Cancer Cohort Studies and

Self-reported chemicals exposure, beliefs about disease causation, and risk of breast cancer

Zota, A.R., A. Aschengrau, R.A. Rudel, and J.G. Brody. 2010. Self-reported chemicals exposure, beliefs about disease causation, and risk of breast cancer in the Cape Cod Breast Cancer and Environment Study: a case-control study. Environmental Health, 9:40. doi:10.1186/1476-069X-9-40
Abstract, Article, Press Release

Attending the IOM meeting

If you’re interested in attending the IOM meeting or commenting you should probably contact the Institute beforehand. (You can register for the meeting online.)

They’ve listed the contact information on the meeting page, but below is the information as of today:

Activity Contact Information

For More Information Contact

Ashley McWilliams

Phone: 202-334-1910
Fax: 202-334-2862
E-mail: BreastCancerandtheEnvironment@nas.edu

Mailing Address

Keck Center
W726
500 Fifth St. NW
Washington, DC 20001
This Institute project is sponsored by Susan G. Komen for the Cure®.  Links to the two previous meetings and background material can be found on the project page. (Susan G. Komen for the Cure® also sponsors the Silent Spring Institute’s science review databases.)

August 6, 2010

A chemical pot pourri

This is a real hodge-podge of items.

Bisphenol A

The Environmental Working Group (EWG) recently announced the findings of a study that found BPA in a large percentage of paper receipts it had collected.  http://ewg.org/BPA_Found_In_Receipts

Chemicals in cosmetics

Another resource EWG maintains is the Skin Deep cosmetic safety database.

http://www.cosmeticsdatabase.com/

Speaking of cosmetics, Annie Leonard (“The Story of Stuff”) has come out with “The Story of Cosmetics”, a look at chemicals in cosmetics and personal care products.  The Story of Stuff blog looks at the cosmetics industry’s reaction.

Learning and developmental disabilities and other diseases and conditions

The Collaborative on Health and the Environment (CHE) covers a wide range of topics, from learning and developmental disabilities to the CHE Toxicant and Disease Database, a searchable database that summarizes links between chemical contaminants and approximately 180 human diseases or conditions, to the Metabolic Syndrome Discussion Group.

BP (not just oil spills)

The CHE site also includes news items like:

6 Aug Thousands sign on for $10 billion BP suit. The revelation that BP’s Texas City refinery emitted toxic benzene for more than a month has ignited a furor in the port community that has suffered its share of deadly industrial accidents and toxic spills. Houston Chronicle.

Yes, before the BP oil spill there was the BP Texas City refinery explosion.  The U.S. Chemical Safety Board conducted an investigation.  I believe that they are looking into whether these incidents show that BP fostered a culture of cutting corners.

Chemicals and depression?

Was reading Peter Kramer’s Against Depression, where he argued that depression is a true illness.  (At least that’s what I’m getting out of it.)  He makes a couple of points that struck me.  One, on p. 156 he states that there is a connection between diabetes and depression.  Unfortunately, he doesn’t cite a source for that.  And if true, it’s not clear which caused which.  That is, does having diabetes make it more likely that you would be depressed?  Or does depression in some way connected to the development of diabetes.  Or could diabetes and depression be caused by the same agent?  (Or some combination of the above.)

He also talks about how long-term stress can result in increased levels of corticotropin and that such stress can lead to depression and illness.  Of course, corticotropin is but one element of the neuroendocrine system.  And with many of these things, there are feedback loops that get out of whack if enough recovery time is not available.  That’s actually why some scientists have proposed that a chronic lack of sleep can cause obesity over the long haul.  The International Agency for Research on Cancer and NIOSH are looking at whether “shift work” (along with a number of chemicals) can be considered carcinogenic.

Leptin: An example of what we didn’t know

Leptin, the appetite hormone, was not discovered until 1994 (though its effects had been observed much earlier).  (Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM (December 1994). “Positional cloning of the mouse obese gene and its human homologue”. Nature 372 (6505): 425–32. doi:10.1038/372425a0. PMID 7984236.) I mention that because chemical industry apologists seem to ignore the fact that we’ve learned a lot about the human body in the last 15-20 years.  And the more we learn, the more we discover how chemicals can mess up our systems.

Regarding leptin, I found the following using the National Library of Medicine’s MedlinePlus service.

A National Cancer Institute fact sheet on physical activity and cancer states that “increasing physical activity may influence insulin and leptin levels and influence breast cancer prognosis.”

An EPA report, “A Decade of Children’s Environmental Health Research:  Highlights from EPA’s Science to Achieve Results Program,” cites an EPA-funded study that found that “autistic children showed higher levels of leptin (a hormone that affects the regulation of body weight, metabolism, and reproductive function, and influences the immune system) in their blood when compared to typically developing children (Ashwood et al. 2007; R829388C002).”

Citation: Ashwood P., Kwong C., Hansen R., Hertz-Picciotto I., Croen L., Krakowiak P., Walker W., Pessah I.N., and Van de Water J. 2007. “Brief report: Plasma leptin levels are elevated in autism: association with early onset phenotype?” J. Autism Dev. Disord. Advanced online publication (DOI 10.1007/s10803-006-0353-1).  Abstract

So our bodies are these incredibly complex systems.  Some chemical companies would have you believe that the stuff they make, even the synthetic chemicals that human beings have never been exposed to before, have absolutely NO effect on our health.

Truth is, despite the Environmental Defense Fund saying that we’re not guinea pigs, we all are.  (See previous post: “Tired of being a guinea pig?“)

“Would you like BPA with those fries?”

April 11, 2010

Some Breast Cancer Cases Caused by a Virus?

It looks like the answer could very well be yes.

The Pink Virus Project

See Dr. Ruddy’s latest post describing her long history in this area.

“Breakthroughs Around the Globe”

Approximately 40% of human breast cancers contain gene sequences that are remarkably similar to a retrovirus known to cause breast cancer in domestic mice. Furthermore, the highest incidence of human breast cancer worldwide occurs in geographic locations where the domestic mouse is native or introduced to the area.

The book, The Pink Virus: Does a Virus Cause Breast Cancer in Women?

Presentation by Dr. Ruddy on The Pink Virus

Summary of Research

http://breastcancerbydrruddy.com/2009/11/01/the-pink-virus-2/

Brief Report on the Pink Virus Breast Cancer Summit

http://www.breasthealthandhealing.com/socialnetworking/messages/20091101.html

Cancer-Causing Virus Linked to Breast Cancer – Includes more info on the Pink Virus Project summit.

Brief bibliography on breast cancer and viruses

Articles cited at bottom of page at http://www.breasthealthandhealing.com/socialnetworking/messages/20091001.html

Updated (and more technical) Bibliography of Research on the Mammary Tumor Virus

http://breastcancerbydrruddy.com/2009/11/15/updated-bibliography-of-research-on-the-mammary-tumor-virus/

Breast Health and Healing’s YouTube Channelhttp://www.youtube.com/user/BreastHealthHealing

A New Virus in a Spontaneous Mammary Tumor of a Rhesus Monkey. Harish C. Chopra and Marcus M. Mason.  Cancer Research 30, 2081-2086, August 1, 1970. http://cancerres.aacrjournals.org/cgi/content/abstract/30/8/2081

Chemical Exposure and Breast Cancer?

The CDC has reported in its Fourth National Report on Human Exposure to Environmental Chemicals that many chemicals are showing up in Americans’ bodies.  (Presence alone does not indicate adverse effects, but as I have blogged about before, exposure during certain windows of development can have long-term effects.)

The Fourth Report includes results for 75 chemicals measured for the first time in the U.S. population.  Among the chemicals: environmental phenols, including bisphenol A and triclosan.  According to the Executive Summary:

  • Bisphenol A (BPA), a component of epoxy resins and polycarbonates, may have potential reproductive toxicity. General population exposure to BPA may occur through ingestion of foods in contact with  BPA-containing materials. CDC scientists found bisphenol A in more than 90% of the urine samples representative of the U.S.population.
  • Polybrominated diphenyl ethers are fire retardants used in certain manufactured products. PBDEs accumulate in the environment and in human fat tissue. One type of polybrominated diphenyl ether,BDE-47, was found in the serum of nearly all of the NHANES participants.

Could women be more vulnerable to a breast cancer virus because of exposure to environmental chemicals (either because the chemicals themselves might contribute, or because they negatively affect the immune system)?  See recent articles at bottom about BPA and phthalates.  See also U.S. News post re what could possibly be one of the more likely sources of BPA exposure—your receipts, not plastic bottles. (Science News itemWarner Babcock Institute for Green Chemistry)

Articles Ahead of Print from Environmental Health Perspectives

Bisphenol A (BPA)

“Placental Transfer of Conjugated Bisphenol A and Subsequent Reactivation in the Rat Fetus.” – Online April 9, 2010.

Nishikawa M, Iwano H, Yanagisawa R, Koike N, Inoue H, Yokota H 2010. Placental Transfer of Conjugated Bisphenol A and Subsequent Reactivation in the Rat Fetus. Environ Health Perspect :-. doi:10.1289/ehp.0901575

Urinary, Circulating and Tissue Biomonitoring Studies Indicate Widespread Exposure to Bisphenol A

Laura N. Vandenberg, Ibrahim Chauhoud, Jerrold J. Heindel, Vasantha Padmanabhan, Francisco J.R. Paumgartten, Gilbert Schoenfelder Online 24 Mar 2010 | doi:10.1289/ehp.0901716

Phthalates

Investigation of Relationships between Urinary Biomarkers of Phytoestrogens, Phthalates, and Phenols and Pubertal Stages in Girls

Mary S. Wolff, Susan L. Teitelbaum, Susan M. Pinney, Gayle Windham, Laura Liao, Frank Biro, Lawrence H. Kushi, Chris Erdmann, Robert A. Hiatt, Michael E. Rybak, Antonia M. Calafat Online 22 Mar 2010 | doi:10.1289/ehp.0901690

Articles notes a weak association between exposure and earlier puberty.  In a press release Dr. Wolff noted that though the association is weak, given the widespread exposure the public health implications are actually quite large.

This was a multi-ethnic longitudinal study of 1151 girls from New York City, greater Cincinnati, and northern California who were 6-8 years old at enrollment (2004-2007).  Measurements were done one year later.

Results: Breast development was present in 30% of girls (ed. note: remember the girls would have been 7-9), and 22% had pubic hair. High-molecular-weight phthalate metabolites were weakly associated with pubic hair development (adjusted PR 0.94 (0.88-1.00), fifth vs first quintile). Small inverse associations were seen for daidzein with breast stage and for triclosan and high-molecular-weight phthalates with pubic hair stage; a positive trend was observed for low-molecular-weight phthalate biomarkers with breast and pubic hair development. Enterolactone attenuated BMI associations with breast development; in the first enterolactone quintile the association of high-BMI with any development was 1.34 (PR, CI 1.23-1.45 versus low-BMI); there was no BMI-association in the fifth, highest quintile of enterolactone.

Conclusions: Weak hormonally active xenobiotic agents investigated in this study had small associations with pubertal development, mainly among those agents detected at highest concentrations.

My point?  There are enough risks for breast cancer from other causes that we do not need to be assaulted by chemicals in our environment.

April 2, 2010

Breast cancer and exposure to phthalates, PAHs, and petroleum byproducts

Several recently published studies on links between exposure to chemicals and breast cancer.

Study Links Chemical Exposure to Breast Cancer Risk

(MedPage Today) Women exposed at work at a young age to petroleum byproducts and synthetic fibers such as acrylic and nylon appear to be at the greatest risk of developing breast cancer after menopause.

Source: Labreche F, et al “Postmenopausal breast cancer and occupational exposures” Occup Environ Med 2010; 67: 263-69.

Exposure to Phthalates and Breast Cancer Risk in Northern Mexico

Lizbeth López-Carrillo et al.  Environmental Health Perspectives, 118(4) Apr 2010.

The authors show for the first time that exposure to diethyl phthalate, the parent compound of monoethyl phthalate (MEP), may be associated with increased risk of breast cancer.

Editor’s Summary

Associations between Polycyclic Aromatic Hydrocarbon–Related Exposures and p53 Mutations in Breast Tumors

Irina Mordukhovich et al.  Environmental Health Perspectives, 118(4) Apr 2010.

The findings suggest that PAHs, environmental pollutants formed by incomplete combustion of organic material (for example, smoking, wood burning, vehicle exhaust), may be associated with specific breast tumor p53 mutation subgroups rather than with overall p53 mutations and may also be related to breast cancer through mechanisms other than p53 mutation.

Editor’s Summary

PAHs in stormwater runoff

Another EHP news item on PAHs notes that researchers found that stormwater runoff was the main pathway by which PAHs enter waterways, contributing about half the New York/New Jersey harbor’s PAH load, and atmospheric deposition was an important contributor of smaller PAH compounds.  (Lisa A. Rodenburg, et al. Mass Balances on Selected Polycyclic Aromatic Hydrocarbons in the New York–New Jersey Harbor, doi:10.2134/jeq2009.0264, Journal of Environmental Quality, March-April 2010 39: 642-653.)

March 28, 2010

Risk factors for breast cancer – Missing one of the major ones?

Up to a third of breast cancers could be avoided (Yahoo! News)

http://news.yahoo.com/s/ap/20100325/ap_on_he_me/eu_med_avoiding_breast_cancer

European breast cancer conference in Barcelona. Carlo La Vecchia cited figures from the International Agency for Research on Cancer (website).  I couldn’t find the precise source for the figures, but perhaps they came from “Estimates of cancer incidence and mortality in Europe in 2008” (abstract only).

Conference website – http://www.ecco-org.eu/Conferences-and-Events/EBCC-7/page.aspx/840

Abstracts – http://www.ecco-org.eu/Conferences-and-Events/EBCC-7/Abstracts-online/page.aspx/2177

Or go directly to http://ex2.excerptamedica.com/ciw-10ebcc/

Type in “cancer” in the search field.  You should get 655 abstracts.

The focus of the conference was clearly on diagnosis and treatment with little to no discussion of environmental factors.  Certainly screening, diagnosis, and treatment are critical, but shouldn’t we try to prevent as much as we can?

More from the Yahoo story

Dr. Michelle Holmes of Harvard University, who has studied cancer and lifestyle factors, said people might wrongly think their chances of getting cancer depend more on their genes than their lifestyle.

“The genes have been there for thousands of years, but if cancer rates are changing in a lifetime, that doesn’t have much to do with genes,” she told The Associated Press in a phone interview from Cambridge, Mass.

Could perhaps increasing exposure to substances in the environment change rates in a lifetime?  That doesn’t have much to do with genes either.  Though if you’re being exposed to chemicals that interfered with how your genes were turned on and off before you were born, or are interfering with that now, perhaps it does.

Breast cancer is the most common cancer in women. In Europe, there were about 421,000 new cases and nearly 90,000 deaths in 2008, the latest available figures. The United States last year saw more than 190,000 new cases and 40,000 deaths.

Tara Beaumont, a clinical nurse specialist at Breast Cancer Care, a British charity, noted that three of the major risk factors for breast cancer — gender, age and family history — are clearly beyond anyone’s control.

What about environmental exposure to chemicals?

IARC, on its World Cancer Day page, notes that it has an active program in the identification of carcinogenic risks. The IARC Monographs identify environmental factors—including chemicals, complex mixtures, occupational exposures, physical and biological agents, and lifestyle factors—that can increase the risk of human cancer.

In other words, there are several other environmental factors besides lifestyle that have been identified.  See the articles below for examples of how environmental factors could be contributing to breast cancer.

While the advice to eat less and exercise more is good (in fact, given that no one really has much direct control over environmental exposures that advice is probably even more important), I find it disturbing that the major risk factors cited in news stories seem to be reduced to diet, lifestyle, gender, age, and family history (that is, genetics), leaving environment out of the picture.

Why is that?  Because it’s easier to blame cancer victims than to confront companies and industries that sell us products that release substances that can mess with our health and who continue to release carcinogens and endocrine disruptors into our air and water?  (I’ll refer you again to the TEDX site, “Prenatal Origins of Cancer” for more information on that.)

Another perspective

In a post “do patients need doctor navigators to use the internet?”, David Collins discusses a March 25 New England Journal of Medicine opinion piece titled “Untangling the Web — Patients, Doctors, and the Internet” in which the authors “expressed a lot of concerns about how the internet is putting patients in touch with a lot of questionable information about disease” and about how they thought that changes the doctor-patient relationship in an adverse way.  (While they do raise some good points about the quality of some of the information on the Internet, I tend to agree with Collins.)

The reason I’m citing that here is the following statement from his post:

When I joined cancer public health in the ’70s the medical community almost universally rejected the idea that food and nutrition had anything to do with the prevention of cancer. People who talked about a relation between nutrition and cancer were sneered at and called the “fruits and nuts” crowd. Thirty-five years later as I approached retirement I had to chuckle inwardly many times about the current enthusiasm for the view that diet and nutrition are key to the prevention of much cancer. These days ya gotta eat your greens and grains!

So even the experts can change their minds….

Finally, it seems that environmental factors only really get attention when there are clusters of rare cancers.

Democratic Senators Eye New EPA Role Investigating Local Cancer Clusters

Environmental Policy Alert – March 24, 2010

From InsideEPA.com’s Environmental NewsStand (pay-per-view news)

Note: The site has a one-time offer of three free articles or documents by creating a new account today.

Senate environment committee Chairwoman Barbara Boxer (D-CA) and Sen. Bill Nelson (D-FL) are working on legislation that would give EPA and the Department of Health & Human Services (HHS) a major new role helping local health agencies investigate and address cancer clusters and communicate risks to local residents.

Press release from Sen. Bill Nelson on legislation

Nelson plans to preview testimony he’s been invited to give at next Wednesday’s hearing (my blog post on the March 17 hearing), which aims to find ways to strengthen the federal government’s hand in investigating cancer clusters, like the Acreage.

Recent Acreage blog post on Nelson’s efforts

Right now the federal Environmental Protection Agency ( EPA ) and Department of Health and Human Services ( HHS ) usually don’t get involved absent a request from a state.
“This effort is aimed at finding ways to bring in more federal resources more rapidly to help protect people, especially little children,” said Nelson, who’s also expected on Friday to announce he’s partnering with U.S. Sen. Barbara Boxer on new legislation to do the same.
Sen. Nelson’s testimony at Senate committee hearing on EPA and children’s environmental health
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