Inside Prevention

DES and breast cancer lawsuit settled

Big news yesterday out of Boston: Pharmaceutical giant Eli Lilly has settled a case brought against it by four sisters who developed breast cancer in their forties, decades after their mother took the synthetic estrogen DES (Diethylstilbesterol) during her pregnancies. A total of 51 women have filed lawsuits in Boston against more than a dozen companies that made or marketed DES, and this was the first case to go to trial. The settlement was announced Wednesday on the second day of testimony.

This is the latest chapter in the tragic legacy of DES. Between 1938 and 1971, doctors prescribed DES for millions of pregnant women to prevent miscarriages – without having been tested for its effect on fetuses. It is now clear that not only was DES ineffective for preventing miscarriages but it had devastating effects on those exposed in the womb. The drug was banned when daughters of women who took the drug were found to have higher rates of an extremely rare vaginal cancer when compared to the daughters of women who did not take the drug. Later, evidence emerged that DES exposure is also associated with an increased risk of breast cancer in the women who took it during the 1950s.

In a follow-up study of daughters who were exposed prenatally to DES, a nearly twofold increase in breast cancer risk was observed in women older than age 40. An even greater effect was found for women over the age of 50, although relatively few of the daughters had yet reached that age at the time of the study. Women exposed in utero who had the most severe abnormalities of their vaginal epithelial cells (an indicator of exposures to higher doses of DES) also had a higher risk for developing breast cancer. The evidence about the health consequences of DES was one of the first indicators that exposure to endocrine-disrupting compounds in the womb can increase risk for later life breast cancer.

The story of DES should serve as a cautionary tale. This tale underscores the need for chemicals testing protocols that consider the risks of exposures early in life. We need chemical testing that looks at the effects of chemicals across the lifespan and that measures early signs for concern – such as exposure-induced changes to how the mammary gland develops – if we are going to prevent such tragic events in the future. And this evidence needs to be folded into comprehensive chemicals policies that ensure these kinds of exposures do not occur as the result of prescribed pharmaceuticals or from inadvertent exposure to chemicals used for other purposes. 

Now undeniable: Breast cancer that comes with the job (Huffington Post, 11/26/2012)

Our own Jeanne Rizzo published her thoughts about the recent Canadian factory worker study on Huffington Post yesterday. Now we have evidence that women who are exposed to hormone-disrupting chemicals in food canning and plastics factories have a sharply higher risk of breast cancer—so what will we do about it? And who will act on behalf of these women?

Unfortunately for these women workers and for all of us (for we too are exposed to some of these chemicals on a daily basis), many industry and government leaders refuse to act based on biological plausibility. Instead, they prefer plausible deniability, saying we need more and more and more evidence—incontrovertible truth, in fact—before we take action. (Read complete article.)

Related articles

Can certain jobs cause breast cancer? A new study suggests yes (The Daily Beast, 11/21/2012)

Jeanne Rizzo: Now Undeniable: Breast Cancer That Comes With the Job

Study spotlights high breast cancer risk for plastics workers (Center for Public Integrity, 11/19/2012)

Can certain jobs cause breast cancer? A new study suggests yes (The Daily Beast, 11/21/2012)

Florence Williams, author of the acclaimed book, Breasts: A Natural and Unnatural History, spoke with Breast Cancer Fund President and CEO Jeanne Rizzo for a piece on The Daily Beast describing a new Canadian study.

The study authors found a higher risk of premenopausal breast cancer among women working in factories that make canned foods and plastic parts for automobiles:

Both the automotive and canning industries are known to use chemicals that affect hormone systems in lab animals, such as BPA, phthalates, and flame-retardants. Phthalates, which are used to make plastic malleable for molding car interiors, have been associated with lower sperm counts in men. BPA, used in the lining of food cans, has been banned from some products in Canada.

“The U.S. has not conducted this kind of workplace study,” said Jeanne Rizzo, president of the Breast Cancer Fund, a California-based nonprofit. “Federal agencies should immediately look into similar occupations in this country and take this seriously.” (Read complete article.)

Study spotlights high breast cancer risk for plastics workers (Center for Public Integrity, 11/19/2012)

Researchers have found a fivefold increase in breast cancer risk for pre-menopausal women who worked in factories that make food cans or plastic automotive parts, as compared to a control group from the same industrial community. In the course of their work, these women were likely exposed to carcinogens and hormone-disrupting chemicals like BPA, phthalates and flame retardants.

The study was published today in the journal Environmental Health; the Center for Public Integrity interviewed Breast Cancer Fund President and CEO Jeanne Rizzo for an in-depth story also out today: 

“These workplace chemicals are now present in our air, water, food and consumer products,” said one of the two principal investigators, James Brophy, an adjunct faculty member at the University of Windsor and a former occupational health clinic director. “If we fail to take heed then we are doing so at our own peril.”

Jeanne Rizzo, president of the Breast Cancer Fund, a San Francisco-based group that has pressed for more research into environmental causes of a disease that claimed nearly 40,000 lives in the United States last year, called the Windsor study “a very powerful piece of work. The piece that’s really been missing for female breast cancer is occupation.” (Read complete article.)

This is big news—and a call to action for industries and governments to do more to protect workers from toxic chemicals.

Chemical industry tries - again - to get rid of the Report on Carcinogens

Without the Report on Carcinogens, we would not have an unbiased, scientific federal government list of chemicals linked to cancer. And that's exactly why the chemical industry is trying to get Congress to defund it.

The National Toxicology Program has produced the Report on Carcinogens every few years for the last three decades. The Breast Cancer Fund bases our prevention work in part on the chemicals listed in the report, including the banned pesticide DDT, hormone replacement therapy and vinyl chloride. The RoC is one of the foundational sources for our State of the Evidence report, which, in turn, directs our public policy efforts and corporate campaigns.

In short, we need the Report on Carcinogens in order to protect public health.

The chemical industry, on the other hand, would like it to go away to protect profits. In fact, this latest attack on the RoC stems from last year's listing of styrene and formaldehyde, which of course industry opposed.

Today members of Congress received a letter signed by organizations representing thousands of parents, consumers, veterans, and environmental health advocates—including the Breast Cancer Fund—opposing this latest de-funding tactic. Breast Cancer Fund Director of Science Sharima Rasanayagam also signed on to a similar letter from scientists.

We'll continue to do everything we can to protect the Report on Carcinogens, for our health's sake.

For more on the chemical industry's latest maneuver, check out our colleague Jennifer Sass's post from the National Resources Defense Council's blog.

Marin breast cancer linked to vitamin D receptor? (San Francisco Chronicle, 8/8/2012)

California's Marin County, north of San Francisco, has some of the country's highest breast cancer rates. New research explores a vitamin D connection. Though not conclusive, this pilot study points to the need to look beyond traditional risk factors like diet, exercise and family history.

A small pilot study of Marin County women determined through testing to be at high risk for breast cancer found them to be almost twice as likely to have a variant of a vitamin D receptor as the overall population of 338 in the study.

Jeanne Rizzo, president of the Breast Cancer Fund, an advocacy group that focuses on the environmental causes of breast cancer, said it's too soon to stock up on vitamin D.

"But this tells us we should be looking at things that are not just traditional risk factors and it's important to continue this investigation," said Rizzo. (Read complete article.)

Reducing breast cancer risk: what we've learned from the Women's Health Initiative

Ten years ago, the medical world was rocked by the discovery that estrogen-progestin hormone-replacement therapy increased the risk of breast cancer and other diseases in post-menopausal women. Hundreds of thousands of women came off HRT and within a few years we saw the first-ever documented decrease in breast cancer rates.

The discovery was made by the government-funded Women's Health Initiative, a study designed to explore the benefits and risks of combined estrogen-progestin HRT in post-menopausal women. The study was halted in 2002 when researchers saw a 26 percent increase in the relative risk of breast cancer in women taking the combined estrogen-progestin HRT compared with those taking a placebo. There were also significant increases in the risk of heart disease, stroke and blood clots.

A follow-up study done three years later showed increases in invasive cancers in women who had been on HRT. But while breast cancer rates remained elevated in this group, there was a trend towards lower rates similar to those in the placebo group, suggesting that the increased risk for breast cancer from combined HRT is reversible within a fairly short period.

As we look at other chemical exposures linked to breast cancer, the WHI study and the resulting drop in breast cancer incidence should give us great hope. The study showed us that by eliminating an avoidable exposure to chemicals we can reduce breast cancer risk. It gave us a tangible example of why we do the work we do—why we work every day to reduce our exposure to toxic chemicals and radiation linked to the disease. So on this 10^th anniversary, we are thankful to the researchers and women who were part of the study. Because of their contribution, millions of women now have clear information about the risks of estrogen-progestin HRT, and all of us working to prevent breast cancer have a case study for why we must continue to call for more research on the causes of breast cancer and for action—by individuals, corporations and government—to prevent exposure to toxic chemicals and radiation linked to the disease.

Worth a read: How chemicals affect us

Nicholas Kristof calls out canned food and cosmetics as culprits and breast cancer as one tragic effect of our current stew of endocrine-disrupting chemicals. His latest column, published yesterday in the New York Times, makes a strong case for more research and better regulation of these chemicals.

Some of our Hereos, including Pete Myers (2008) and Linda Birnbaum on behalf of the National Institute of Environmental Health Sciences (2012) are involved with a new scientific analysis that raises flags about endocrine disruptors.

Big Chem says all this is sensationalist science. So far, it has blocked strict regulation in the United States, even as Europe and Canada have adopted tighter controls on endocrine disruptors.

Yes, there are uncertainties. But the scientists who know endocrine disruptors best overwhelmingly are already taking steps to protect their families. John Peterson Myers, chief scientist at Environmental Health Sciences and a co-author of the new analysis, said that his family had stopped buying canned food.

“We don’t microwave in plastic,” he added. “We don’t use pesticides in our house. I refuse receipts whenever I can. My default request at the A.T.M., known to my bank, is ‘no receipt.’ I never ask for a receipt from a gas station.” (Read complete article.)

"Endocrine disruptor" is still a foreign term to most Americans, but this is an issue that needs your awareness and action. Read the article and pass it along.

Styrene industry gets Congress’ ear on cancer listing, and we all lose

Today, the National Toxicology Program’s (NTP) crucial Report on Carcinogens is on trial in Congress and the scientists who decided—based on scientific evidence—to list styrene as a reasonably anticipated human carcinogen are being called to defend their work in the face of industry accusations that the listing hurts jobs.

In truth, of course, chemicals linked to cancer hurt our health and the health of workers exposed to them.

Within days of the NTP’s June 2011 decision to list the chemical styrene, trade groups representing the styrene industry attacked the report. In fact, they fought for years to keep styrene out of the report altogether.

Now chemical industry representatives, including a Dow Chemical exec, have pushed themselves in front of lawmakers as part of a Congressional hearing entitled How the Report on Carcinogens Uses Science to Meet its Statutory Obligations, and its Impact on Small Business Jobs.

The Report on Carcinogens was mandated by Congress in 1978. It reviews the peer-reviewed science testing chemicals’ effects on inducing or promoting cancer, and then lists the appropriate chemicals as known human carcinogens or reasonably anticipated human carcinogens. Chemicals that are not suspected carcinogens are not listed in the report.

The NTP and the Report on Carcinogens provides us with robust and thorough evaluations of carcinogens carried out by an objective scientific agency. The report provides essential public health information that can help consumers make informed decisions and support advocacy efforts to reduce exposures to carcinogens.

The Breast Cancer Fund and many of our colleagues have written letters to encourage Congressional support for the NTP and the Report on Carcinogens so that we continue to have rigorously evaluated evidence to help inform our advocacy and educational efforts.

You can watch the hearing live online [the recording will also be available at this link]. Our eyes and voices are critical to keeping the scientific process free of political and economic influence.

Kaiser Permanente detoxes AND saves money

Great news! Yesterday, health-care giant Kaiser Permanente announced it would stop using IV medical equipment made with the toxic chemicals PVC and DEHP.

 

When PVC is made, vinyl chloride—a known human carcinogen— is released, so any move to reduce the use of PVC plastic decreases our exposure to these toxic pollutants linked to cancer. DEHP is one of a group of endocrine-disrupting chemicals called phthalates that have complex effects on several hormonal systems. DEHP has been shown in lab studies to increase breast cancer cell proliferation and to interfere with breast cancer treatment.

 A Washington Post story notes that this switchover affects nearly 100 tons of medical equipment — 4.9 million IV tubing sets and 9.2 million solution bags — each year. Great, right? But it gets better: the change is also expected to save Kaiser almost $5 million a year.

Way to go, Kaiser, for showing that you can do the right thing to reduce toxic exposures and even save money along the way.