Are researchers and doctors downplaying environmental factors?
David Bragi, Special to SF Gate
Monday, February 11, 2002
Christine Clark maintains a healthy diet, exercises regularly and avoids
alcohol and tobacco. She thought she would be the last person on earth to get
breast cancer. But last year, the 53-year-old Palo Alto, Calif., resident
said, she became at least the sixth woman in her 50-house neighborhood to
contract some form of cancer over the past 12 years. "This is only among the
women I personally know," she added.
She suspects that a nearby electrical transformer station may be producing
unhealthy levels of electromagnetic radiation, but she does not know how to
prove or disprove it. "I felt angry as hell when I was diagnosed," Clark
said. "I felt like I did everything possible to not get it. Every medical
person I talked to all said they have no idea what causes it. I personally
wish someone would investigate the environmental probabilities of this
Across the country, citizens have become increasingly aware that toxic-waste
dumps, pesticides, power lines and other sources of pollution or emissions
may be creating cancer clusters in their communities. But many experts feel
that cancer researchers and organizations tend to downplay these
environmental factors and focus instead on lifestyle and genetic causes of
cancer, leaving a big hole in our knowledge of the disease.
More Research Needed
There continues to be evidence of connections between exposure to
environmental hazards and cancer, as well as considerable public interest in
the subject. For instance, 3,500 residents of Anniston, Ala., are suing
Solutia Inc. -- formerly known as Monsanto -- for allegedly contaminating the
community with dangerous levels of polychlorinated biphenyls (PCBs), known
carcinogens, from a local manufacturing plant over the course of several
decades. And in Toms River, New Jersey, 69 families successfully settled a
lawsuit filed against Ciba Specialty Chemicals Corp., Union Carbide Corp. and
United Water Toms River for allegedly causing dozens of cancer cases in local
children via polluted water.
Yet some cancer organizations minimize the potential hazards of industrial
pollutants. For instance, the American Cancer Society's Cancer Facts and
Figures 2002 report states, "Public concern about cancer risks in the
environment often focuses on unproven risks or on situations in which known
carcinogen exposures are at such low levels that risks are negligible."
When cancer researchers do study the effects of potentially harmful
substances, they tend to focus on the effects of short-term and high-dose
exposures, such as a chemical-factory worker caught in the middle of an
industrial accident. What's lacking is much interest in studying long-term,
low-dose exposures, such as the health effects of living close to the same
factory for 20 years.
"Pollution has been overlooked and underfunded as a potential cause of
cancer," said Gina Solomon, senior scientist at the Natural Resources Defense
Council and an assistant clinical professor of medicine at the University of
California at San Francisco. "There is more research being done now than
there used to be, but it's still only a fraction of the total research that's
being done on cancer."
Instead, cancer research generally concentrates on how an individual's
personal behavior or genetic makeup can affect one's risk of developing
cancer, which irks Samuel Epstein, professor of environmental and
occupational medicine at the University of Illinois Medical Center/Chicago
and an authority on the causes and prevention of cancer. "It's focused
virtually exclusively on blaming the victim," he said. "If you have cancer,
it's your own fault. You either chose the wrong [genetic] parents, or you
drink too much or you eat too much fatty foods."
The kind of research required to determine the effects of long-term exposures
to toxic chemicals is complex and expensive. For one thing, it is much easier
and cheaper to ask tobacco addicts how many packs they smoke per day or
whether their parents ever had cancer than trying to calculate how much
contaminated water a person has ingested over a lifetime or how many vats of
chemicals he or she has walked past at work. "To some degree, the science has
followed the path of least resistance and worked to track down the links that
can most easily be made," said Solomon. "So those were the low-hanging fruit;
now we have to reach a little bit higher and try to use more sophisticated
tools to do the research on the environment."
Follow the Money
Sophisticated research tools often require higher levels of funding, and much
of the funding for cancer research comes from the very industries that
produce toxic substances. Critics argue that that this may be affecting the
quality of cancer research. "People are following the money," said Solomon.
"A lot of research is now being done with private funding, and, increasingly,
major corporations are funding schools of medicine and other scientific
institutions. There is a lot of concern that these institutions may not want
to bite the hand that feeds them."
By example, Solomon cited the American Chemistry Council, a trade group that
represents chemical manufacturers. The organization actively funds scientific
research into possible links between chemical manufacturing and problems in
the environment, such as health risks. Yet, she claimed, "for the most part,
research funded by the American Chemistry Council comes out showing there are
no links. Some scientists look with skepticism on those results."
According to a brochure put out by the council, in 1999 it committed $100
million over five years to fund health and environmental research related to
chemical use. Many in the scientific community, and laypersons as well,
however, remain unconvinced of the impartiality of their results. For
instance, one of the findings in the brochure mentioned a recent study of
"low-level environmental exposures to chloroform," which concluded that
"tumor formation in animals is not relevant to chloroform risk assessment for
David Clarke, senior director of the council's Science Policy Team, responds
to allegations of bias by emphasizing the industry's reliance on scientific
research. The council's confidence in science, he said, is based on the
principle that it matters not who does the science, but how it is done.
"That's why science is the most universally shared form of knowledge, and
makes progress where mere opinion remains stalled," Clarke added. "It allows
skeptics to check and recheck results, and to challenge them based on facts."
Doctors Who Don't Know
Regardless of how cancer researchers do their work, physicians who actually
treat patients can make use only of the knowledge available to them. Yet
medical schools pay little attention to the topic, according to Ted
Schettler, a physician and the science director of the Science and Health
Environmental Network. "You find very little in the way of course-material
content being given to physicians in training with respect to environmental
contributors to human disease," he said.
So when patients are diagnosed with cancer, attending physicians are likely
to attribute the cancer solely to lifestyle or genetic makeup, which doctors
are more likely to have studied.
"When a doctor sees a patient who comes in with lung cancer, that doctor will
say, 'Did you smoke?'" said Solomon. "Even if the patient just smoked a tiny
amount, that cancer is written down and written off as being smoking related,
when that may or may not be true. That person might have smoked and gotten
away with it if they hadn't also been exposed to asbestos or diesel exhaust,
"So I think that in the overwhelming mass of smoking-related cancers, there
are still a number of other environmental cancers that are hiding," she
added, "and they may even be linked."
Even a knowledgeable physician may prefer to concentrate on those areas, such
as lifestyle, where the doctor-patient relationship can have the most impact.
"Physicians who see individual patients in their offices can talk to them
about their diet, their exercise, their smoking habits, whether or not they
wear seat belts, how much sleep they get, whether they abuse drugs and a
variety of other personal habits that the patient has immediate control
over," said Schettler. "There is little that that physician can say to the
patient about avoiding breathing air pollutants or something that might be in
the public water supply."
Critics of current trends in cancer research allege that America is poisoning
its own nest. Those allegations need the opportunity to meet the test of
thorough scientific research, free of political influence. Industry sources
suggest that factories and buses and transformers are more reliable than our
fears of them, but to be truly reassuring, these claims need to be confirmed
or refuted by independently funded studies conducted by researchers with no
financial interest in the outcome.
There is a need for more and better research into possible links between
cancer and our modern world's highly industrialized, artificial environment.
Cancer patients, as well as their physicians, families and neighbors, deserve
some real answers.
David Bragi, a freelance journalist who lives in El Cerrito, California, is
Editor of the multicultural webzine New Tribal Dawn.
©2002 SF Gate
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