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#520 - Brain Cancer Update, 13-Nov-1996

In the U.S., brain cancer has been steadily increasing about 0.7% per
year since 1973. This steady increase is noteworthy by itself. However,
among people over age 65, brain cancer has been increasing 2.9% each
year, an astonishingly rapid rise in a cancer that is almost always
fatal in the elderly. At this rate, the disease is doubling every 23
years among the elderly. Today roughly 17,500 Americans (9600 males,
7900 females) are diagnosed with new brain cancers each year.[1] During
the period 1973-1990 brain cancer steadily increased in other
industrialized countries as well, especially among the elderly.[2]

Naturally the question arises, are these increases real or do they
simply reflect better diagnosis? Several careful studies of this
question have concluded that much of the increase in brain cancer is
real, and does not merely reflect better diagnosis.[3] For one thing,
the steady increases began before the invention of modern diagnostic
equipment. New imaging techniques (cat scans in the mid-1970s, and
magnetic resonance imaging [MRI] in the 1980s) did make the diagnosis
of brain tumors easier and more accurate. When cat scans and MRI became
available, brain tumors formerly missed were now found; on the other
hand, non-cancer brain problems formerly misdiagnosed as brain tumors
could now be properly identified as something besides cancer.
Furthermore, analysis has determined that the AIDS epidemic is not the
cause of the observable brain cancer increases.[3]

Although the causes of brain cancers remain a mystery, in all
likelihood the problem has multiple sources including dental x-rays;[4]
occupational exposures to chlorinated hydrocarbons, organic solvents,
paints and oils;[5] pesticides;[6] electromagnetic fields (EMF);[7]
hormonal status in women;[8] and N-nitroso compounds.[9]

Because brain cancers are increasing in both men and women,
occupational exposures are unlikely to be a major cause. A new study
published this month suggests that the artificial sweetener, aspartame
(marketed as Nutrasweet and Equal), may be implicated.[10] At least
half of the American people --knowingly or not --now expose themselves
to aspartame in "diet" food products and soft drinks. Aspartame is 180
times as sweet as sugar, so provides sweet taste with fewer calories.

When G. D. Searle, the pharmaceutical manufacturer, sought approval for
aspartame from the U.S. Food and Drug Administration (FDA) in 1973, a
long controversy ensued.[11] Some scientists within the FDA suspected
that aspartame might cause brain cancer in laboratory animals. If this
were shown to be true, aspartame would have been banned under federal
law. FDA initially approved aspartame for certain food uses in 1974,
but two citizens --John W. Olney, M.D., and James S. Turner, challenged
that decision and requested a full hearing. To settle the controversy
and avoid the expense of a full hearing, FDA Commissioner Donald
Kennedy established an independent Public Board of Inquiry (PBOI)
consisting of 3 qualified scientists from outside the agency. The PBOI
reviewed the available data and drew conclusions from it. On October 1,
1980, the PBOI issued its decision, saying "the evidence suggested that
aspartame might induce brain tumors" in laboratory rats and,
accordingly, the PBOI concluded that aspartame "should not be approved
for marketing until further animal testing was conducted to resolve the
brain tumor issue." In response to the PBOI's findings, FDA revoked
Searle's license to sell aspartame.[11,pg.38289]

However, later that same year (1981) a new FDA Commissioner, Arthur
Hull Hayes, Jr., appointed by President Ronald Reagan, simply reversed
the decision of the PBOI and licensed aspartame for "dry" uses as a
substitute for sugar.[11] No new studies were initiated to shed light
on the question of brain cancer. Under the guidance of Dr. Hayes, FDA
simply reinterpreted the old data and asserted that the reinterpreted
data showed that brain cancer was not a problem. Thus aspartame became
a legal --though intensely controversial --food additive.

In 1983, Commissioner Hayes extended Searle's aspartame license to
include its use as a sweetener in "diet" soft drinks, and aspartame
sales took off. In 1985 Monsanto bought Searle, and Monsanto now
aggressively markets Nutrasweet for "diet" sweeteners, selling roughly
20 million pounds of aspartame for use in the U.S. each year at $90 per
pound, plus unknown quantities overseas. On average, Americans ingest
38 grams of aspartame per person per year.[12] (Meanwhile, intake of
total calories per person per day in the U.S. has increased from 3300
in 1970 to 3700 in 1990, so "diet" foods and drinks are not having the
desired effect, overall.)[13]

The aspartame study published this month, by John W. Olney of
Washington University in St. Louis, suggests that the steep increases
in brain cancer in Americans in the 1980s and 1990s may have been
caused by exposure to aspartame.

Olney offers three reasons for concern:

(1) The kinds of cancer rising most rapidly in people (glioblastomas)
are the same kind found in 3.8% of aspartame-fed rats in one of
Searle's studies;

(2) Monsanto asserts that aspartame could not cause cancer because it
breaks down into harmless constituents in the human stomach,[14] but
Olney points to a 1993 study showing that aspartame can be nitrosated
and therefore might be expected to become a N-nitroso compound in the
human stomach. N-nitroso compounds are potent carcinogens, some linked
to brain tumors.[15]

(3) Olney analyzes the National Cancer Institute's (NCI) data[1] and
finds two sharp increases in brain cancers. He believes aspartame might
have caused these increases because it was introduced rapidly, whereas
other suspected causes of brain cancer (listed above) were introduced
gradually and would not be expected to cause sharp increases. Olney
says cancer requires several cell injuries, and older people may
acquire many such injuries during their lives and may thus be ready to
be "pushed over the edge" by exposure to aspartame. This could explain
the short delays between introduction of aspartame to the American diet
and the rapid rises in brain cancer that Olney points to in the NCI
data. (Cancers are usually delayed by a decade or more after exposure
to a cancer-causing agent, but Olney points to brain cancer increases
only a couple of years after FDA approved aspartame.)

Wherever the truth lies, FDA is unlikely at this point to re-examine
the safety of aspartame. To do so would be, in some sense, to admit the
haste --perhaps it could even be termed foolhardiness --of its earlier
decision to ignore the evidence of brain tumors in rats fed aspartame.

The issue back in 1980 was this: In one Searle study, 3.8% of
aspartame-fed rats got brain tumors. What was the "normal" rate of
brain tumors in this strain of rat (known as Sprague-Dawley rats)?
Commissioner Hayes acknowledged that all of the data available to
answer this question had "flaws" (his word) because the "normal"
animals had ALL been exposed to experimental chemicals or drugs, or had
been fed irradiated food. However, instead of ordering new studies that
would avoid such flaws, to answer this important question Dr. Hayes
simply asserted that a 3.8% rate of brain tumors in aspartame-fed rats
was not significantly different from the rate of brain tumors in
"normal" rats.[11,pgs.38312-38315] Furthermore, when the Commissioner
applied two statistical tests (of his own choosing) to the data in this
study, those tests showed significant increases in brain cancers among
female rats fed aspartame. The Commissioner then removed one of the
aspartame-fed rats from the study, asserting that its brain tumor had
not been caused by aspartame. After the removal of this rat, the cancer
increases were no longer statistically significant.[11,pg.38320] Thus
FDA approval of aspartame appears to have been tainted by decisions
based on something other than science. It seems reasonable to ask that
such approval be reconsidered now, given that human brain cancers are
steadily and rapidly increasing.

Nevertheless, FDA has dug in its heels on this issue, and it apparently
will be left to independent researchers to examine the health
consequences of exposing half (or more) of the population to aspartame.
Given that funding for scientific research in the U.S. --including
research at academic institutions --is increasingly controlled by
private corporations, and not by government or other independent
sources, it is difficult to see where the necessary research funds
could come from. In any case, a huge experiment is being conducted now
on more than 100 million Americans. Whether anyone cares to analyze the
data from this experiment, or not, remains to be seen.

--Peter Montague (National Writers Union, UAW Local 1981/AFL-CIO)

=====

[1] Benjamin F. Hankey and others, "Brain and Other Nervous System
[Cancers]," in Barry A. Miller and others, editors, SEER CANCER
STATISTICS REVIEW 1973-1990 [NIH Publication No. 93-2789] (Bethesda,
Maryland: National Cancer Institute, 1993, pgs. III.1-III.20. And:
Nigel H. Greig and others, "Increasing Annual Incidence of Primary
Malignant Brain Tumors in the Elderly," JOURNAL OF THE NATIONAL CANCER
INSTITUTE Vol. 82, No. 20 (October 17, 1990), pgs. 1621-1624.

[2] Yang Mao and others, "Increasing Brain Cancer Rates in Canada,"
CANADIAN MEDICAL ASSOCIATION JOURNAL Vol. 145, No. 12 (December 15,
1991), pgs. 1583-1591. And: M. Bahemuka and others, "International
Mortality from Primary Nervous System Neoplasms: Distribution and
Trends," INTERNATIONAL JOURNAL OF EPIDEMIOLOGY Vol. 17, No. 1 (1988),
pgs. 33-38. And: Are Helseth and others, "Neoplasms of the Central
Nervous System in Norway," APMIS Vol. 96 (1988), pgs. 1066-1074. And:
Anders Ahlbom and Ylva Rodvall, "Brain Tumor Trends [letter]," THE
LANCET November 25, 1989, pg. 1272. And: Y. Ben-Shlomo and G. Davey
Smith, "[Untitled letter]," THE LANCET November 25, 1989, pgs. 1272-
1273. And: F. Levi and C. La Vecchia, "Trends in Brain Cancer
[letter]," THE LANCET October 14, 1989, pg. 917. And: Anders Ahlbom,
"Some Notes on Brain Tumor Epidemiology," in Devra Lee Davis and David
Hoel, editors, TRENDS IN CANCER MORTALITY IN INDUSTRIAL COUNTRIES
[Annals of the New York Academy of Sciences Vol. 609] (New York: New
York Academy of Sciences, 1990), pgs. 179-190. And: Devra Lee Davis and
others, "Is Brain Cancer Mortality Increasing in Industrial Countries?"
AMERICAN JOURNAL OF INDUSTRIAL MEDICINE Vol. 19 (1991), pgs. 421-431.
And: Devra Lee Davis and others, "Is Brain Cancer Mortality Increasing
in Industrial Countries?" in Devra Lee Davis and David Hoel, editors,
TRENDS IN CANCER MORTALITY IN INDUSTRIAL COUNTRIES [Annals of the New
York Academy of Sciences Vol. 609] (New York: New York Academy of
Sciences, 1990), pgs. 191-204.

[3] Marie Desmeules and others, "Increasing Incidence of Primary
Malignant Brain Tumors: Influence of Diagnostic Methods," JOURNAL OF
THE NATIONAL CANCER INSTITUTE Vol. 84, No. 6 (March 18, 1992), pgs.
442-445. And: Nancy L. Eby and others, "Increasing Incidence of Primary
Brain Lymphoma in the US," CANCER Vol. 62 (1988), pgs. 2461-2465. And:
Peter Boyle and others, "Is the Increased Incidence of Primary
Malignant Brain Tumors in the Elderly Real?" JOURNAL OF THE NATIONAL
CANCER INSTITUTE Vol. 82, No. 20 (October 17, 1990), pgs. 1594-1596.
And: Mark. H. Werner and others, "The Increasing Incidence of Malignant
Gliomas and Primary Central Nervous System Lymphomas in the Elderly,"
CANCER Vol. 76 (1995), pgs. 1634-1642.

[4] S. Preston-Martin and others, "Risk factors for gliomas and
meningiomas in males in Los Angeles County," CANCER RESEARCH Vol. 49
(1989), pgs. 6137-6143. And: S. Preston-Martin and S.C. White, "Brain
and salivary gland tumors related to prior dental radiography:
implications for current practice," JOURNAL OF THE AMERICAN DENTAL
ASSOCIATION Vol. 120, No. 2 (1990), pgs. 151-158.

[5] S. Cordier and others, "Gliomas and exposure to wood
preservatives," BRITISH JOURNAL OF INDUSTRIAL MEDICINE Vol. 45 (1988),
pgs. 705-709. And: Terry L. Thomas and Richard J. Waxweiler, "Brain
Tumors and Occupational Risk Factors," SCANDINAVIAN JOURNAL OF WORK,
ENVIRONMENT AND HEALTH Vol. 12 (1986), pgs. 1-15. And: Katherine Mallin
and others, "Occupational Cancer Mortality in Illinois White and Black
Males, 1979-1984, for Seven Cancer Sites," AMERICAN JOURNAL OF
INDUSTRIAL MEDICINE Vol. 15 (1989), pgs. 699-717. And: M. Musicco and
others, "Gliomas and occupational exposure to carcinogens: case-control
study," AMERICAN JOURNAL OF EPIDEMIOLOGY Vol. 116 (1982), pgs. 782-790.
And: R.M. Park, "Brain cancer mortality at a manufacturer of aerospace
electromechanical systems," AMERICAN JOURNAL OF INDUSTRIAL MEDICINE
Vol. 17 (1990), pgs. 537-552. And: Ross C. Brownson and others, "An
Analysis of Occupational Risk Factors for Brain Cancer," AMERICAN
JOURNAL OF PUBLIC HEALTH Vol. 80, No. 2 (February 1990), pgs. 169-172.

[6] A. Blair and others, "Lung cancer and other causes of death among
licensed pesticide applicators," JOURNAL OF THE NATIONAL CANCER
INSTITUTE Vol. 71 (1983), pgs. 31-37. And: M. Musicco and others, "A
case-control study of brain gliomas and occupational exposure to
chemical carcinogens: the risk to farmers," AMERICAN JOURNAL OF
EPIDEMIOLOGY Vol. 128 (1988), pgs. 778-785.

[7] R.S. Lin and others, "Occupational exposure to electromagnetic
fields and the occurrence of brain tumors," JOURNAL OF OCCUPATIONAL
MEDICINE Vol. 27 (1985), pgs. 413-419. And: W. Mack and others,
"Astrocytoma risk related to job exposure to electric and magnetic
fields," BIOELECTROMAGNETICS Vol. 12 (1991), pgs. 782-790.

[8] P.M. Black, "Brain Tumors, Part II," NEW ENGLAND JOURNAL OF
MEDICINE Vol. 324 (1991), pgs. 1555-1564. And: B. Schlehofer and
others, "Association between brain tumors and menopausal status,"
JOURNAL OF THE NATIONAL CANCER INSTITUTE Vol. 84 (1992), pgs. 1346-
1349.

[9] A. Koestner, "Characterization of N-nitrosourea-induced tumors of
the nervous system; their prospective value for studies of
neurocarcinogenesis and brain tumor therapy," TOXICOLOGIC PATHOLOGY
Vol. 18, No. 1 part 2 (1990), pgs. 186-192.

[10] John W. Olney and others, "Increasing Brain Tumor Rates: Is There
a Link to Aspartame?" JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL
NEUROLOGY Vol. 55, No. 11 (November 1996), pgs. 1115-1123. And see:
H.J. Roberts, "Does Aspartame Cause Human Brain Cancer?" JOURNAL OF
ADVANCEMENT IN MEDICINE Vol. 4, No. 4 (Winter 1991), pgs. 231-241. And
see: Russell L. Blaylock, EXCITOTOXINS; THE TASTE THAT KILLS (Santa Fe,
N.M.: Health Press [P.O. Drawer 1388, Santa Fe, N.M. 87504], 1994).

[11] Arthur Hull Hayes, Jr., "Aspartame: Commissioner's Final
Decision," FEDERAL REGISTER Vol. 46 (July 24, 1981), pgs. 38285-38342.

[12] Table 225 in STATISTICAL ABSTRACT OF THE UNITED STATES 1995
(Washington, D.C.: U.S. Government Printing Office, 1995).

[13] Table 224 in STATISTICAL ABSTRACT OF THE UNITED STATES 1995
(Washington, D.C.: U.S. Government Printing Office, 1995).

[14] Robert Frank, "Aspartame Critic Seeks More Research on Possibility
of Links to Brain Tumors," WALL STREET JOURNAL November 8, 1996, pg.
B5.

[15] S.E. Shephard and others, "Mutagenic Activity of Peptides and the
Artificial Sweetener Aspartame after Nitrosation," FOOD AND CHEMICAL
TOXICOLOGY Vol. 31 (1993), pgs. 323-329. And see note 9.

Descriptor terms: brain cancer; statistics; x-rays; dental x-rays;
occupational safety and health; emf; n-nitroso compounds; hormones;
aspartame; nutrasweet; equal; searle; monsanto; fda; food safety; john
olney; james turner; donald kennedy; arthur hull hayes, jr.;
carcinogens;