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#265 - Breast Cancer Epidemic Continues; Prevention Philosophy Is Ignored, 24-Dec-1991

A global epidemic of breast cancer is killing more women each year in
all industrialized countries;1 in the U.S., one in every nine women now
gets breast cancer, and the occurrence of this dreaded disease is
increasing steadily.[2] Every year more than 175,900 American women
discover they have breast cancer and every year 44,500 die of it, each
of them robbed of an average of 19 years of life--a total loss to our
society of 825,000 person-years of life each year. After a 20-year "war
on cancer," the nation's cancer establishment still has no firm idea of
the causes of this scourge; now, as we will see, new ideas are
emerging, but from outside the establishment.

The "cancer establishment" is a common name for the the group of men
and women--mostly men--who decide how to spend $2 billion of taxpayers'
money each year on cancer research. Cancer research is an expensive and
fiercely competitive business. As with all scientific research, in
cancer research the questions you ask will limit the kinds of answers
you can get. In addition, your perception of any problem can be
affected by the way you express or display your answers. For example,
incidence of breast cancer is decreasing among women younger than 50
but increasing among women older than 50. So if you average women of
all ages, you mask the effect in older women, allowing you to claim
that the breast cancer picture doesn't look so bad. The "cancer
establishment" likes to average things this way and becomes
aggressively hostile toward people who insist on looking into the age-
specific details.[3]

In the U.S. and elsewhere, breast cancer is one of the most rapidly
increasing cancers. Incidence (occurrence) of cancer is measured as the
number of women who get it among every 100,000 women. Between 1973 and
1986, among U.S. women aged 55-64, breast cancer incidence increased
steadily 1.4% per year until 297 per 100,000 were getting it in 1986.
In the 65-74 age group, breast cancer increased 2.0% each year during
the same period until 412 women among 100,000 were getting it. In the
age group 75-84, breast cancer incidence increased 1.8% each year,
1973-1986, until 447 women out of 100,000 were getting it. Among all
women, aged 45-84, breast cancer increased at a steady 1.4% per year
from 1973 to 1986 until, on average, 318 women out of 100,000 were
getting it.[4]

Not only is the incidence rate increasing, as we saw in the previous
paragraph, but among older women the death rate is increasing as well
(measuring deaths per 100,000 women). Between 1973 and 1988 the death
rate for breast cancer among U.S. women under age 65 decreased 0.3% per
year, but among women 65 and older it increased at a steady 0.9% per
year.[5]

The figures vary not only by age but by race as well. In the period
1973-1988, breast cancer deaths among white women under 65 decreased by
6% but among same-aged black women they INCREASED 11.3%. Among white
women 65 and older, breast cancer deaths increased 11.3% during the
period, but among same-aged black women the increase was 19.5%.[6]

Breast cancer appears to be caused by social and environmental
conditions more than by genetics. Japanese women living in Japan have
about one-quarter as much breast cancer as American women. But when
Japanese women move to America, by the second generation their risk of
breast cancer has risen to "normal" American levels. Something in the
environment--food, air, and water--is at work. Social conditions
probably also make a difference--age of first birth (younger is
better), amount of exercise (some seems to be better than none), animal
fat in the diet (less is better), green vegetables and fiber in the
diet (more is better) and so on.[1],7

Cancer experts believe they understand factors that account for 30% of
breast cancer, leaving 70% of the disease unexplained.[2]

Recently conditions in Israel have shown that chlorinated chemicals (in
this case, pesticides) may be an important cause of breast cancer.[7]
In most industrial countries, deaths from breast cancer in young women
have been decreasing but in Israel in the 1960s and 1970s breast cancer
among young women was INCREASING. Then during the decade 1976-1986, the
death rate from breast cancer dropped sharply among Israeli women 44 or
younger while the death rate among older Israeli women continued to
rise. Improved therapy does not seem to account for the improved death
rate among young Israeli women. What could explain this unusual pattern
in Israel?

Measurements of three carcinogenic (cancer-causing) pesticides in cow's
milk and in human milk in Israel in the 1970s revealed levels of
contamination 5 to 1000 times higher than in the U.S. Lindane, DDE [a
chemical created when DDT breaks down in the environment] and alpha-BHC
were all heavily contaminating Israeli cows' milk and thus human
tissues. Then in 1978 a crescendo of public protest brought a ban, and
thus rapid reduction in all these contaminants. By 1980 breast milk
contamination had dropped 90% or more among Israeli women.

Could these chlorinated carcinogens have caused the unusual reduction
in breast cancer deaths among young Israeli women? Many scientists
outside the "cancer establishment" seem to think so. Corroborating this
view is a soon-to-be-published study revealing that American women with
breast cancer have significantly elevated levels of DDT, DDE and PCBs
in their fat, compared to a control group of women who do not have
breast cancer.[8]

The scientists who studied pesticides and breast cancer in Israel made
the important observation that all known factors contributing to breast
cancer affect the hormone estrogen. As they said, "The thread that
links ALL these factors together runs through the metabolism of
estrogen...."[7] Recall from RHWN #264 and 263 that many common
synthetic [created by humans] chlorinated chemicals now found
everywhere in the environment--including PCBs, dioxins, furans, and
many pesticides--mimic or interfere with estrogen and other sex
hormones in wildlife and humans. Yet so far the cancer establishment
expresses contempt for such ideas because they have not adopted a
prevention philosophy.

One cannot help wonder, if cancer of the penis struck 175,900 U.S. men
each year, followed in most cases by surgical phallectomy [removal],
whether there wouldn't be a pained outcry from Congress with an instant
and generous outpouring of funds to find causes and promote prevention.
Yet in the case of women's most deadly, disfiguring, traumatic and
costly cancer, the good old boys who dominate the cancer establishment
continue funding work on surgery, chemotherapy and radiation--ways to
cut, poison and burn women in the name of saving them--rather than
funding research on ways to maintain women's health through prevention.
Our lack of knowledge of the precise causes of breast cancer, after a
20-year "war on cancer," is a national disgrace and the people
directing this failed "war" should be put out to pasture.

--Peter Montague

=====

[1] Lenore Kohlmeier, Juergen Rehm, and Hans Hoffmeister, "Lifestyle
and Trends in Worldwide Breast Cancer Rates," in Devra Lee Davis and
David Hoel, editors, TRENDS IN CANCER MORTALITY IN INDUSTRIAL COUNTRIES
(New York: New York Academy of Sciences, 1990), pgs. 259-268.

[2] Devra Lee Davis, "Testimony of Devra Lee Davis, Ph.D., M.P.H.,
F.A.C.E before Congress of the United States Human Resources and
Intergovernmental Relations Subcommittee of the Committee on Government
Operations Hearing on Breast Cancer December 11, 1991."

[3] For example, see Eliot Marshall, "Experts Clash Over Cancer Data,"
SCIENCE Vol. 250 (Nov. 16, 1990), pgs. 900-902, where one of cancer's
"good old boys" says age-specific data showing cancer increases are
"boring" and "junk."

[4] Devra Lee Davis, "Testimony..." cited above.

[5] Lynn A. Gloeckler Ries and others, CANCER STATISTICS REVIEW 1973-
1988 [National Institutes of Health Publication No. 91-2789]. Bethesda,
MD: National Cancer Institute, 1991, pg. I-36. [6] Lynn A. Gloeckler
Ries, cited above, pgs. I.[44] and I.[45].

[7] Jerome B. Westin and Elihu Richter, "The Israeli Breast-Cancer
Anomaly," in Devra Lee Davis and David Hoel, editors, cited above, pgs.
269-279.

[8] Discussed briefly in Devra Lee Davis and David Hoel, editors, cited
above, pg. 267; the author of the forthcoming paper is Mary Wolf of Mt.
Sinai Medical Center in NYC.

Descriptor terms: breast cancer; cancer; us; industrialized countries;
japan; israel; pesticides; health; breast milk; cows milk; carcinogens;
chlorinated chemicals; estrogen; prevention;