As you already know if you came here from esteemed correspondent Jeanne Sather's blog The Assertive Cancer Patient, the day before yesterday, my true love (now aka "Harvard muffin") forwarded me an e-mail, which read in pertinent part:
October 17, 2007
7:30–9:30 pm
104 Harvard HallWhile treatments are better for cancer and survival rates higher, there are significantly more newly diagnosed cancers than ever before. Devra Davis, cancer epidemiologist and environmentalist, and author of a new book, The Secret History of the War on Cancer, will discuss how the toxins in our environment are contributing to this surge in cancer, how scientists are influenced by the companies who fund their research, and her vision for a healthier environment. After the talk, The Secret History of the War on Cancer will be available for purchase and signing.
Devra Davis is the director of the Center for Environmental Oncology at the University of Pittsburgh Cancer Institute. The event is sponsored by the Harvard Extension School’s Environmental Management program.
Attendees should RSVP to George Buckley at [email protected] by noon on Tuesday, October 16.
My little Harvard muffin invited me to join him at this talk, to which he was invited because of a class he's taking in epidemiology this semester.
Pardon me while I seem to digress for a moment. I promise it will make sense in a minute.
You may not remember this, but October 17, 1989, was the day of a giant earthquake in the Santa Cruz Mountains which rocked the San Francisco Bay Area. I was then living in the Santa Cruz Mountains. As it happened, I had just been diagnosed with malignant melanoma the day before (October 16) in Los Gatos, and then that morning in San Jose had been ordered to my first surgery ever, scheduled for the very next day, October 18. Thus on October 17 my friends at work had taken me out drinking at lunchtime. Thus it happened that I was sitting on the toilet drunk off my ass and terrified for my life on the top floor of a small San Jose office building when the big one hit.
Oh, the glamour that is my existence in this world.
So maybe even knowing that background you still won't get this, but the fact is, going to listen to this woman speak seemed to me like a perfect way for me to spend the 18th anniversary of that particularly bad, weird day. To my delight, it proved to be an extremely useful and validating experience.
Dr. Davis had a lot to say, and most of it is in her new book, the aforementioned Secret History of the War on Cancer. Though I shall happily share with you here some excerpts from my notes on her talk, you should understand that I could not possibly write down everything she said, and strongly recommend that you get your hands on a copy of this book. (We would have purchased it ourselves, but sadly brought no cash. We will be rectifying this shortly, and after I read it, I may have further notes to share.)
Dr. Davis, a Harvard alumnus, began her talk by telling us a little about herself. Turns out she grew up in Donora, Pennsylvania. She explained the significance of this, that this was a town in the Rust Belt where once upon a time in the 1940s 18 people in one day dropped dead of air pollution. She told us how both her parents died of cancer, her father who had once surved a benzine explosion at age two and then spent his whole life working with chemicals in one capacity or another and/or simply living in that town leaving the world at age 55 of multiple myeloma, her mother some years later of stomach cancer.
She told us how as a child, one day she came home from school in a nearby city (Pittsburgh, I think she said) and asked her mother if there was another town called Donora in Pennsylvania. Her mother got quiet and asked her why she was asking that. Davis told her that they'd heard in school that day about a town with the same name as their town that was supposed to have terrible pollution.
"Well," said her mother, "do you know how sometimes we have to drive around with our lights on even at 2:00 in the afternoon? And do you know how we have to clean the walls of the house every month because they turn all brown? Well, I guess nowadays you'd call that 'pollution,' but we always just called it 'making a living.'"
All this is not only part of the subject of her first book, When Smoke Ran Like Water, but also why Dr. Davis grew up to be an environmental oncologist. Now, looking around and seeing how all cancer-related research money seems to be going toward treatment and none toward figuring out the causes of cancer, and why cancer has become this unchecked, ballooning epidemic for all humanity, she has written a book about some of the stuff we do know, why we don't know more, what she feels we ought to be paying more attention to, and what we ought to be demanding of science, government and industry to start putting this whole dynamic in check.
One reason this seems to her especially urgent, she says, is that in the developing world, as chemicals and more technologically advanced manufacturing processes increase, so do the rates of cancer, and yet there is no advanced diagnosis or treatment for cancer, no chemo or radiation therapy or gene therapy or thousand-dollar-a-pill pharmaceuticals in any of these places. And these places are most of the world. So while it has always been urgent that we look for and address environmental causes of cancer, now it is more urgent than ever.
That's just one reason, though. Others closer to home seem fairly obvious.
Dr. Davis talked (and talks in her latest book) about all the things that are known to cause cancer, how long we have known about them, and why we have "forgotten." Radiation, for example, was a known danger by the early 1900s when famous people who worked with developing it into something useful had already died of their exposure to it, people like Mme Curie and a cherished assistant of Thomas Edison. Dr. Davis went on to list these known cancer causes as reported in 1936 by the International Congress of Scientific and Social Campaign Against Cancer, a group of serious scientists around the world:
- hormones
- X-radiation
- solar radiation
- coal tars/soots
- benzene
- cobalt and uranium mining
One member of the Congress, a Dr. Ruffo who had his own clinic in Buenos Aires, had already drawn a connection between cancer and, guess what, yes:
- tobacco
- suntanning
White people need 15-20 minutes of sunlight a day in order to use Vitamin D; people of African descent need more; however, as early as the 1930s, it was known that excessive solar radiation would cause skin cancer.
So if the world already knew all these things in 1936, how did the world seem to forget? That's when the story turns ugly. (And it's probably nothing you don't already know unless you just fell off the turnip truck yesterday.)
As I understood her explanation, one big deterrent from attention toward all these things was militarization. When war came to Europe, that's where all technological attention got focused. This also was a time when large businesses came into their greatest wealth and power ever.
Dr. Davis told the story of an organization called the Women's Field Army, headed by Marjorie Illig (a radiologist "until marriage," according to her biography) and a Dr. Clarence Cook. This was a radical organization which advocated things like birth control and took up the cause of cancer in the 1930s and '40s. At this time, most women who got "women's" cancers (e.g., ovarian, uterine, breast) simply died of them. Part of why was their inability to talk to their [almost universally male] doctors even when they could feel something going very wrong with these particular areas. The Women's Field Army began campaigns to educate women and help them feel more comfortable bringing these issues up with their doctors, who were then supposed to know what to do about it, get them into treatment and save their lives. And many lives were saved as a result of their efforts.
There are some weird little side stories here, though. The pap smear had already been invented by the late 1920s and proven accurate and an effective way to save lives by 1942. However, it was not implemented in this country until the late 1950s, and not in England until 1988. In this country, specifically within the American Cancer Society, Dr. Davis says a huge fight raged. It was part of the Red Menace madness. Many feared that the pap smear represented taking control out of the hands of private medical practice and giving way to the rise of socialism. Meanwhile, women died.
I am not clear on what the excuse was in England.
Meanwhile, remember how the WFA was founded in part by Dr. Clarence Cook? Well, after WWII, Dr. Cook went to work for the tobacco industry, which in collaboration with both the AMA and the American Cancer Society happily funded many studies about cancer and its causes -- as long as tobacco was excluded. You could say that Big Tobacco and these two supposedly philanthropic organizations bribed doctors not to look at tobacco. This went on for decades, well into recent years, well into my lifetime and probably yours. This is now common knowledge, but it's not the only instance of this kind of chicanery.
Dr. Davis talked about how many published statistics are misleading, and why some don't exist. She talked about the town Reveilletown, LA, a polluted factory town until the 200 inhabitants were paid to move away -- paid as long as they signed documents promising never to complain if they got sick and never to provide any data about their health and where they'd lived to any data gatherers. There's a similar story to be found in Mossville, LA, another town that no longer exists. The CDC has studied the blood of surviving residents of that town and found high levels of dioxin, but this is the only data available because the company that caused the pollution there paid well to prevent other data from ever being collected.
Apparently, there are lots of stories like this, many lost forever. These are just two in one very poor state.
Davis told a sad story of being asked by a mentor, Sir Something-or-Other, a Great God of Cancer Science whose name I failed to write down (but I'm sure it's in the book), to reconsider data on a paper she was writing, data which linked certain statistics about pollution and cancer. And she did reconsider, and she did edit her interpretation of the numbers and tone down her conclusion. He was a Great God, after all; surely he must be right and she would bow to his experience and understanding. Then the Great God died and she found out that he'd been on the Monsanto payroll for years. And now she has to wonder for the rest of her life whether his advice came from genuine concern for truth in reporting, or whether it was influenced by his hidden masters.
Then there are statistics such as the recently released one that deaths from cancer in the U.S. have gone down two percent a year for the last ten years. This is big news. You know what else is big news? Cancer diagnoses are up.
Fewer men are dying of smoking-related cancers. Yay, right? However, more men are being diagnosed with cancers not related to smoking than ever before. Non-Hodgkins lymphoma is up, especially in Italy and Japan, and in this country among farmers, men who work with solvents, and people who work with chemicals like napthylene (sp? the stuff in moth balls).
For women, smoking-related cancer diagnoses are up, cancers not related to smoking are up, and women today are being diagnosed with breast cancer at 1.5 times the rate of their grandmothers. Only one in ten women diagnosed with breast cancer has gotten it as a result of genetic material passed on from one of her parents. All the rest are happening for other reasons, but hardly any effort or money is devoted to studying those other reasons. Almost all breast cancer money goes toward treatment, which is very, very lucrative, especially, as I know from reading the Breast Cancer Action site and other materials beyond those included in this particular talk, when a company can make money both from toxic chemicals such as pesticides and very expensive cancer medications. (Astra Zeneca, I'm looking at you, you and your sickening "Honey, we'll get through this together" advertising campaign perpetrated last October. As Jeanne would say, "Gag me on a pink ribbon." But I digress.)
Another thing to bear in mind: less than 15% of the population of the United States is over 65 years of age, but this is the population in which 85% of all cancers are diagnosed.
One of the slides Dr. Davis showed us at the beginning of her talk was about identical twins. Identical twins are not in fact perfect clones of each other, but as close as we have to matching sets of DNA. She showed the DNA of identical twins at age three, and you could already see some differences between the strands, but not huge. Then she showed the DNA of identical twins at age 50. These strands show radical differences. You would never guess they were from twins. Her belief is that environment and experience account for the differences. Her belief is that people are getting so much cancer at age 65 and older simply because they have lived the longest and thus been exposed to the greatest number of pollutants.
As yet another tiny example of the overwhelming amount of data she sees as proof that many cancers are caused by exposure to environmental contamination, much of it completely avoidable, Dr. Davis told the story of a friend of hers who developed bladder cancer at age 19. In fact, the patient's whole family was riddled with cancer. Thing was, the patient was adopted and shared no genetic material with any of these people. The only thing they had in common was the polluted town where they lived.
There's also the way we overuse and misuse certain technological assets of our current world. Cell phones really can cause brain cancer, and standards for the cancer-causing emissions which sink two inches into the cranium vary drastically from nation to nation. As Dr. Davis says, cell phones save lives. However, the way they are being used, especially by young people who live with them practically glued to their heads, is not safe at all. (Hint: Use earbuds.)
Per one of Dr. Davis' slides, according to a paper published in the Journal of the American College of Radiologists (and she cited "J Am Coll Radiol 2007; 4:272-284"), the amount of radiation emitted in the United States in connection strictly with diagnostic tests each year is equal to that emitted by the explosion at Chernobyl. Furthermore, one CT scan of a baby's head can submit the child to the equivalent radiation from between 200 and 6000 chest X-rays in one go. Children are ten times more vulnerable to the ill effects of radiation than adults. And yet, we have no federal standards for the training and certification of CT technicians, and no national database on radiation doses. Records are not kept from birth of the specific amount of radiation to which each child has been exposed just from diagnostic testing.
Dr. Davis made the point in her talk that we are receiving ten times more tests in our lives than our predecessors, and yet we are not ten times more healthy. In fact, the overuse of certain kinds of tests may be making us sicker. (Annual mammograms, anyone?)
I could go on and on with the statistics she quoted. Really, at this point, I think you get the idea and should just go buy the book.
As part of a handful of proffered solutions, Dr. Davis encouraged what she calls "girlcotting." Boycotting is saying no to things, she said. "Girlcotting" then would be saying yes. She bases the word (which she may or may not have coined; I don't know) on the fact that it is women who do the shopping for households, and women who are taking more and more interest in ingredients and saying not just no to horrible household chemicals but yes to genuinely safer alternatives.
She encourages parents to really not let their kids use cellphones without earbuds, and to find out before allowing children to undergo CT scans exactly how much radiation the children will be exposed to and if equivalent or better data cannot be gathered by a single X-ray or an MRI.
Dr. Davis urged against the use of anti-microbial soaps. They contain Lyban which combines with chlorine in our tap water to create chloroform, which is highly toxic.
She told us there are lots of ERs now where they automatically give you vitamins, antioxidants and selenium, when you come in with a trauma. She reminds us that there is much we can do with exercise and nutrition (though I have to say I think that's more about overall health and ability to fight disease rather than cancer prevention, because I've known a lot of non-steroid-using gym rats who eat their organic broccoli religiously to get all kinds of cancers).
On one of her slides, besides her own website Dr. Davis also listed the following useful links:
PreventingCancerNow.org or
EnvironmentalOncology.org
if your browser won't take you there
Toxipedia.org
ewg.org
Visit them for even more information.
Many smart students asked many smart questions. How, for example, can doctors not know things like the potential damage that can be done with too many radiation-based diagnostic tests? How can doctors not know or think about how much radiation a person is getting during such a test? Why are they ordering so many? Dr. Davis pointed out that medical training is highly specialized and that there are a range of options via which a person can get radiation-based diagnostic testing, from an ER where it's all about saving a life right now and to hell with the long-term consequences of the method to a strip mall full-body scan joint where you pay your X-hundred dollars and then they CT your whole body, no prescription necessary, just to find out if there's anything you should be worried about.
Another question was about doctors now being in bed not with the tobacco industry but with Big Pharma. Dr. Davis referred us to a book by Marcia Angel on this topic. She told us there are absolutely no systems in place to prevent this same kind of abuse from happening over and over again, none whatsoever. However, I think I understood that she expects this may change as increasingly high numbers of doctors themselves suffer cancer. The cryptic note I wrote at this point was
1 of 4 die of cancer
1 of 2 are drs.
I think what I meant to write was that one in four of all deaths recorded are attributed to cancer right now, and that one of every two cancer deaths is that of a doctor, but that seems kind of high. Still, there is something going on here, and as more and more doctors themselves experience the joy that is cancer treatment, something is bound to change.
Dr. Davis closed the formal portion of her talk with a quote from Spinoza, "If you want the future to differ from the past, you must study the past," and a photo of a German statue outside one of the concentration camps entitled The Defiant Inmate, which she also used at the close of her first book. The statue shows a concentration camp prisoner standing straight up, looking up, with his hands in his pockets, a pose which would apparently have gotten a real prisoner shot all by itself. I don't speak German, but if I transcribed it correctly, the inscription reads, "Den totem zur ehr den lebenden zur mahning," or "We honor the dead to warn the living." My understanding was that she meant to make the point that nothing will change unless all of us stand up like the defiant inmate and individually and collectively demand it, and unless we take a good, honest look at what has been the so-called War on Cancer started even before Nixon officially named it in 1971 in part to distract attention from his failure at war in Southeast Asia and commit ourselves at last to making it real, one by one, demanding answers not marketing campaigns and cover-ups, purchasing only safe, healthful foods and products, and demanding that significantly more of our collective resources go toward determining causes of cancer and eliminating them even if it inconveniences the most powerful people and companies in the world -- and even if it inconveniences us personally. (I might be editorializing a bit, but I'm pretty sure this was her point.)
Then, as part of the second-to-last smart question anybody asked her before the lecture broke up, my true love, since Davis had mentioned both pollution of a particular Chinese town and cell phones, told the assembled company of his experience in a movie theater in China a couple of years ago where every single Chinese person in the audience was sitting with a cell phone glued to his/her ear, while the movie was playing, throughout the entire show. In light of such real-life scenes among others, he asked her what hope she really had for us making things better over the course of the rest of this century.
"Well," she told him, "I'm a Jew, and I live in Washington sometimes. You can't do either without being an optimist."
And I think that's as good a place as any to stop.
Questions? Comments? Feel free.
Meanwhile, even though they'll probably never see this, I want to thank both Dr. Davis for a clear and rousing synopsis of her work to date and the delightful and enthusiastic Dr. Buckley, whose class we crashed, for letting us sit in on it.
wow! I especially love how excited you sound about the whole thing. And thanks for the excellent links.
My work is tangentially related to cancer research. That's absolutely true about what gets funded/not funded, etc.
Plus I've been meaning to read Dr. Davis' book; heard her on the radio a while ago and forgot to write her name down. So glad you reminded me.
Posted by: alphabitch | October 20, 2007 at 09:02 PM
Aha. I always pictured you as a public librarian, sitting behind the reference desk with your rhinestone glasses and the ghost of a tiara, Queen of Facts.
And hell yes I'm enthusiastic. Those of us who have been rabid proponents of the organic and natural foods movement for decades -- and been called unreasonable crackpots for it -- can only take validation from what she has to say, as can those of us who have been very selective in our own use of conventional medical treatments -- and been called crackpots for that, too.
Posted by: Sara | October 20, 2007 at 10:30 PM
I especially relate to the aspect of toxins and cancers. I was exposed to dioxins early. And I have been experiencing weird things all my life. Vague symptoms. Now a new mass where sarcoma was removed six years ago. To me it is as though we have to very very VERY carefully back out of the mess we have ourselves in. I am 56 and heading into another MRI (with ativan in hand). Barbara
Posted by: Barbara J. Gill | October 21, 2007 at 07:58 PM
hi sara-
saw your link over at jeanne's place and wanted to thank you for the great feast my eyes and brain just enjoyed. people think i'm nuts when i won't breathe their air fresheners, drink their diet coke, or use their toxic cleaners. this isn't rocket science, people! must we continue to resist it because we are lazy and spoiled? have we no respect for our bodies?
thanks again, for there is nothing quite like validation. eat your antioxidants, folks!
Posted by: jessica | October 22, 2007 at 11:32 AM
Barbara, hang in there. Here's hoping for a stupendously boring diagnosis. And Jessica, yes.
I just want to make sure, though -- and this is me talking, not Dr. Davis, though she might agree for all I know -- that people understand that things have gotten way beyond any one thing we can or should not put in our mouths. There is no magic bullet a single person can swallow to ward off cancer, and there is no magic cloak of impermeability any one of us can don to protect ourselves. You can do everything right, never smoke, never drink, eat perfectly healthily and exercise every day, come from an immaculate gene pool (as if there were such a thing), and still fall ill with cancer, especially if you are over 65. We need to look at our own nutrition and our own choices as consumers to give ourselves as individuals the most potential strength to live happy lives with the real bodies we have in the real world we have, a world which has gotten systemically polluted over the course of generations and won't be cleaned up or re-engineered in just one. And we need to make and create for each other every healthy, conscientious choice we can in order to start that clean-up. But the problem is bigger than a vitamin bottle or any individual person's kitchen or snacking habits.
To illustrate the massive amount of pollution this planet has sustained in the last hundred or so years, Dr. Davis told of a population of polar bears in a particular part of Norway where ten percent of the bears are born hermaphroditic probably as a result of ocean pollution including not just industrial chemicals, and "cleaning" products, and perfumes, and petroleum but all the literal tons of pharmaceuticals we have peed out of our own bodies. When tested, if I understood and remember correctly, the fat of these polar bears shows an accumulation of all these things.
Every organism on the planet is susceptible to damage from what we have already put in the ocean alone. Yes, we need to eat our antioxidants to support our individual physical ability to fight, especially those of us who already have cancer. But what will ultimately stem the tide of the worldwide epidemic is a complete rethinking of how we conduct our collective life as a species upon this planet. It only starts with what you and I put in our mouths, our gardens, our cars, on our backs, in our attics. (Asbestos is still used in insulation, did you know that? And where do you think that goes when it gets replaced?) There has to be a worldwide commitment to taking responsibility for the consequences of our choices beyond the boundaries of our own bodies. This is something humans have not historically been very good at, but that doesn't mean we can't learn.
Posted by: Sara | October 22, 2007 at 03:28 PM
I've always wanted to be a librarian, so you're not that far off :)
Posted by: alphabitch | October 24, 2007 at 05:50 PM