There may be no two scarier words for women than breast cancer.
The most common invasive malignancy among women around the world, breast cancer’s rates during the last several decades have nearly tripled in the United States. Today, this cancer is the leading cause of death in U.S. women in the prime of their lives—between their late 30s and early 50s.
No other epidemic has seemed so elusive—and so immune to preventive measures. When it comes to heart disease, we can lower cholesterol and improve fitness regimens to alleviate or even elude it. To avoid lung cancer, we can stop smoking or never smoke. To avoid AIDS, practice safe sex.
So what prospects are there for stopping this cancer that has spread across the American landscape like an invisible, invincible scourge?
“With breast cancer, there’s no magic bullet, no straight line like that from cigarettes to lung cancer, but we are honing in on clues to mechanisms behind this complex disease—and ways to possibly decrease our risks,” says Dr. Cheryl Perkins, senior clinical advisor for scientific developments for Susan G. Komen for the Cure, the Dallas-based cancer-fighting organization.
At the invitation of Komen, a multi-disciplinary team led by researchers from the Silent Spring Institute, with Harvard Medical School, Roswell Park Cancer Institute and the University of Southern California identified 216 chemicals pervasive in our environment that cause breast tumors in animals.
The study is groundbreaking, some experts say, because it begins to identify potentially preventable exposures to a wide range of environmental chemicals, behaviors, and lifestyles that may be promoting this disease. Most of the conventional risk factors for the disease, such as age, gender, family history, and age at first full term of pregnancy “can’t be modified,” according to Komen.
“We’ve spent far too long detecting and treating the disease,” argues Devra Lee Davis, an Professor of Epidemiology at the University of Pittsburgh's Graduate School of Public Health and director of the Center for Environmental Oncology at the university's Cancer Institute, “which means that we’ve become efficient at processing more and more sick people without identifying promising avenues of prevention.”
Like other cancers, breast cancer is a disease involving abnormal cells that grow and spread. The cellular abnormalities are caused by inherited genes or lifestyle factors such as smoking, hormones, poor diet and overeating, or damaging compounds in the environment, according to researcher Ruthann Rudel of Silent Spring Institute.
Because breast cancer rates can vary so drastically from place to place, researchers have long assumed that there are contributing environmental factors. The fact that there’s a fivefold greater risk of getting it by living in an industrialized country is one clue, say the Silent Spring Institute researchers. A 1989 study by the U.S.
Environmental Protection Agency found that breast cancer rates were higher in the 339 U.S. counties with hazardous waste sites and groundwater contamination than in other areas. However, relatively few epidemiological studies—looking at the illness across various populations—have been conducted, according to these researchers.
Another problem, Rudel says, is that many of the 216 chemicals in question have been examined in terms of certain other kinds of cancers, but not in relation to breast cancer, despite its alarming spread. Yet the extent of our exposure to these chemicals is widespread and troubling, according to this study.
In this country, 73 are present in consumer products, such as furniture, sprays, polishes and the like, or contaminants in food; 35 are air pollutants, coming out the tailpipes of our cars and trucks, for example, or out of factories and power plants; and 29 are produced at more than 1 million pounds per year.
While chemical exposures have been long suspected as culprits, pinpointing the causes for breast cancer, or factors associated with a higher risk of developing the disease, has been extremely difficult.
Part of that has to do with the fact that breast cancer is so “multi-factorial,” involving so many genetic, hormonal, lifestyle or environmental factors at play, according to Dr. Gina Solomon, associate clinical professor of medicine at the University of California at San Francisco.
Another factor is that genes and environmental factors interact, so that some women are more genetically predisposed—making it difficult to tease out the environmental factor on its own.
Also, breast cancer has a very long latency, probably several decades from the time a cancer was triggered to its eventual appearance. Some research suggests that triggers for the disease may come in the development of the breast tissue in the womb or in childhood, so the link is difficult to prove.
Up until now, few definitive causes have been found. One of the few agreed-upon causes of breast cancer is ionizing radiation, found in X-rays, CT scans, fallout from atom bombs, living close to nuclear power plants, and other sources of radioactive materials.
Another known breast carcinogen in humans is alcohol.
The researchers point to a recent analysis of six studies involving 322,647 women and 4,335 cases of invasive breast cancer: They found a 9 percent increase in the risk of breast cancer for every 10 grams of alcohol per day consumed. A third strong association to the disease, recently discovered, is hormone replacement therapy.
Komen’s Cheryl Perkins says the research doesn’t yet yield “definite clear health directives” with regard to avoiding potentially troublesome chemicals but could in the future. Women who do their best to lose weight after menopause and engage in increased physical activity will lower their risks, however, she says.
Dwight E. Randle at Komen advises, “Consumers can consult this database for guidance and make up their minds about what exposures they can eliminate to reduce their risks.”
According to the American Cancer Society, this year some 178,480 women in the United States that will be diagnosed with the invasive form of this disease, usually requiring surgery and chemotherapy, and another 58,490 diagnosed with a precancerous (‘in situ”) condition that could lead to it, usually requiring surgery and radiation treatments. But less than 10 percent of those people will have any known genetic predisposition to the disease.
Komen is actively pursuing evidence of risk factors that can be changed, commissioning a second study to look at environmental factors, focusing particularly on “endocrine-disrupting” chemicals that mimic the effects of hormones and thus disrupt the endocrine system.
One trend is encouraging, says Davis: “Business is booming in the 'green chemistry' sector, providing consumers with non-toxic alternatives to conventional cosmetics and household cleaning products, just as the green building industry is giving consumers healthier alternatives in architecture and the construction field.”
Source: msn
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