By John Unger Zussman
When Bonnie was diagnosed with breast cancer almost two years ago, she was unwilling to chalk it up to random chance. She took it personally. “I wasn’t unlucky,” she said. “I was poisoned.”
Last month, I wrote about Bonnie (a pseudonym), her decisions about cancer treatment, and what I learned from watching her make them. Bonnie and I both appreciate the support, comments, and stories you shared after that post. Now I want to talk about what we learned from her quest to find out who, or what, poisoned her—like an infected film-noir heroine who has just 24 hours to identify the poison, catch the culprit, and find the antidote.
It was in 1971 that President Nixon declared war on cancer, one of the few actions of his presidency that I applauded. Since then, many billions of dollars have been spent and millions of lives lost. We now have innumerable new treatments touted as “cures” for cancer. Yet cancer is still prevalent and survival rates have improved only slowly if at all (much of the decrease is attributable to reduced smoking and earlier detection). Post-menopausal breast cancer in particular is now common, and Bonnie is a member of a large and ever-growing community.
In my opinion (and Bonnie’s), the war on cancer has been undermined, like many wars, by a failure to cast the mission correctly. It placed all its reliance (and budget) on screening and treatment, on detecting cancers early and on finding a “cure.” And although it’s laudable to “race for the cure,” at some point you’ve got to wonder what is causing all this cancer.
But causation gets very little attention, probably because there’s a lot of money to be made in screening and treatment, but not so much in prevention.
How do we prevent cancer? An obvious place to start is our lifestyle, especially diet and exercise. The American diet is overloaded with fat, salt, and high-fructose corn syrup. We pig out on fast food and snack food while we sit on the couch watching “The Biggest Loser” and ignore the treadmill in the corner. Obesity is at record levels and increasing.
So is our diet predisposing us to cancer? Studies are suggestive. As Nicholas Kristof points out in a New York Times column called “Cancer from the Kitchen?,” most women living in Asia have low rates of breast cancer. But ethnic Asian women born and raised in the U.S.—including the daughters of Asian immigrants—have higher rates.
In a recent book called Anticancer, David Servan-Schreiber talks about the “terrain” of the body as being more or less hospitable to cancer. The idea is that cancer cells need a certain environment in which to flourish, and there are things we can do to make that more or less easy for them. For example, the antioxidants in certain fruits and vegetables, such as green tea, cabbage, and pomegranate juice, seem to antagonize cancer cells. “Eat your veggies,” it turns out, was not just maternal nagging.
This is not to say that green tea will cure cancer, and in fact, early studies of the impact of diet on breast cancer survival produced only mixed results. But a recent comprehensive study of diet and exercise—the Women’s Healthy Eating and Living (WHEL) study—was more definitive. For survivors of early-stage breast cancer, eating at least five servings of vegetables and fruits a day, and walking briskly for 30 minutes, six days a week, cut their risk of death from breast cancer by 50%! This should have made headline news—and would have if a drug company could have patented it.
(The link above is a summary, or you can read the actual journal report here.)
Now, Bonnie’s diet has always been reasonable. She hasn’t eaten fast food for 20 years, eats minimal snack food, and isn’t obese. Since her diagnosis, she eats more vegetables (especially the “anticancer” cruciferous ones like broccoli, cauliflower, and cabbage), less meat, little processed food, and no soda. This is far from being a burden. Bonnie’s a terrific chef, and the new meals are delicious.
But in her quest to prevent a recurrence or metastasis, Bonnie is focusing on a more insidious cause of cancer—carcinogens in our environment.
This is not just her opinion. It is shared by the 2009 report of the President’s Cancer Panel, which was released last month. (The link above is to the full, 200-page report. You can also read commentaries on it in another Nicholas Kristof column or in a Huffington Post article by Alison Rose Levy.) Here is a sampling of the panel’s findings:
- “A growing body of research documents myriad established and suspected environmental factors linked to genetic, immune, and endocrine dysfunction that can lead to cancer and other diseases.”
- “Only a few hundred of the more than 80,000 chemicals in use in the United States have been tested for safety.”
- “Weak laws and regulations, inefficient enforcement, regulatory complexity, and fragmented authority allow avoidable exposures to known or suspected cancer-causing and cancer-promoting agents to continue and proliferate in the workplace and the community…. Many known or suspected carcinogens are completely unregulated.”
Why is our world filled with toxic chemicals? Because it’s profitable. Because the corporations that put them there do not want to be troubled to clean up their mess. And neither do the legislators they bankroll.
What kind of chemicals are we talking about? Since we’re talking about diet, let’s start there. Commercially processed food—in additional to its fat, salt, and high-fructose corn syrup content—is full of additives, preservatives, artificial colorings, hormones, antibiotics, and pesticide residues. This is a result of our “modern” food system, which over the past 50 years has replaced family farms and conventional farming methods with factory farms, monoculture, overreliance on pesticides and fertilizers. If you have any doubts that mainstream food is poisoning us, check out the Oscar-nominated documentary, “Food, Inc.”
But the problem doesn’t end with what’s in the food and the way it’s produced; it’s also how it’s packaged, stored, and cooked. It comes to us in cans and plastic containers that contain bisphenol A (BPA) and leach phthalates and endocrine disruptors. We microwave it in the same plastic containers or cook it in Teflon pans that begin to degrade at cooking temperatures above 500° F. (In the case of microwave popcorn, we get both—the bags contain perfluorooctanoic acid, or PFOA, a known carcinogen related to Teflon.) We are living laboratories for artificial chemicals. Kristof’s column gives a good introduction to some of these toxins.
Now, not all of these chemicals are proved to cause cancer. But that’s the cancer panel’s point. Since the research hasn’t been done, it only makes sense to be wary of them. We are so concerned that the medications we take be both safe and effective, and the FDA generally takes a hard line at enforcing this. Why aren’t we (and they) equally concerned about food additives?
So, in Bonnie’s quest to transform her diet, the food she eats is almost less important than where it comes from. She now buys the vast majority of her (mostly organic) produce from farmers’ markets, and has found a local farm that raises natural lamb, pork, chicken, and eggs, without added hormones or antibiotics. She thinks it’s essential to avoid factory-farmed anything, since mass farming techniques use so many questionable chemical additives. She abandoned her non-stick skillet, bought glass containers for storage, and microwaves food in a Pyrex pie plate.
And she’s found that she has to be eternally vigilant. Tricks and traps are everywhere. For example, “fresh” orange juice from cartons, according to Alissa Hamilton, author of Squeezed: What You Don’t Know About Orange Juice, may have been picked and squeezed months earlier. It’s stored without oxygen, and then flavored with synthetically produced “flavor packs” produced by fragrance manufacturers. The manufacturers don’t have to label these additives because they’re made from orange byproducts.
But toxins aren’t just in food and our kitchen utensils; they’re also in our air, our water, our cosmetics, at work, and at home—they even find their way into newborn babies. As the Cancer Panel points out:
“To a disturbing extent, babies are born ‘pre-polluted.’ … [They] can be exposed to toxins in utero via placental transfer and/or after birth via breast milk. Tests of umbilical cord blood found traces of nearly 300 pollutants in newborns’ bodies, such as chemicals used in fast-food packaging, flame retardants present in household dust, and pesticides.”
The study they cite was conducted by the Environmental Working Group, one of the premier groups working to remove toxins from our environment. You can hear more about it in a recent address to the Commonwealth Club of California by Kenneth Cook, EWG’s president. You can listen to it for free here , or download it as a podcast here or from iTunes.
It’s essential to become smarter, toxin-avoidant consumers, and the EWG website offers abundant helpful information. For example, you can find a series of tips for making your home a healthier place.
Companies that pollute the environment with carcinogens are particularly insidious when they present themselves as green—or pink. Breast Cancer Action, a small but effective activist organization, has focused on this “pinkwashing” problem with a campaign called “Think Before You Pink™” It urges consumers to resist buying pink-ribbon products from companies that actually worsen the cancer epidemic.
A recent and egregious example of pinkwashing is KFC who, in partnership with Susan G. Komen for the Cure, is now selling pink buckets of factory-farmed, fat-laden fried chicken to “cure breast cancer.” We expect this kind of deception from KFC, but the Komen foundation should know better. You can tell them to stop by sending a message from BCA’s site—and by not patronizing this product.
Since BCA first criticized the KFC/Komen partnership, outrage about the hypocrisy has gone viral. It was featured on The Colbert Report and has been roundly criticized by bloggers like John Robbins.
BCA successfully persuaded General Mills to stop putting the bovine growth hormone rBGH, a known carcinogen, in Yoplait yogurt. They are now trying to get Eli Lilly to stop manufacturing rBGH at all. Unlike other breast cancer organizations, they accept no donations from pharmaceutical companies, health insurers, or other companies whose products are involved in cancer diagnosis or treatment. They also accept no money from chemical manufacturers, oil or tobacco companies, or others who might possibly contribute to cancer incidence.
As Bonnie says, there are no certainties in life or cancer. No one can guarantee that eating organic food will keep you cancer-free. Bonnie relies on Western medicine and the guidance of doctors who are trained in it.
But she is not going to sit back and simply wait for them to cure her. She is also doing everything she can to strengthen her immune system and keep herself healthy. And that involves eating right, exercising, avoiding toxins, and supporting organizations that are trying to remove them from our environment. Nothing about this cancer epidemic is going to change unless we become proactive. Bonnie’s message to you is: Don’t wait until you get cancer to take responsibility for your own health.
Let me repeat the disclaimer from last month’s post: I am not a medical doctor, so my reflections are meant to be descriptive and not prescriptive. I wouldn’t pretend to tell anyone else what to do. Again, I invite your comments and, especially, your own stories.
My thanks to “Bonnie” for her input and inspiration.
Copyright © 2010 by John Unger Zussman. All rights reserved.
Resources and Notes:
David Serban-Schreiber, MD, PhD, Anticancer: A New Way of Life (2008).
Keith I Block, MD, Life Over Cancer: The Block Center Program for Integrative Cancer Treatment (2009).
Rick Smith & Bruce Lourie, Slow Death by Rubber Duck: The Secret Danger of Everyday Things (2009).
Food, Inc. (documentary written and directed by Robert Kenner, 2008)
President’s Cancer Panel 2008-09 Annual Report, Reducing Environmental Cancer Risk: What We Can Do Now (2010)
- You can also read an account of the food industry’s response to the PCP report, and some background on their medical/executive director.
Environmental Working Group website
Breast Cancer Action website
Think Before You Pink™ website
4 thoughts on “Poisoned”
Good post on a difficult subject–and a painful one. I wonder what other animals in this world are so self-destructive.
That said, as medical professional that sees cancer patients every day, I have to wonder about the possibility that cancer is not only linked to the environment, or what we eat, but also has a viral origin. I’ve seen so many people who had cancer 20 years ago and suddenly develop it again–in the same way that a case of chicken pox from 20 years ago becomes shingles.
I’m not saying that there aren’t links to the environment; I’m saying that I’m questioning whether there are also other factors. Using the chicken pox example, we become more susceptible to viruses–such as chicken pox– and harmful bacteria when our immune system is compromised. If we eat processed, unhealthy food and cook it in pots and pans that transmit more chemicals to us, perhaps we become immunocompromised and are thus more susceptible to a cancer virus. That’s my personal hypothesis.
When HIV was first identified, Karposi’s Sarcoma went from being a cancer (sarcoma) to being linked to the virus. Just saying.
And saying all that, what I wonder, on a psychological level, is about our need to control. When I wonder about the viral possibility, I am essentially saying that cancer, for the most part, might be out of our control. When Bonnie narrows it down to our environment, she is (naturally) seeking control of a horrible, deadly disease. Ultimately, perhaps, the question for both of us is more of a spiritual one– what can we trust in this world, if anything?– than a medical one. I wish Bonnie all the best and hope that her disease remains in abeyance and that she lives a long, healthy, happy life.
Jane, thank you for sharing this remarkably astute comment. A couple of years ago, Bonnie and I attended a lecture on evolutionary medicine by Dr. Paul Ewald of the University of Louisville. (It was part of a Stanford course on Darwin’s legacy, commemorating Darwin’s bicentennial. The lecture is available on YouTube and is well worth a couple hours of your time.) Ewald is a strong advocate of the viral basis of cancer. As late as 1979, he pointed out, viruses and other infectious diseases were not thought to be involved in human cancer at all. Now, about 20% of cancers have known links to viruses, according to the World Health Organization. The best-known examples are cervical cancer, “caused” by the Human Papilloma Virus (HPV), and Kaposi’s Sarcoma, “caused” by HIV (as you mention).
The 20% figure will only grow as research identifies more links. For example, three viruses are strongly associated with breast cancer (but not yet proven as causal factors): HPV, Epstein-Barr Virus, and the human version of the Mouse Mammary Tumor Virus (MMTV). Ewald theorizes that these viruses break down cellular defenses to cancer, such as limitations on cellular division, natural cell death (apoptosis), and mutation repair. Once the defenses are compromised, mutations and other factors can lead to the proliferation of cancer cells.
I put “caused” in quotes because cancer, like most things, is multiply determined. It’s not that viruses cause these cancers instead of genes, hormones, or environmental toxins. It’s that all (or several) of these factors combine in a process that leads to cancer. The more we can reduce the action of any or all of these factors, the less likely cancer is to gain a foothold and proliferate.
If the viral hypothesis is true, far from decreasing our ability to control cancer, it would give us additional means of control. Although antivirals are not as effective as antibiotics as a means of curing infections, we are reasonably good at preventing them with vaccines. For example, we already use the HPV vaccine to reduce the risk of cervical cancer.
One problem is that Ewald, though a well respected researcher, has had trouble getting the medical establishment to listen to his hypothesis. Despite the known counterexamples, it violates the “accepted” model of cancer development and proliferation, so it’s viewed with suspicion. This resistance is exacerbated by the fact that pharmaceutical companies, which fund clinical trials, make a lot more money (and incur less liability) manufacturing chemotherapy drugs than vaccines.
You are certainly correct that all we can do is try to control the factors we can control, and hope that is enough. Thank you for your insights as well as your good wishes for Bonnie.
Thank goodness for Pyrex. It’s nice to see all this information in one place.
Just reading this again, in the recent wake of Koman’s reprehensible behavior regarding Planned Parenthood. Weren’t you before that curve! May I suggest you post an entry about everyone’s favoirte — the Brussels sprout?