The women in my family are not plagued by breast cancer. I am not yet 30. I don’t often think about my breasts and feel fearful. But an article last month in Orion, “Exposed: the mammogram myth and the pinkwashing of America,” by Jennifer Lunden, got my attention. Lunden brought to light the failings of mammogram screenings – questioning the efficacy of the procedure based on, among other things, the rate of false diagnosis that led to unnecessary surgeries coupled with the rate of non-detected malignant tumors.
More powerful than that, Lunden makes a compelling case for prevention versus cure.
Consider this: According to the Breast Cancer Research Foundation, worldwide approximately 1.3 million women are diagnosed with breast cancer each year. That means that one out of eight women will develop breast cancer in their lifetime. The highest rates of breast cancer, according to World Cancer Research Fund International, are in industrialized countries – Europe, Australia, New Zealand and North America. Though these higher rates might be a consequence of better screening, with lower numbers in developing countries resulting from lack of access to good healthcare, Lunden presents evidence that the higher rates of cancer in places like the United States are actually connected to our industries and the chemicals we ingest and apply to our bodies, often unknowingly, every day. To the extent that breast cancer is environmental, what can we do to prevent it?
Proactive prevention
As with any health problem, there are some people more at risk than others on account of genetics, but with breast cancer, personal fitness and wellness also factor significantly into personal risk. Controlling your weight and raising your level of physical activity can make a difference. Excess estrogen is one red flag contributor to breast cancer development (one reason why birth control pills and menopausal hormone therapy are on the watch list for increased risk). Lean, active bodies maintain a healthy natural flow of estrogen and prevent estrogen buildup in fat deposits.
But good health is only the tip of the iceberg. The greatest causes of breast cancer today are likely environmental, according to the group Breast Cancer Fund. They classify environmental hazards as chemicals in plastics, cosmetics, household products, food, air, water and health care products. Proactive prevention means knowing what these harmful chemicals are and where to find them.
Start by examining your lipstick, deodorant and antibacterial soap. Look at your shampoo, perfume, sunscreen and toothpaste.
Paranoia? Many mainstream brands contain chemicals that we know are bad for us, such as lead, which is not safe at any level, and aluminum.
Then consider the lesser-known but widely used chemicals such as triclosan. Classified as a pesticide, triclosan has been shown to affect the hormone system, specifically thyroid hormones. The perceived benefits of its anti-bacterial and anti-mold properties allow for its use in toothpastes, deodorants and antibacterial soaps.
Nine out of 10 biopsy samples from cancerous breast tissue show buildup of parabens. Nonetheless, parabens continue to be used extensively in shampoo, makeup, cleansers and other products because of their anti-fungal and preservative qualities.
Likely exposure continues with food. BPA is one reason plastic water bottles which contained BPA have gone out of fashion. Studies exposing normal breast cells to BPA have shown gene responses similar to that of a highly aggressive tumor. When heated, this unstable compound, also found in the plastic lining of metal food cans, in baby bottles and microwave ovenware, leaches into food products.
And there is rBGH, the bovine growth hormone with carcinogenic effects that is banned in Europe, Japan, Canada and Australia—but not in the United States, where avoiding cancerous toxins is the consumer’s responsibility.
Mammogram alternatives
Which brings us to radiation. Exposure to radiation is a big factor in a woman’s increased risk for breast cancer, according to Lunden’s research. We are exposed to small amounts of radiation every day from our microwaves, sun exposure and wireless technology. We are exposed during air travel and at the hospital with CT scans, x-rays and, yes, mammograms.
Despite a massive campaign over the last few decades encouraging mammograms (the Susan B. Komen Foundation encourages women over the age of 40 “of average risk” to get mammograms every year), new recommendations from the U.S. Preventive Services Task Force now suggest that women wait until their 50s to begin mammogram screenings, perhaps because some statistics showed that early screenings yielded false positives in almost 50% of cases. But even women approaching 50 might want to consider that each mammogram delivers 70 millirems of radiation, about the amount a body would normally absorb over a two and a half month period. It is incremental, but it does raise the chance of developing cancer. And there are alternatives.
Ultrasounds use non-ionizing radiation, a type of electromagnetic radiation that does not have enough energy to restructure atoms or molecules. The process has its own potential risks. Ultrasounds heat the tissue, creating small pockets of gas in body fluids and tissues, the long-term effects of which are unknown. But if the goal is to avoid radiation, ultrasounds, offered as a screening option at the University of Utah and other Salt Lake hospitals, are a good bet especially for women with dense breast tissue for whom mammograms screenings are less precise.
Thermography, a form of breast cancer detection approved by the FDA, though doctors recommend using it only in addition to having a regular mammogram, does not use any radiation. The method is a kind of inverse mammogram. Instead of shooting radiation rays into the breast, the thermal imaging measures the natural radiation from the body tissue to find abnormal cells. These screenings require no compression of the breast, can image the entire breast and are effective for all sizes and densities. The service, not covered by Medicare and only by some insurers, is offered by only two private practices in Salt Lake.
Little is agreed upon at this time regarding diet and breast cancer prevention. Evidence exists that these foods support breast health: cruciferous vegetables (broccoli, cabbage, collard greens), salmon, olive oil, parsley, antioxidant fruits and fiber (lentils, beans).
Breastfeeding and limiting alcohol consumption are practices that may protect a woman from breast cancer. Regular self-exams are considered possibly helpful for early detection.
Until we do find a cure for breast cancer, education and prevention that starts at home is a wise strategy, and it may well continue to be the only strategy.
Lunden reveals a cynical truth in “Exposed”: Major corporations that sell the pesticides and chemicals that are making women sick —Dow Chemical, DuPont, Monsanto, AstraZeneca— support the causes and make the drugs that treat breast cancer. Breast cancer is making money for some very powerful people. Prevention is not in their best interest. But women can, to an extent, take prevention into their own hands.
Why pink ribbons are not a solution
This month, National Breast Cancer Awareness Month, pink ribbons will be on everything from staplers and keychains to coats and watering cans. But take a closer look and most of that pink will have less to do with curing breast cancer than attracting sympathetic buyers.
Since the pink ribbon is not regulated, any company can put it on their product. Before reaching for these items, intending to put your money towards a cause, the organization Breast Cancer Action has a list of helpful questions you will want to ask:
Does any money from this purchase go to support breast cancer programs?
What is the maximum amount donated?
What organization gets the money and what do they do with the funds?
Does this purchase put me or someone I love at risk for exposure to toxins linked to breast cancer?
That last question might seem a bit odd, but it is a reality of pinkwashing.
Consider the Avon lipstick that gave $1 from each purchase to cancer research while the ingredients of the product contained parabens, formaldehyde and other toxins. Or the Evian bottled water that donated to cancer research, but had BPAs in the bottle. Or the 2010 Kentucky Fried Chicken promotion “buckets for a cure” that sold pink buckets of grilled chicken to raise money for the Susan G. Komen for the Cure while simultaneously in a lawsuit against the state of California which charged that KFC’s grilling process produced high levels of PhIP, a carcinogen linked to cancer.
Useful links
For more information and resources, read Jennifer Lunden’s article, “Exposed: The Mamogram Myth and the Pinkwashing of America” in the September/October edition of Orion magazine, available online at http://www.orionmagazine.org.