05 May 2012

"Licensed to Ill"

(Photo courtesy USA Today)
I am not usually one to be affected by celebrity events. I tend to treat these “momentous” celebrity news stories with an eye roll and an angry rant about all of the important news in the world being supplanted by the trivial. But oddly, the reports yesterday of the death of Beastie Boys’ Adam Yauch hit me hard. I could not understand why at first. Sure, I grew to like the Beasties, after forgiving them for their peppy frat-boy (yet admittedly funny) tunes of the mid-eighties. As a diehard music fan, particularly in my 20s, I know I saw them live at least once during what now in my mind is a blurry haze of my concert-going days. I distinctly recall the throngs of tens of thousands of Beasties fans jumping up and down in unison at one of the Tibetan Freedom Concerts that Yauch organized in Washington, D.C. Nevertheless, why was I moved by the death of a rich, famous musician I did not know and of whom I was merely a casual follower? One word: Cancer.

My generation, X, comprise the population aged from roughly early to mid thirties, to about fifty. That age range corresponds quite closely with the age at which cancer has seemed to first strike at many people I know. When my parents and grandparents were that age, they knew few if any people who had suffered or perished from the disease. Yet, beginning six years ago with the untimely deaths of my childhood neighbor as well as my dear college friend, the number of my peers living through and dying of cancer has surpassed the fingers I have on which to count them. Of course, my anecdotal evidence of increasing rates of cancer in my age group is not enough to prove a trend. As a trained scientist, I know that a systematic gathering of unbiased data needs to occur to provide true evidence of anomalous rates of cancer in aging Gen Xers. But I also know that gathering reliable data of such trends is difficult.

Obtaining precise records of cancer incidence and potential causal factors associated with the disease is nearly impossible given our record keeping methods. Barring immoral human disease experimentation (such as the horrendous Tuskegee incident), public health researchers must rely on retrospective studies to derive data. They must have medical records of patients that take into account all potential causal factors related to disease, and/or create questionnaires which account for all possible variables. If any data is inaccurate or incomplete, as it always is, few valid results may be obtained. Questions that may implicate environmental exposures are rarely asked of patients, often because our society does not wish to connect the dots between our "convenient" lifestyle and its consequences. We would rather blame victims of cancer than those who introduce cancer-inducing pollutants into our environment and our bodies. I know this not only as a scientist, but as a cancer sufferer myself.

The conventional wisdom about cancer, echoed in doctors’ offices throughout the country, is that one contracts a tumor either from detrimental personal lifestyle choices and/or from defective inherited genes which render one more “susceptible” to the disease. Let us destroy both of these myths once and for all.

First, lifestyle factors such as poor food choices or lack of exercise are only tangentially tied to cancer. There may be some correlation, but certainly no causations, unless one speaks of food tainted with carcinogenic substances. While eating a nutritious diet, exercising regularly, and maintaining a normal body weight may certainly help you - especially because many carcinogens accumulate in fat tissue, and healthful foods can increase the immune response - these factors are not enough in and of themselves to significantly reduce cancer rates in a population living in an environment rife with carcinogens.

Second, though DNA certainly plays an inextricable role in carcinogenesis, as cancer is derived from the mutations of DNA, inheritance is only peripherally related to the disease. The inheritance of “susceptibility” is merely relevant if one is exposed to carcinogenic agents. Even in the most studied cancer susceptibility genes, BRCA1 and BRCA2 (for breast cancer), women with the gene who were born before 1940 are shown to have little increased risk of cancer while those born after 1940 have a much greater risk.[i] So what is the difference between these two groups of women? The limiting factor that determines increased susceptibility is not the gene itself, but the exposure to carcinogens. Women with the same "cancer" genes born before World War II, before the widespread, common usage of tens of thousands of synthetic chemicals, have a far lesser chance of being diagnosed with cancer than their younger counterparts. Moreover, inherited lethal or highly problematic genetic diseases tend to be rare in populations. But as of 2004, one in three Americans will be diagnosed with cancer; it is the second leading cause of death in the United States. As natural selection – the cornerstone of evolution, which is the principle theory in all of biology – tells us, any highly deleterious or fatal gene will decrease in the population rather than increase. Cancer rates have increased exponentially over the past century or more, which is incompatible with the notion that the presence of widespread cancer today is due to mere heredity.

Rather than focus upon the plethora – over 100,000 – of synthetic chemicals in our air, water, food, and general surroundings, rather than recall the many that are classified as potential or known carcinogens, rather than recognize that most of these hundreds of thousands of chemicals are completely unregulated and untested for health effects, and rather than ask patients about their potential exposures to such toxic substances when diagnosing patients with cancer, doctors revert to the standard pat question: “Do you have a family history of cancer?”  To be fair, physicians are rarely if ever trained in environmental toxicology or environmental health; they rarely if ever seek root causes of disease, let alone etiologies related to environmental toxins. Even if they were to try to do so, honing in on one carcinogen among the thousands or more to which we have all been exposed and carry within our bodies would, in most cases, prove to be a feckless task.
I grew up along the Hudson River in northern Westchester County, NY. Unbeknownst to me at the time, the river in which I waded and swam had been deemed the largest Superfund site in the nation due to  PCBs dumped into it decades ago by General Electric. For sixteen years I lived on this river, less than two miles from the Indian Point nuclear power plant, which has been leaking low levels of radioactive substances for years. Furthermore, I spent a decade in D.C. drinking highly chlorinated tap water, the byproducts of which are linked to colorectal cancer. I also spent six years in smog and air-particulate-laden Los Angeles. Any of these exposures, in addition to exposures from consumer and cosmetic products that I utilized throughout my life, as well as from the radiation I received via routine dental and chest X-rays, and other non-routine medical radiation diagnostic procedures, could have contributed to my own cancer diagnosis. Unless one endures a sustained exposure to one highly concentrated known carcinogen, such as might occur in an occupational environment, cancer remains relatively untraceable due to the ubiquity of carcinogenic agents in our environment. What better way to prevent the tracking of responsibility to the specific culprits of the disease? (Deliberate “Sabotage?”)
I was diagnosed with colon cancer almost four years ago now, during a two-year stint in North Dakota. Not once did anyone ask me about where I had been born, where I had lived, or to what I may have been exposed. Given these circumstances, surely no accurate record of any variables related to my diagnosis exist. Thus, any public health study on cancer that might include me would be missing innumerable pieces of key data. Besides asking about my family (most of whom had never had cancer, and certainly not at my young age), my medical practitioners did not delve into my cancer causes at all. They merely kept repeating “what a fluke” my cancer was in such an otherwise healthy young woman with no medical history of anything whatsoever. The experience of friends and peers in the few years prior and since then would appear to confirm the ignorance of such a statement.

Adam Yauch had a handful of years on me, yet still had far too many left ahead to be lost so soon to such a disease. Though I of course know nothing of his situation, I would wager a guess that his doctors also reassured his family that his cancer was merely a fluke of nature, a random misfortune in an otherwise healthy man. Only a willfully ignorant society in utter denial could tolerate statements that demonstrate such a callous disregard of all that is obvious. We are all somewhat complicit as we remain complacent in the face of such overwhelming evidence of the detrimental effects of our polluted civilization. The randomness of cancer is highly overstated. We who suffer it are victims of a toxic environment created by an utterly toxic culture. Cancer is less an arbitrary occurrence than an inevitability. It would seem that as the title of the Beastie Boys debut album states, our industrial capitalist society has been fully "Licensed to Ill."

[i] Langston, Nancy. Toxic Bodies: Hormone Disruptors and the Legacy of DES

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