THE NEWS OF 1998, PART 1
It's time for our 1998 wrap-up.
Evidence continued to accumulate during 1998 that your diet can
drastically alter your chances of getting heart disease and
cancer, including breast cancer.
The good news is that eating monounsaturated fats (the kind
found in olive oil, canola oil, and nuts) seems to have a
protective effect against these major diseases.[1] The nuts
highest in monounsaturated fats are hazelnuts, macadamias,
pecans, almonds, pistachios, Brazil nuts, walnuts, and peanuts.
The bad news is that hydrogenated vegetable oil and partially
hydrogenated vegetable oil can have major harmful effects,
increasing your chances of heart attack and cancer, including
breast cancer. It is the trans-fatty acids in hydrogenated
vegetable oils that seem to be the culprits.[2]
Hydrogenated vegetable oils are mainly found in margarine and
vegetable shortening, which in turn are common ingredients of
bread, cookies, crackers, chips, candy bars, and many baked
goods such as doughnuts. Many french fries are now cooked in
hydrogenated vegetable oils. If you eat a normal American diet,
it is hard to avoid large doses of hydrogenated or
partially-hydrogenated vegetable oils, but the evidence is
mounting that they are really bad news and should be avoided
whenever possible.
Alberto Ascherio at the Harvard School of Public Health estimates
that trans-fatty acids are now killing at least 30,000 Americans
every year.[3] Read the label and purchase wisely.
Breast Cancer Prevention
During 1998, evidence continued to accumulate indicating that a
significant portion of female breast cancer is preventable
because it is caused by exposure to cancer-causing agents
(chemicals and radiation -- including hydrogenated vegetable
oils) added intentionally or unintentionally to the environment
and food. (See REHW #571, #572, #573, #574, #575.)
About 182,000 new cases of breast cancer occur in American women
each year, and 46,000 deaths occur annually from the disease. In
the U.S., the occurrence of breast cancer has increased steadily
at the rate of one percent each year for the past 40 years.
The "cancer establishment" -- the cluster of government agencies
and private corporations that controls the flow of cancer
research dollars (see REHW #571, #572) -- is feeling tremendous
pressure to demonstrate a preventive approach to breast cancer.
Accordingly, the National Cancer Institute announced in April
that a drug called tamoxifen had cut the occurrence of new
breast cancers by 45% in a group of 13,388 women who were
thought to have a high probability of getting the disease.[4]
Government regulators acted swiftly and the news media trumpeted
the story. A committee of the U.S. Food and Drug Administration
(FDA) announced in September that it was recommending that the
FDA approve tamoxifen as a drug for "reducing the risk" of
breast cancer. A spokesperson for the FDA told the NEW YORK
TIMES that "potentially tens of millions of women" could be
candidates for tamoxifen treatments at a cost of $80 to $100 per
month per person. Tamoxifen is marketed under the name Nolvadex
by Zeneca, the chemical company that sponsors Breast Cancer
Awareness Month each year. Tamoxifen has been used for breast
cancer chemotherapy for two decades.
The FDA committee carefully avoided using the words "prevent" or
"prevention" because it said tamoxifen may merely delay the
onset of cancers and not actually prevent them; it is too early
to tell. Still, the message from the cancer establishment was
unmistakably one of prevention. The NEW YORK TIMES ran a
front-page story saying tamoxifen's approval by FDA "would be a
milestone in efforts to prevent cancer."[5] Even before the
tamoxifen study was published, the TIMES wrote an editorial
about it, calling tamoxifen "a breast cancer breakthrough." "For
the first time, scientists have demonstrated that breast cancer
can not only be treated but actually prevented," the TIMES
editorial said.[6]
Unfortunately, it is not clear that tamoxifen represents a real
victory for most women. The TIMES acknowledged in its editorial
that, if 1000 women took tamoxifen for 5 years, 17 breast
cancers would be avoided, and bone fractures from osteoporosis
would be reduced; however in the same 1000 women during the 5
years tamoxifen would cause an additional 12 endometrial cancers
(cancers of the lining of the uterus) and at least 10
potentially-fatal blood clots. The published study also reported
an increase in strokes and eye cataracts among those treated
with tamoxifen, compared to a control group.
In its news story, the TIMES reported that the FDA committee
"said it did not yet have enough information to determine which
women were at high enough risk of breast cancer to make the
drug's hazards, including potentially fatal blood clots as well
as cancer of the uterine lining, worth its benefits."
The National Cancer Institute has released a computer "risk
disk," a diskette containing a program intended to help women
judge their risk of getting breast cancer. The diskette is
available in both PC and Macintosh formats; telephone
1-800-4-CANCER or sign up to receive the diskette by mail at
http://cancertrials.nci.nih.gov.
Of course, no one should rely on a computer program -- or on
information they read in the news media -- to make decisions
about their health without consulting a qualified medical
specialist.
Two smaller studies of tamoxifen and breast cancer were
published in September and neither of them showed any benefits
from tamoxifen treatments.[7,8,9] Differences in criteria for
recruiting women into the studies may have produced the
contradictory results. Nevertheless, definitive evidence of
tamoxifen's benefits and dangers must await further study.
In late April, the NEW YORK TIMES reported on two unpublished
studies of a drug called raloxifene. According to the TIMES,
both studies show that raloxifene can reduce a woman's chances
of getting breast cancer without increasing her chances of
getting endometrial cancer. A study is now under way to compare
the effects of raloxifene vs. tamoxifen.[10]
To us, the tamoxifen and raloxifene studies reveal a curious
shift in the cancer establishment's view of "prevention." To
most people, cancer prevention means preventing exposures to
cancer-causing agents. Instead cancer "prevention" is coming to
mean treating a woman with a potent drug year after year, in an
attempt to counteract the effects of her lifelong exposure to
carcinogens. The eagerness of the NEW YORK TIMES to promote this
new view of prevention on page 1, and in its editorial columns
(often relying on preliminary data from unpublished studies),
is, itself, curious and worrisome. It is as if the cancer
establishment has abandoned the struggle to get carcinogens out
of the environment and the nation's food supply, relying instead
on drug treatments. It occurs to us that there is simply no
money to be made in old-style prevention. It is hard to make a
living by reducing women's exposures to radiation and
carcinogenic chemicals. But getting FDA approval for a new drug
can be extremely lucrative even if its benefits hardly outweigh
its dangers.
To us, the most interesting study of 1998 was never reported in
the NEW YORK TIMES or any other of the mass media. In
September, researchers at the University of Birmingham in
England reported exposing pregnant rats to small amounts of
dioxin on the 15th day of pregnancy.[11] [Dioxin is a
highly-toxic, chlorinated byproduct of combustion, incineration,
metal smelting, and the manufacture of many chemicals, including
pesticides. All Americans carry amounts of dioxin in their
bodies that the U.S. Environmental Protection Agency considers
dangerous. (See REHW #390, #391.)]
The female offspring of the dioxin-exposed pregnant rats were
born normal, but by the time they were 7 weeks old, their
mammary glands had developed an unusually high number of
"terminal end buds" -- the places in a breast where breast
cancers develop. Four studies have shown that there is a direct
correlation between the number of terminal ends buds in a breast
and its susceptibility to breast cancer.
The Birmingham researchers went on to expose these young rats
(and a control group) to a well-known carcinogenic chemical
(dimethylbenz[a]anthracene). Sure enough, the dioxin-exposed
young rats developed many more breast cancers than did the
control group.
This elegant study shows that (a) timing of exposure to dioxin
(and presumably to other toxicants) is critical; (b) exposure to
a chemical before birth can predispose an animal to breast
cancer later in life even if the chemical itself is known to
INHIBIT breast cancer when exposure occurs later in life, as is
the case with dioxin; (c) present methods of testing chemicals
for their cancer potential are missing the boat, failing to ask
the right questions about the dangers of the cancer-causing
chemicals we are all legally exposed to year after year.
There are important opportunities to prevent breast cancers, and
other cancers, in this world, and they do not require us to
expose tens of millions of women to powerful chemotherapy drugs
year after year. They simply require us to develop the political
will to clamp down on the murderous practices of industrial
polluters and the food industry. |
