President’s panel analyzes environmental cancer impact

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Lung cancer cell Image: © Dennis Kunkel Microscopy, Inc/Vi/Visuals Unlimited/Corbis

Environmental toxins are a greater cause of cancer than previously believed, according to a new report from the President’s Cancer Panel — an advisory group that considers testimony from several cancer researchers to inform the president’s policies on cancer prevention. In the more than 200-page annual report (PDF), the authors say that, while much about the long-term effects of exposure to known carcinogens and environmental toxins remains unstudied, what evidence there is suggests that the “true burden of environmentally induced cancer has been grossly underestimated,” the authors write.

While studies analyzing the health impact of environmental toxins continue to trickle out — TIME recently did a round-up of the latest research on the effects of everything from pharmaceuticals in the water supply to common household hazards — as we work to gain an understanding of environmental risk factors, most of us continue to be exposed to potentially harmful chemicals on a daily basis. In a letter to President Obama that prefaces the report, co-authors Dr. LaSalle D. Leffall, Jr. and Margaret L. Kripke point out:

“With nearly 80,000 chemicals on the market in the United States, many of which are used by millions of Americans in their daily lives and are un- or understudied and largely unregulated, exposure to potential environmental carcinogens is widespread. One such ubiquitous chemical, bisphenol A (BPA), is still found in many consumer products and remains unregulated in the United States, despite the growing link between BPA and several diseases, including various cancers.”

Yet, while the authors recommend increased funding for more rigorous study of environmental toxins, what can we do to reduce the risk of harmful exposure now? In hospitals and doctor’s offices, the authors emphasize the need to minimize radiation exposure, and consider environmental exposures when taking patient histories. From a public policy standpoint, they recommend that lawmakers and government agencies err on the side of caution:

“A precautionary, prevention-oriented approach should replace current reactionary approaches to environmental contaminants in which human harm must be proven before action is taken to reduce or eliminate exposure. Though not applicable in every instance, this approach should be the cornerstone of a new national cancer prevention strategy that emphasizes primary prevention, redirects accordingly both research and policy agendas, and sets tangible goals for reducing or eliminating toxic environmental exposures implicated in cancer causation.”

Speaking to reporters on a conference call this afternoon organized by the Breast Cancer Fund, Dr. Richard Clapp, a professor of epidemiology at Boston University School of Public Health and one of the experts who submitted testimony to the panel, explained it this way: with the existing, reactionary policies, “you have to wait until the bodies are counted before you can go back and say, ‘Oh, you shouldn’t allow people to be exposed to that chemical.'” A shift toward a more proactive, precautionary approach would put the onus on manufacturers to ensure that the products are safe — and incentivize the development of safer chemicals — instead of simply putting things on the market and then asking questions later.

But how are individuals supposed to make sense of all of this while we wait for such a transformative policy shift? When it comes to offering advice on preventive steps for individuals, the panel stresses the need to reduce toxin exposure among children in particular. But then they go on to offer vague — and alarming — guidance for parents, suggesting that they reduce exposure to harmful chemicals by carefully selecting “foods, house and garden products, play spaces, toys, medicines, and medical tests that will minimize children’s exposure to toxics.”

Sandra Steingraber, a bladder cancer survivor, biologist, and author of Living Downstream: An Ecologist’s Personal Investigation of Cancer and the Environment who also contributed testimony to the panel, concedes that taking all of these messages into account can be overwhelming for individual families. “It is frustrating,” she said on the Breast Cancer Fund call, adding that a comprehensive public health approach would take this responsibility out of individuals’ hands. “I am the mother of young children, I need to shop quickly, I need to throw things in that cart and get out the door — it is overwhelming and I don’t think there’s a happy face we can put on that,” she said.

Yet Steingraber says that the report isn’t all bad news. “There’s good news here,” she says. What would be devastating is if cancer were mostly attributable to genetics — “… because there would be nothing we could do about that except wait for our genes to blow up inside of ourselves,” Steingraber says. Instead, the report highlights the fact that some cancers are caused by things that we can do something about.

Unless — or until — lawmakers adopt precautionary policies, individuals bear the bulk of responsibility for looking out for potentially harmful chemicals. The panel recommends that people who work around potentially hazardous chemicals remove their shoes before entering the home, and wash their clothes separately, for example, that people use water filters, drink out of and store food in BPA-free containers (glass or ceramic), use sunscreen, look up any potential hazards of items in their home in the Household Products Database and, though they concede that there is currently “no evidence to support a link between cell phone use and cancer,” while research is ongoing, suggest that “[a]dults and children can reduce their exposure to electromagnetic energy by wearing a headset when using a cell phone, texting instead of calling, and keeping calls brief.”

While some may interpret the advice as emphasizing caution, and attempting to encourage prevention, others — including cancer researchers — are wary that the report overstates risks. Speaking with the Los Angeles Times, Dr. Michael Thun, formerly an epidemiologist at the American Cancer Society said:

“We agree that there are many important issues here … but a reader would come away from this report believing that pollutants cause most cancer.”

Thun stressed that most cancers are caused by tobacco, alcohol, UV ray and radiation exposure and sexually transmitted diseases, and said that the report “presents an unbalanced perspective” of risk factors, the L.A. Times reports.

Yet others —including the report authors — say that a systemic emphasis on caution and prevention is a vital step in the right direction. As Dr. Leffall told ABC News:

“We think based on what we know, when you look at all the data, it just appears to us that there are areas where its been greatly under-reported… We don’t know 100 percent, but that’s why we believe we need to do more research.”