When I was a new patient I hated hearing about “causes of cancer” because it immediately made me think about the causes of my cancer. And when I think of the causes of my cancer, there’s a tendency to bring in some element of blame. Was it my fault I ended up a young adult cancer patient? Was it my parents’? Was it their parents? Was it something any of us could have prevented?
These are all, as yet, unanswerable questions, particularly in pancreatic neuroendocrine cancer in a 26-year-old. But now, I don’t mind so much letting them enter my mind. Almost a year and a half (on April 25) into my life as a cancer liver/survivor, I am more welcoming of discussion about causes of cancer, particularly if it’s based in scientific fact, certainly as I have embarked on my vegan trial, but also because i’m a planner and it’s my inclination to identify problems in the world around me and try to fix them through policy. So I went to a lecture this evening on environmental exposures and cancer (given by a woman with very impressive clinical, public health, and researcher credentials from UCSF) with an open mind, a determination to not blame this on myself or my family–but not really knowing what to expect. Are there known causes of cancer? If there are why aren’t they common knowledge? And why are they still out there?
It turns out that there are a lot of environmental carcinogens that are known almost definitely to the scientific and academic communities but are either not known or not regulated out in the world. Or if they are known and regulated, they’re not enforced. Like many pesticides–including one being considered (methyl iodide) for use on strawberries in California. Like Bisphenol A (BPA; more on this in the bullets at the end). Like diesel exhaust. Like a flame retardant (PBDE) used in pretty much all foam cushions in California. It was pretty mind-blowing to hear it explained so clearly and so matter-of-factly–there was a PowerPoint with a list. I wasn’t aware there were so many known carcinogens out there. I wasn’t aware that the ones I had heard of (like lead, formaldehyde, and mercury) were known carcinogens. And I was shocked that the products we buy and the places we go aren’t free from them. Not, apparently, as much of a no-brainer as it sounds.
Of course, as with many causal relationships, there are ifs, ands, or buts that make the issues with environmental causes of cancer and other diseases murky (notice how many qualifying words I was careful to put in this post). Cancer is nearly always multi-factorial. Smoking cigarettes is known to cause cancer (and cigarettes are one of the only carcinogens known to the general public), but not every smoker gets cancer. You don’t automatically get cancer from many–or most–carcinogens. You nearly always get cancer from a combination of environmental exposures and social factors and a genetic predisposition, or two of the three, or one of the three, or some of one and more of another.
So some people choose to take their chances. We here in the U.S. particularly hold tightly to our free-market and free-choice values, so if you want to choose to take your chances, you’re free to. And god forbid regulating many of these things would interfere with our free market. After all, it’s kind of a can of worms. Pretty much anything you buy or ingest or touch, from hand lotion, to kale, to vitamin D supplements, to plastics, to imports from China, to something as basic as tap or bottled water could either have a carcinogen in it, or have come into contact with one at some point, or could be iffy from a regulatory standpoint. So where do you even start?
I could tell when I was talking to my parents about this lecture on the phone that they were rolling their eyes as I spoke. “Yeah? So what were the credentials of this woman who spoke?” We’re still alive, we’ve been living in this world for our whole lives–so what does it matter?
I don’t know. We all choose our own battles. There are things that governments can do to make some things more attractive or less attractive than others, but there’s always going to be someone who’s willing to pay all the taxes in the world to continue driving their Hummer, or, perhaps more on the subject, to smoke their cigarettes. To me, it’s less an issue of health (because I already have cancer and i’m not going to be able to cure it by eating vegetables), and more an issue of ethics, of outrage and protest that we let companies put chemicals into products that aren’t regulated, that are known to cause cancer–and, more complicatedly, that we let our world get this way. I don’t want to support that. Yes, I know if I really didn’t want to support that, I should go live off the grid somewhere or move to Mars. But i’m not that much of a hippie, and i’m already tainted by cancer, and chemo, and radiation from all these scans, so I am stuck in this mess of a world and with making do with what I can. With choosing my battles, I guess. We all do this. I do this with other things. I walk by the people who campaign for Greenpeace and for Save the Children and think to myself, “I can’t be bothered. I have cancer. I have so many other things to worry about.”
Right now, for me, choosing my battles includes being vegan. In this lecture, I learned that dioxins, which are by-products of burning (like from diesel fuel and industry), are carcinogens (like the ones we hear about that act like estrogen in our bodies and may contribute to breast cancer and other cancers). Because no one really produces them on purpose, they’re hyper-prevalent, and they’re hard to avoid, and they’re hard to regulate. But they’re attracted to and stored in fat for really long periods of time. Animals are oftentimes exposed because they’re outside and they eat things that are outside and they’re sometimes located in areas that people don’t want to live like next to freeways because the land is cheap. Anyway, animals often transfer these dioxins to us through their meat and their milk and their cheese and their fat and their (eek) eggs. The suggestion? The same suggestion that, if you pay attention to this diet stuff, you hear over and over and over–limit your fat intake. Don’t eat meat. Or at least, if you’re going to eat meat, eat organic or grass-fed. Or at least if you can’t do any of that, don’t eat much meat.
Even so, the lecturer admitted to eating grass-fed beef occasionally because she likes it. Like I said–we all choose our battles.
Some other things I learned that I didn’t know before:
- BPA is another estrogen-mimicker that, in addition to being in certain plastics like some hard water bottles, is also in most canned foods. Fresh or frozen or glass or cardboard are better choices than aluminum cans.
- Cannabis aka marijuana aka pot is also an estrogen-mimicker!
- Food in plastic containers cooked in the microwave is not shown to have many harmful chemicals leech into it unless the plastic is soft or the (soft, plastic) lid is touching the food.
- Soy, though talked about a lot as being another estrogen-mimicker, isn’t shown in the research to be harmful to health or carcinogenic. In fact, it might have anti-breast cancer effects. I don’t think this applies as much to processed soy.
- Organic domestic labels on produce are pretty trustworthy. Organic imported labels are also pretty trustworthy. Domestic conventional labels are somewhat trustworthy (only 5% violations in outlawed pesticides used). Imported conventional labels are not very trustworthy (15-20% violations).
- Some produce that one would think is OK to buy non-organic, like bananas, have pesticides applied to the roots (systemic pesticides) so the whole vegetable or fruit, peeled or washed or not, is exposed. The Environmental Working Group has a list of the most-pesticide prone produce to the least.
- It’s legal to bring chemicals that haven’t been studied to market. The substances in dietary supplements (like vitamins) are largely not regulated.
- I could probably go on…