Monday, April 5, 2010

Chapter 31 - Living Downstream: An Ecologist Looks at Cancer and the Environment By: Sandra Steingraber

This chapter may prove interesting since it hints at a possible connection between the environment and cancer. There may likely also be a reference to Love Canal as well due to the affects seen in it inhabitants.

Now onto the intro paragraph. Sandra Steingraber is the author of Post-Diagnosis (Firebrand Books, 1995) which is a volume of poetry that is based upon her personal experiences with bladder cancer. That coupled with the loss of a close friend to cancer along with the knowledge that cancer affected many members of her immediate family, drove her to study the research of a Rachel Carson in her book Silent Spring (Houghton Mifflin, 1962).When Steingraber explored the sources of pollution she was exposed to around while growing up in Illinois she found numerous sources of pesticides and some industrial plant near the Illinois River that were a source of pollution.She then wrote the book from which his post is titled and a excerpt is taken. In it she argues through poetry and fact that we can reduce our exposure to environmental carcinogens and discusses reckless industrial agricultural pollution.

The key concept of this chapter is: the need for further research on environmental factors in cancer incidence.

Sandra begins with s description of how people react when she tells them about her fight with bladder cancer in the past. numerous people assume she is simply from a family unlucky enough to have a strain of cancer, she is adopted however, meaning the cancer must have been caused by something other than genetic heritage. A main idea in this early section is that families share environments and that can lead to even adopted children sharing similar health issues. One fact presented is "Deaths of adopted parents from cancer before the age of 50 increased the rate of mortality from cancer fivefold among adoptees...Deaths of biological parents from cancer had no detectable effect in the rate of mortality from cancer among the adoptees."

Sandra then lists relatives that have died of cancer including two aunts and two other relatives on her Father's side as well as an uncle currently undergoing treatment. Her brother-in-law was diagnosed with cancer at 21 (he also cleaned out chemical drums for a living), three years before that Sandra was diagnosed and three years before that her mother was diagnosed. Her mother was diagnosed in 1974, a year which saw a small spike in breast cancer incidents. This was partially because the First Lady Betty Ford and Second Lady Happy Rockefeller underwent mastectomies, of which word spread. Women then rushed to doctors and a large number of people were diagnosed in a short space of time.

The next section is dubbed Ecological Roots. In 1983 on a train ride to a cancer test Sandra noticed a headline on a newspaper back page article titled: Scientists Identify Gene Responsible For Human Bladder Cancer. Researchers at Massachusetts Institute of Technology extracted DNA from a human bladder and were able to identify the exact alteration which caused a certain gene to go bad. In essence what happens is that a gene gets crossed for another (like snow and show, or black and block) This caused the cell to manufacture valine instead of the amino acid glycine.

Thirteen years later Sandra was in possession of numerous scientific articles involved with bladder cancer. Two suppressor genes (p15 and p16) are involved as well by being deleted. p53 is also a common gene in many cancers including about half o bladder cancer incidents. The relation between these genes and other processes has been determined and here is a quote from the section to explain some of it: "Consider, for example, that redoubtable class of bladder carcinogens called aromatic amines - present as contaminants in cigarette smoke; added to rubber during vulcanization; formulated as dyes for cloth, leather, and paper;used in printing and color photography; and featured in the manufacture of certain pharmaceuticals and pesticides." That is a fair number of places to find what are essentially health threatening toxins. The first cases of excessive bladder cancer reports was published in 1895. Aromatic amines detoxified from the body through a process called acetylation which is handled by various genes. People with low levels of these enzymes are more at risk for bladder cancer. More than half of Americans and Europeans are estimated to be slow acetylators.

Bladder cancer is one of the most studied cancers and has given much insight into cancers of all kinds and their various stages. However, we have been unable to use all this knowledge to wage an effective campaign against bladder cancer. "Th fact remains that the overall incidence rate of bladder cancer increased 10 percent between 1973 and 1991. Increases are especially dramatic among African Americans: among black men, bladder cancer incidence has risen 28 percent since 1973, and among black women, 34 percent." Less than half of bladder cancer incidence among men and one-third of incidence among women is thought to be from smoking, the single largest known risk factor for the disease. The question remains as to what causes it in the rest of the people who live with it. From a file she posses Sandra wrote that "industries reporting to the Toxics Release Inventory disclosed environmental releases of the aromatic amine o-toluidine that have totaled 14,625 pounds in 1992 alone." O-toluidine is in residues in the dyes of commercial textiles. In 1996 a study showed a sixfold increase of bladder cancer amongst workers who were exposed to the substance. Sandra also states that what her folders don't contain is "a considered evaluation of of all known and suspected bladder carcinogens-their sources, their possible interactions with each other, and our various routes of exposure to them." To expand on this some examples include scenarios such as multiple articles of clothing being washed together, the ecological fate of the sources of the cancer and why - almost a century after their identification - are carcinogens such as amine dyes used and released into the environment in the first place?

There are believed by Sandra to be several obstacles preventing us from addressing cancers' environmental roots. One is that the bulk of cancer research is devoted to inherited cancers which is a mistake, One supporting fact is that only 1-5% of colon cancers are hereditary whilst only 15% show any familial component, and the remaining 85% is referred to as "sporadic". Even when inherited cancers appear there is usually an environmental component or influence.

Cancer rates are not increasing because we have suddenly begun to sprout new cancer genes. In a world free of aromatics and other such toxins we would see far fewer incidences and people born as slow acetylators would not need to worry about exposure or risk and people who inherit defective genes would not need to worry about environmental exposure triggering a potentially life-threatening disease. We are causing increasing incidences of cancer though the mishandling of toxins.

Sandra takes a few paragraphs to describe the waning days of Rachel Carson. In the last year of her life she stood before the U.S. Senate subcommittee and shared her views on environmental contamination and human rights. In her novel Silent Spring she urged the recognition of a individuals right to to know about any poisons introduced into their environment and the right to protection against said poisons. Sandra then states that she believes the process of exploring to know more about carcinogens in our environment is a three-part inquiry. She then uses The character of Scrooge as a metaphor by stating that we need to look back at our past, reassess our current situation and imagine an alternative future. She then describes the process in some detail which I will simply sum up. We start retrospectively for two reasons with the first being an appreciation (not in a good way) of the fact we carry carcinogens in our bodies and still remain in contact with banned chemicals such as PCBs and DDT. Secondly We need to pay attention to possible sources of cancer and the effects of substances such as pesticides over the course of time, since cancer does not just appear out of the blue, but unfolds over a period of decades. We need to know what pesticides were sprayed in our neighbourhoods and what chemicals we keep under the kitchen sink. We must also cross-reference such things with our neighbours to reminisce with people and places we grew up in to open our eyes to possible health threats. We must keep tabs on our genealogical and ecological roots.

Now we come to a section discussing the human rights aspect. "A human rights approach would also recognize that we do not all bear equal risks when carcinogens are allowed to circulate within our environment." People who work with these substances are at higher risk for health related issues and people are not uniformly vulnerable to the affects of carcinogens. "Cancer may be a lottery, but we do not each of us hold equal chances of "winning."" Sandra then puts things into perspective via an example to demonstrate the issue of dealing with carcinogenic cancers. Assume that the conservative estimate of 2% representing the number of carcinogen related cancer is true. That means about 10,940 people in the U.S. die of environmentally caused cancers every year, which is higher than the number of women who die from hereditary breast cancer. "This is more than the number of children and teenagers killed each year by firearms - an issue that is considered a matter of national shame." Yet no funding is provided for studying environmentally caused cancers while millions is poured into breast cancer research and this is not recognised as a source of shame? Sandra then states that the 10,940 Americans will not die quick peaceful deaths or show up in newspapers. She then rights: "These deaths are a form of homicide." There are some strong words which I will not debate about in my blog but should be not be ignored. We should all think about that statement at least a little bit.

Now for the ending section. To end off this chapter Sandra presents the principle of the least toxic alternative, which basically states that toxic chemicals shall not be used so long as the task at hand can be accomplished another way. This means we must chose the least harmful way of solving problems form cockroach removal or stains from woolens. Any movement away from zero toxic chemical use should be preceded by a finding of necessity. and then coordinate active attempts to develop affordable non-toxic alternatives. This principle is designed to move us away from the debates of how to treat or avoid cancers related to carcinogens in the environment and unwinnable battle to set maximum limits on their presence in the water, air, food, workplace, etc. The principle is supposed to make us look toward the release of carcinogens in the environment as unthinkable as practicing slavery.

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