Prevention as Cure: The Challenge of Breast Cancer

Breast cancer cells

Image by crafty_dame/Flickr

For six years I have watched a very dear friend fight against her breast cancer.  First diagnosed at 32, she underwent radical treatments— surgeries, radiation and chemo— only to develop metastatic breast cancer after three years. Metastatic breast cancer is a death sentence. We all hope for miracles, but the reality is that the median life expectancy for women with this advanced stage of the disease is 2 years. 

My friend is not alone. In fact, she is one of three million women in the United States who have, or who have been treated for, breast cancer.  She is also among the growing number of women under 50, with no family history of breast cancer, who are getting the disease.  In 2012 alone, despite significant advances in treatment over the past decade, the disease killed more than 40,000 women and 227,000 more were diagnosed with it.    

Today, every woman should ask: “What can I do to prevent the disease for myself or my daughter?” Breast cancer has both genetic and environmental risk factors, aad while medicine doesn’t yet know how to identify and alter genes that might make us more susceptible, we can do things to reduce risks in our environment.  But first, women need to know what those risk factors are.

Breast Cancer: The household chemical connection

It turns out that some of them come from products we use in our households every day.

A new report just released by the federal Interagency Breast Cancer and Environment Research Coordinating Committee (IBCERCC) details what we know – and don’t know – about the environmental contributors to the risk of breast cancer and offers a long-sought blueprint for research into breast cancer prevention.

The report makes a number of important recommendations based on researchers’ increasingly detailed understanding of the breast itself, which turns out to be a highly dynamic organ. It undergoes multiple periods of rapid change over the course of a woman’s life: from conception to puberty, pregnancy, lactation and menopause.  The breast is also full of hormone receptors. 

For these reasons, the IBCERCC report recommends that more attention be paid to chemicals with estrogen-like characteristics and to the effects of their exposure in women during critical periods of breast development. The hope is that research in this area will lead to the development of tests that improve our ability to identify breast carcinogens.  

Already, some promising efforts are underway. A consortium of researchers, including scientists from the University of California-Berkeley, the breast cancer research group at the Silent Spring Institute, and the cross-agency government program Tox21 are collaborating on the development  of tests that will do a better job of predicting what chemicals  help cause breast cancer. These groups outlined their work at a recent meeting convened by Environmental Defense Fund (EDF) as part of our new initiative on advancing chemical testing and public health in the 21^st century.

Using public policy to save lives

To accelerate the development of such tests, however, we need a legal mandate. Few chemicals used in food, personal care products, and household cleaners have undergone any testing for cancer risk, and even fewer have been adequately tested for effects that might occur during critical periods of breast development.  Why? Because the laws governing chemicals used in household products don’t require such testing.

This is true even for chemicals, like bisphenol A, which can mimic the effects of the body’s hormones. Bisphenol A (the subject of my recently published book) is used in everything from the lining of food cans to receipt paper and can mimic the effects of estrogen and interfere with the effectiveness of some breast cancer treatment drugs.

Recognizing this fundamental policy failure, the IBCERCC report calls for reform of our nation’s chemical policy, including changes to our main chemical safety law, the Toxic Substances Control Act of 1976 (TSCA), which has not been substantially updated in 37 years. The President’s Cancer Panel, the American Public Health Association, the American Medical Association, and the American Academy of Pediatrics have made similar recommendations. 

Breast cancer is largely a preventable disease. To reduce the risks of chemical exposures, we need tests that accurately detect breast carcinogens, and we need policies that require such testing.  These goals are achievable in the near term, but only if we demand them.

EDF is working with a growing coalition to support strong chemical policy that protects health.  But we need everyone to speak out on this life or death issue.  Let’s work to prevent breast cancer and get toxic chemicals out of our products, our homes and homes and our lives. The lives of too many young women, my friend included, are being cut short by this disease. It’s time to say enough. Make your voice heard.