Breast Cancer Prevention Begins in the Womb

TedSchettlerwritten by Ted Schettler, MD, MPH
Science Director

As breast cancer awareness month ends with its primary emphasis on early detection I’ve been more interested in what we’ve learned about opportunities for prevention. Amidst all the pink ribbons and disagreements about optimal mammography scheduling an important theme seems to be finally taking hold. Although opportunities abound throughout life, breast cancer prevention begins in the womb.

This idea is not new. Twenty-five years ago Dimitri Trichopoulos proposed that breast cancer risk could originate in utero, influenced by maternal hormone levels.[1] Later studies linked hormone and growth factor levels with populations of breast stem cells in umbilical cord blood—a plausible mechanistic connection to cancer risk. A 2011 analysis reported a nearly two-fold increased risk of breast cancer in daughters of women who took estrogenic diethylstilbestrol (DES) during pregnancy before 1971.[2] This year, Barbara Cohn and colleagues reported that the highest maternal levels of the hormone-disrupting pesticide DDT during pregnancy were associated with a nearly four-fold increased risk of breast cancer in their daughters.[3]

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Thank You for Supporting CHE

Dear CHE Colleagues,

“A good start lasts a lifetime.” That’s what Linda Birnbaum’s mother told her when Birnbaum was growing up. Now Dr. Linda Birnbaum is Director of the National Institute of Environmental Health Sciences and works tirelessly to ensure we all get a good start in life by reducing exposures to toxic chemicals during the prenatal period and on through adolescence—in fact, across the entire lifespan.

And that’s what CHE does too. Prevention is at the heart of our work. We know that there are many contributors to a healthy start in life—socioeconomic, psychosocial, gene-environment interactions, nutrition, and so forth. But what is most often left out of the priority list of many excellent programs designed to protect children’s health are chemical contaminants. This means we’re not giving the next generation the greatest possible chance at reaching their fullest potential. By integrating this critical piece, CHE is creating a ‘win-win’ for children, families, and communities.

Over this past year, the audio-recordings of our exceptional conference calls on the emerging environmental health science have been downloaded 90,000 times, reaching people concerned with these issues around the world. Our Toxicant and Disease Database continues to be utilized and lauded by those in the federal government as well as researchers, health professionals, and laypeople alike. Our resources on environmental contributors to diabetes/obesity, infertility, cancer, and learning disabilities are consistently accessed on our website. Our publications, such as the “CHE issue” of San Francisco Medicine, the journal of the San Francisco Medical Society, offer useful analyses on cutting edge research and its implications for clinical practice and policy.
With your generous donation, we will continue to educate and motivate tens of thousands of scientists, health professionals, health affected groups and concerned citizens across the globe who want to improve public health in their respective countries and local communities. With your generous donation, we will continue our efforts to ensure that all children get the best start possible so that they can enjoy healthy, long and productive lives and see their children, grandchildren and even great grandchildren grow and thrive.

With gratitude and warmest wishes for the holidays,

Elise Miller, MEd

P.S. Remember: Donating to CHE is an investment in your children’s and grandchildren’s health—and future.

Advising Parents in the Face of Scientific Uncertainty: An Environmental Health Dilemma

Karin Russ
Coordinator of the CHE Fertility and Reproductive Health Working Group

A new article in Environmental Health Perspectives highlights the work of UCSF’s Program on Reproductive Health and the Environment, as they educate patients, providers and decision makers about environmental contaminants affecting reproductive health.  While their worked is focused on pregnant women and families of reproductive age, the challenge of providing advice even when there is scientific uncertainty rings true across populations. Individual education is important, allowing each person to weigh the importance of the information in their own situation, but further action is required on the societal level. Prevention is the most effective way to improve public health. By reducing environmental contamination in air, water, food and consumer products, we can prevent exposures and ensure health is the centerpiece of all our decision making.

Read the article.

Acting on the Science We Already Have

Elise Miller, MEd

“Our own thought process impacts the health of our ecosystem almost more than anything else,” Dr. Virender Sodhi explained at an Indian cooking class I attended last weekend. “The real problem is we most often take action on what we don’t know and don’t act on what we do know.”

His comments reminded me of a simple pie chart representing “our knowledge of the universe” that a professor I had in graduate school presented. One tiny sliver is labeled “what we know.” A sliver about twice the size of the first is labeled “what we think we know.” The next quarter of the pie is labeled “what we know we don’t know.” And the rest is “what we don’t even know we don’t know.”

As I reflected on this, I realized similar categories could be applied to the three CHE national calls we have scheduled this month. The first to be held this Friday, April 15th, might be described as “what we think we [are beginning to] know”—an update on the emerging science regarding environmental contributors to diabetes and obesity. The second call, on April 18th, will focus on “what we know we don’t know [but want to know]”—a forum for soliciting visionary ideas for NIEHS’ strategic planning process. And the third, on April 20th, will illuminate “what we already know [enough about to take action on]”—an interview with Carl Candor, author of Legally Poisoned: How the Law Puts Us as Risk from Toxicants.

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President’s Cancer Panel Report on Environmental Contributors to Cancer

Elise Miller, MEd

Rarely has anyone told me that they felt teary-eyed with joy when reading a newly published government report. But at least three prominent environmental health leaders I know said they felt just that when reviewing the President’s Cancer Panel report, Reducing Environmental Cancer Risk: What We Can Do Now, released last week. The report provides a multi-layered analysis of over 450 scientific studies linking chemical exposures to various forms of cancer and suggests action steps we can take on both personal and policy levels. Its publication garnered immediate press attention, with articles in the Washington Post, the New York Times, USA Today, and other media sources. Some cancer experts, including those representing the American Cancer Society who provided testimony to the PCP along with a number of respected academics and industry leaders, however, have expressed concern that the report overstates certain findings. Those discussions will no doubt continue to take place.

What should not be lost in any debate on these issues, however, is the report’s unequivocal recommendation that chemical exposures need to be considered along with lifestyle choices, genetics and other factors that may contribute to cancer—otherwise, we will only continue to see unacceptably high rates of childhood leukemia, breast cancer, prostate cancer, brain tumors and many other cancers that can shatter the lives of so many families and communities and add huge costs to the health care system. In short, this report brings to the forefront why the potential health impact of certain chemicals—chemicals that are now ubiquitous in the everyday products we use, in our food and water, and even in our own bodies—need to be an integral part of any primary prevention research and public health initiative on cancer.

Other notable aspects of this report include the emphasis on taking precautionary action in the face of potential threats to public health, the promotion of new worker safety standards, and the inclusion of military activities. In addition, it makes a persuasive economic case for why we need to develop alternatives and prioritize green chemistry as well as a human rights case for focusing not just on reducing the number of deaths but on improving the quality of life, particularly for those in disproportionately impacted communities. Finally, this report is unusually compelling and comprehensive because it offers clear steps we can take on multiple levels to reduce the incidence of cancer. In short, it calls for nothing less than a national cancer prevention strategy—inclusive of all potential contributing factors—that is wholly embraced by our communities and fully supported by the federal government, the health sector, and industry.

To learn more about this seminal report and its implications, please join us for our CHE partnership call on Tuesday May 18th.