Chronogram, August 4, 2005


[Rachel's introduction: "Despite widespread adherence among the scientific community to the commonsense precautionary principle 'An ounce of prevention is worth a pound of cure,' studies that look for links between breast cancer incidence and environmental factors are not commonplace."]

By Susan Piperato

Despite widespread adherence among the scientific community to the commonsense precautionary principle "An ounce of prevention is worth a pound of cure," studies that look for links between breast cancer incidence and environmental factors are not commonplace. "We are canaries in a coal mine, and we have been for years," says Hope Nemiroff, executive director of Breast Cancer Options (BCO), a grassroots organization offering information and support for women diagnosed with breast cancer, based in Ulster County. While breast cancer has become the "most commercialized illness with money being raised for the cure," she says, "even the National Institutes of Health and the National Cancer Institute admit they haven't spent enough time looking at the causes and why the disease happens in the first place."

That means pushing for research, both nationally and within our own community, says Nemiroff. Working toward the same goal are the Breast Cancer & Environmental Risk Factors program at Cornell University, and more than 20 fellow organizations (including Breast Cancer Options) that make up the New York State Breast Cancer Support and Education Network (co-directed by Andi Gladstone at 607-279-1043), a statewide coalition of organizations dedicated to providing support and education services to more than 100,000 women and their families affected by breast cancer, located from Buffalo to Long Island.

According to recent reports issued by the nation's leading cancer organizations (the American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries), the risk of getting cancer is falling nationwide and survival rates for many cancers are improving, thanks to progress made by programs in prevention, early detection, and better treatments.

However, not all types of cancers, or regions, have benefited equally from such programs. In 2004, an estimated 40,000 women nationwide died of breast cancer, according to the American Cancer Society. Breast cancer is now the most prevalent type of cancer for American women, as well as the top cause of cancer-related deaths among women ages 40 to 55.

Since 2003, New York State has held second place nationwide for breast cancer incidence and mortality rates. Annually in New York State, approximately 3,000 women die of breast cancer. Although Monroe County, in the northwestern area of the state, has the highest rates of breast cancer at 150 to 160 incidents per 100,000 women, rates for counties in the Hudson Valley region also show cause for concern.

According to the New York State Cancer Registry, overseen by the New York State Department of Health (NYSDOH), Hudson Valley breast cancer incidence rates for 1996-2000 were 140 to 150 per 100,000 women (the highest rating) in Rensselaer and Rockland counties; 130 to 140 per 100,000 women in Ulster, Dutchess, Orange, Westchester, and Albany counties; 120 to 130 per 100,000 women in Greene and Sullivan counties; 110 to 120 per 100,000 women in Putnam and Columbia counties; and below 110 per 100,000 women in Delaware County (the lowest rating).

However, checking rates by zip code on the "Maps and Stats by Zip Code" menu of the website for the Program on Breast Cancer & Environmental Risk Factors (BCERF) at Cornell University, can turn up statistics that are potentially more alarming than those from the Cancer Registry. Some zip codes' rates fall below expected statistics; for example, from 1993 to 1997, there were 127 actual incidences of breast cancer reported in Kingston 12401, with the area's actual rate falling below its "expected" rate of 132.4. However, in nearby Woodstock, incidence rates are 15 to 49 percent higher than expected; and several areas near Kingston, including New Paltz, Pine Hill, Glenford, Hurley, and West Hurley, exceed their "expected" statistics by 50 to 100 percent.

Carmi Orenstein, educator and assistant director of BCERF, says, "In New York State we know [statistics] by county and zip code and it's often alarming," but adds, "cancer clusters," or areas of extremely high cancer incidence, are not necessarily being indicated. "There may be some small clusters, but an epidemiologist wouldn't call this a cancer cluster, that's for sure." Breast cancer, she explains, is a "multifactorial disease" with known and hypothetical risk factors, including protective or harmful changes in breast fat cells influenced by onset of menstruation, predisposition, age of first pregnancy, and whether a woman breast-feeds, as well as "every interaction a woman has with the environment," from ionizing radiation (which caused high rates of adult onset of breast cancer, for example, in Japanese infants and young women exposed to atomic bombing) to environmental estrogens (synthetic chemicals that "mimic" estrogen, cause endocrine disruption, and may stimulate cell division in the breast).

Nonetheless, BCERF's mission is to study the link between breast cancer incidence and exposure to endocrine-disrupting chemicals common in environmental pollution and pesticides, as well as conduct forums throughout New York State on "cancer-related issues that are important in a region, and report on what we're working on," says Orenstein. "We have a lot of diverse projects, like studying contaminants in the water supply. But the most important thing we do is get people from different agencies talking to each other and the public."

So, until both the cure and the causes for breast cancer are discovered, what do we Hudson Valley residents do to guard ourselves, our families, and our communities from breast cancer? "Learn to live defensively," says Nemiroff.

Become an Activist

"In order to get studies working and get answers, people really need to be involved," says Orenstein. The New York State Cancer Registry, located in Albany at the New York State Department of Health, collects, processes, and reports on information about every New Yorker diagnosed with cancer. To register or find out more about rates, visit their web site.

Since NYS Breast Cancer Network was formed, says Gladstone, breast cancer advocacy organizations have been able to influence public policy, including adding treatment coverage to the Healthy Women Partnerships program for mammography and other cancer screening for low-income and/or uninsured women; requiring state agencies to buy safe and sustainable products and services; and establishing a statewide health tracking and biomonitoring program. "This monitors people's toxic loads in different areas of the state and correlates illness incidence with what's going on with the individuals and pollution," she says. The network also helped draft legislation for the Neighbor Notification Law requiring 24 hours' notice be given before spraying pesticides. The only problem: the law is county- optional, and so far, only seven counties -- Albany, Erie, Nassau, Rockland, Suffolk, Tompkins, and Westchester -- have signed on.

Get informed

In a study published last month by the Environmental Working Group, researchers at two major laboratories found a total of 287 types of industrial chemicals and pollutants in umbilical cord blood from 10 babies born during August and September 2004 in US hospitals -- including pesticides, consumer product ingredients, brominated flame retardants used in clothes and textiles, and stain and oil repellants found in fast food packaging, clothing, and furnishings.

Chemicals possibly related to cancer can be found in surprising places, says Nemiroff. Breast Cancer Options' 2005 Breast Cancer Risk Reduction Calendar lists the top anticancer and lowest-in-pesticides foods, along with 125 chemicals with which most people are unfamiliar -- found in everything from makeup to cleansers -- and gives hints on how to keep house and eat safely.

The BCERF Cancer and Environment Forum will take place on Friday, September 30, 10am-3pm, at 711A Legislative Office Building, Albany. Call (607) 255-1185 for more information.

Copyright 2005 Luminary Publishing, Inc.