PSA - Support Toxic Chemical Reform

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Dear Tamera,

There's been a sea-change and we need to keep the momentum going. The President's Cancer Panel (PCP), which represents the "mainstream" voice when it comes to cancer, recently adopted a position on environmental causes of cancer that we heartily support.

The April 2010 report issued by the PCP, "Reducing Environmental Cancer Risk: What We Can Do Now," takes a huge step forward - it recommends taking a precautionary approach to environmental contaminants and studying vulnerable populations (including low-income communities) that more often reside in highly polluted areas. It also calls for a more effective system to ensure that chemicals are proven safe before they are put on the market. Two decades of advocating for a healthier world are now resulting in calls for action at the highest levels!

Breast Cancer Action applauds the PCP for its thoughtful report and urges our leaders in Congress to take immediate action to reduce environmental cancer risks.

Join the Environmental Working Group in telling your Senators to support toxic chemicals reform!
If you feel inspired by this report, seize this moment and join us in supporting our allies at the Environmental Working Group by signing their online petition to ask your Senators to co-sponsor the Safe Chemicals Act. This legislation will strengthen our currently ineffective chemical regulatory system by requiring manufacturers to prove the safety of their products before consumers are exposed to them.

It only takes a minute - and the health of everyone depends on it. Thank you very much for supporting this legislation - and our work - that will lead to healthier, less toxic environments for all of us.


Be well,

Barbara A. Brenner, J.D.
Executive Director

Oops! Where did it Go????

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Have you heard the joke that begins: "...a funny thing happened to me..." ? Well, the joke is on me! Four weeks ago I went through a third round of reconstructive surgery. Part of this round included a nipple grafting. (And yes, it is as icky as it sounds. A real slice, dice, and sew job!)

On Monday, while getting dressed for court I noticed that my coveted little protrusion was gone. I went to the magnifying mirror and closely inspected the area. Yup. That's right Alice, me nipple was gone! And, yes, I did say out loud to myself, while standing in the middle of the bathroom..."CRAP, me nipple is gone." And it was said with an affected East End accent. Then I began giggling uncontrollably. It has taken me days to stop.

Indeed, the only thing that saved me from a particularly exhausting day on the criminal bench was knowing what was missing underneath the black robe!

Well, the joke continued. The next day when I stepped into my shower I saw something kinda funky in the corner. I inquisitively leaned down to inspect further. EUREKA! There IT was. In all ITS gruesome glory.

I unceremoniously rinsed IT down the closest rabbit hole -- the shower drain. Its okay, IT's biodegradable.

More than ever, my thoughts are turning back to the Lotus. And, if I want a nipple that bad, I suppose that I can always buy a truly detachable one from the neighborhood "Adult Shoppe" or Auto Zone*.

PSA - Treatment Concerns Regarding of DCIS

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Progress in Predicting Invasive Breast Cancer - Researchers Identify Biomarkers That May Help Decide Who Will Need Aggressive Treatment

By Charlene Laino
WebMD Health NewsReviewed by Laura J. Martin

MDApril 28, 2010 -- Doctors are a step closer to being able to predict which women with noninvasive breast tumors will go on to develop invasive breast cancer -- and therefore whether or not they need more aggressive treatment.

Researchers studied nearly 1,200 women with ductal carcinoma in situ (DCIS), a noninvasive and very early form of breast cancer confined to the milk ducts. They found that a combination of three tissue biomarkers was associated with a high risk of developing an invasive breast cancer with the potential to spread eight years later.

Also, DCIS that was diagnosed from a breast lump was linked to a greater risk of subsequent invasive cancer than DCIS that was diagnosed by mammography.
There's still a long way to go before the personalized approach to treatment is ready for prime time.

"But the study gets us closer to our goal of separating women with DCIS into risk groups, so as to avoid overtreatment of women with low-risk breast lesions and undertreatment of women with high-risk lesions," study researcher Karla Kerlikowske, MD, of University of California, San Francisco, tells WebMD.

The study was published online by the Journal of the National Cancer Institute.

Get Your Personalized Breast Cancer Treatment Report

Overtreatment of DCIS
Currently, overtreatment of DCIS, which will be diagnosed in over 47,000 women this year, is the big problem, according to Kerlikowske.

"Since there's currently no way to predict which women with DCIS will go on to develop invasive cancer, almost all are offered radiation after the lump is removed [lumpectomy] or mastectomy and sometimes hormone therapy. But our results suggest as many as 44% of women with DCIS may not require any treatment other than removal of the lump and can instead rely on active surveillance, or close monitoring," Kerlikowske says.

The close monitoring offers these women a safety net, she says. "If a tumor comes back, we can always give radiation then."

Radiation therapy not only carries a risk of side effects such as nausea, vomiting, and fatigue but also precludes irradiating the same area of the breast a second time, Kerlikowske says. "So you want to save it for when it is really needed," she says.

Predicting Invasive Breast Tumors
The study involved 1,162 women aged 40 and older who were diagnosed with DCIS and treated with lumpectomy alone between 1983 and 1994.

Overall, their eight-year risks of developing a subsequent DCIS or a subsequent invasive cancer were 11.6% and 11.1%, respectively.

When the researchers looked at women whose DCIS was diagnosed by feeling a lump, the eight-year risk of subsequent invasive cancer was substantially higher than average, 17.8%.

Then they looked at different combinations of biomarkers using tissue that had been stored for 329 of the women when they were first diagnosed with DCIS. These biomarkers include estrogen receptor, progesterone receptor, Ki67 antigen, p53, p16, epidermal growth factor receptor-2, and cyclooxygenase-2.

Predicting Invasive Breast Tumors continued...
The study showed that women who express high levels of three biomarkers -- p16, cyclooxygenase-2, and Ki67 -- also had a substantially higher-than-average eight-year risk of developing invasive cancer (27.3%).

The researchers stratified all 1,162 women into four risk groups. A total of 17.3% were in the lowest-risk group, with only a 4.1% chance of developing invasive cancer at eight years; 26.8% were in the next lowest risk group, with a 6.9 chance of developing invasive cancer at eight years. If the findings are validated, it is these two groups that could forgo treatment other than lumpectomy and active surveillance, Kerlikowske says.

A total of 27.6% of the women were in the high-risk group, with a nearly 20% chance of developing invasive cancer at eight years. These are the women who need more aggressive therapy with radiation and perhaps hormone therapy, she says.

Factors associated with a higher risk of having a subsequent ductal carcinoma in situ included having no cancer cells remain within 1 millimeter of the area from which the lump was removed and different combinations of biomarkers.

Unanswered Questions
Still, many questions remain.

For starters, about half of women who developed invasive cancer in the study didn't have the three biomarkers or DCIS diagnosed from a lump, so the researchers have to figure out what other factors are at play, Kerlikowske says.

Also, the approach has not been shown to actually extend lives.

Additionally, the study involved women who had undergone lumpectomy alone, which is no longer the standard of care, says Ramona Swaby, MD, a breast cancer specialist at Fox Chase Cancer Center in Philadelphia.

Recurrence rates are lower in women who also get radiation and if needed, hormone therapy, so it's important to see if the findings hold up in such women, she tells WebMD.

Craig Allred, MD, of Washington University School of Medicine in St. Louis, also calls for further study in an editorial accompanying the study. Still, "if validated, the results could optimize current therapy in certain settings: [withholding] radiation from women with low-risk DCIS, for example," he writes.

Several companies have expressed interest in helping to further develop and eventually market any tissue biomarker test, which will also need FDA approval, according to Kerlikowske.

Since it utilizes the same method and can be done at the same time doctors determine a tumor's hormone-receptor status, she doubts it will cost more than a few hundred dollars.

Funding for the research was provided by the National Cancer Institute and the California Breast Cancer Research Program.

My own personal journey is with Invasive Lobular Carcinoma (ILC) - Stage III. On my journey, however, I have had many women within my circle of contacts that have been diagnosed with Stage O DCIS. Many of whom have made tough personal choices regarding how they were going to address their diagnosis. To be candid, I have been concerned by many of the choices made. But, again, it is a personal choice and one that is never easily made. Part of my sincere hope for all women who have this early diagnosis is that they make their decisions not from visceral fear, but informed knowledge. My thoughts, prayers and hopes are with the friends, colleagues, and daughters that make up the 47,000.

PSA - Op Ed from the NY Times: "President's Cancer Panel"

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May 6, 2010
Op-Ed Columnist
New Alarm Bells About Chemicals and Cancer
By NICHOLAS D. KRISTOF
The President’s Cancer Panel is the Mount Everest of the medical mainstream, so it is astonishing to learn that it is poised to join ranks with the organic food movement and declare: chemicals threaten our bodies.

The cancer panel is releasing a landmark 200-page report on Thursday, warning that our lackadaisical approach to regulation may have far-reaching consequences for our health.

I’ve read an advance copy of the report, and it’s an extraordinary document. It calls on America to rethink the way we confront cancer, including much more rigorous regulation of chemicals.

Traditionally, we reduce cancer risks through regular doctor visits, self-examinations and screenings such as mammograms. The President’s Cancer Panel suggests other eye-opening steps as well, such as giving preference to organic food, checking radon levels in the home and microwaving food in glass containers rather than plastic.

In particular, the report warns about exposures to chemicals during pregnancy, when risk of damage seems to be greatest. Noting that 300 contaminants have been detected in umbilical cord blood of newborn babies, the study warns that: “to a disturbing extent, babies are born ‘pre-polluted.’ ”

It’s striking that this report emerges not from the fringe but from the mission control of mainstream scientific and medical thinking, the President’s Cancer Panel. Established in 1971, this is a group of three distinguished experts who review America’s cancer program and report directly to the president.

One of the seats is now vacant, but the panel members who joined in this report are Dr. LaSalle Leffall Jr., an oncologist and professor of surgery at Howard University, and Dr. Margaret Kripke, an immunologist at the M.D. Anderson Cancer Center in Houston. Both were originally appointed to the panel by former President George W. Bush.

“We wanted to let people know that we’re concerned, and that they should be concerned,” Professor Leffall told me.

The report blames weak laws, lax enforcement and fragmented authority, as well as the existing regulatory presumption that chemicals are safe unless strong evidence emerges to the contrary.

“Only a few hundred of the more than 80,000 chemicals in use in the United States have been tested for safety,” the report says. It adds: “Many known or suspected carcinogens are completely unregulated.”

Industry may howl. The food industry has already been fighting legislation in the Senate backed by Dianne Feinstein of California that would ban bisphenol-A, commonly found in plastics and better known as BPA, from food and beverage containers.

Studies of BPA have raised alarm bells for decades, and the evidence is still complex and open to debate. That’s life: In the real world, regulatory decisions usually must be made with ambiguous and conflicting data. The panel’s point is that we should be prudent in such situations, rather than recklessly approving chemicals of uncertain effect.

The President’s Cancer Panel report will give a boost to Senator Feinstein’s efforts. It may also help the prospects of the Safe Chemicals Act, backed by Senator Frank Lautenberg and several colleagues, to improve the safety of chemicals on the market.

Some 41 percent of Americans will be diagnosed with cancer at some point in their lives, and they include Democrats and Republicans alike. Protecting ourselves and our children from toxins should be an effort that both parties can get behind — if enough members of Congress are willing to put the public interest ahead of corporate interests.

One reason for concern is that some cancers are becoming more common, particularly in children. We don’t know why that is, but the proliferation of chemicals in water, foods, air and household products is widely suspected as a factor. I’m hoping the President’s Cancer Panel report will shine a stronger spotlight on environmental causes of health problems — not only cancer, but perhaps also diabetes, obesity and autism.

This is not to say that chemicals are evil, and in many cases the evidence against a particular substance is balanced by other studies that are exonerating. To help people manage the uncertainty prudently, the report has a section of recommendations for individuals:

¶Particularly when pregnant and when children are small, choose foods, toys and garden products with fewer endocrine disruptors or other toxins. (Information about products is at www.cosmeticsdatabase.com or www.healthystuff.org.)

¶For those whose jobs may expose them to chemicals, remove shoes when entering the house and wash work clothes separately from the rest of the laundry.

¶Filter drinking water.

¶Store water in glass or stainless steel containers, or in plastics that don’t contain BPA or phthalates (chemicals used to soften plastics). Microwave food in ceramic or glass containers.

¶Give preference to food grown without pesticides, chemical fertilizers and growth hormones. Avoid meats that are cooked well-done.

¶Check radon levels in your home. Radon is a natural source of radiation linked to cancer.

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I invite you to visit my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.

The Power of the Lotus

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Lotus flowers are amazing and have strong symbolic ties to many Asian religions especially throughout India. The lotus flower starts as a small flower down at the bottom of a pond in the mud and muck. It slowly grows up towards the waters surface continually moving towards the light. Once it come to the surface of the water the lotus flower begins to blossom and turn into a beautiful flower.

Within Hinduism and Buddhism the lotus flower has become a symbol for awakening to the spiritual reality of life. The meaning varies slightly between the two religions of course but essentially both religious traditions place importance on the lotus flower.

In modern times the meaning of a lotus flower tattoo ties into it's religious symbolism and meaning. Most tattoo enthusiast feel that the a lotus tattoo represent life in general. As the lotus flower grows up from the mud into a object of great beauty people also grow and change into something more beautiful (hopefully!). So the symbol represent the struggle of life at its most basic form.

Lotus flower tattoos are also popular for people who have gone through a hard time and are now coming out of it. Like the flower they have been at the bottom in the muddy, yucky dirty bottom of the pond but have risen above this to display an object of beauty or a life of beauty as the case might be. Thus a lotus flower tattoo or blossom can also represent a hard time in life that has been overcome.