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

******
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.

•

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

******


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.

Decisions of a "General Contractor" - To Trust or Not to Trust

******

. . .The question in my mind is: is it necessary to do anything?

While I ponder that unceasing question, I have begun introducing bee pollen into my daily regimen. (As well as reading the "Beatles Anthology" from cover to cover - I'm up to the year 1965!) What the heck. It makes as much, if not more, sense than what I keep running into in the medical arena. . . .

Well . . .

I have been pondering the question, and I have come to one decision: time to change Dr. GYN. It's sad - as I have been with this same group since 1995, and it may seem a bit reactionary, but I cannot overlook the historical facts.

Fact one: it was this GYN group that had put me on Paxil, and kept me on it during a pregnancy. Paxil is now known to cause birth defects and miscarriages. That pregnancy ended in a long & drawn out miscarriage as we watched the fetus's heart beat slowly slow down over time. At that time, I kept questioning what was causing this miscarriage, and if it could be the Paxil. Dr. GYN was adamant that Paxil had no known side-effects that would cause a miscarriage. In their defense, the public's knowledge of Paxil's side effects is just now becoming more readily accessible. My research at the time (1998) however, did uncover that there was indeed room for concern. I took myself off the Paxil and went on to conceive and give birth to a healthy baby boy three years later.

Fact two: it was this GYN group that gave me injections of progesterone for 6 months to treat my amenorrhea. This was after my mammograms and physical exams identified a palpable mass that was mislabeled as "dense fibrous tissue." The current information on progesterone is:

Scientists at Michigan State University (The team of faculty is part of MSU's Breast Cancer and the Environment Research Center, one of four centers nationwide funded by the National Institute of Environmental Health Sciences and the National Cancer Institute. The center brings together researchers from MSU's colleges of Natural Science and Human Medicine to study the impact of prenatal-to-adult environmental exposures that may predispose a woman to breast cancer.) have found exposure to the hormone progesterone activates genes that trigger inflammation in the mammary gland. This progesterone-induced inflammation may be a key factor in increasing the risk of breast cancer. . . ."Progesterone turns on a wide array of genes involved in several biological processes, including cell adhesion, cell survival and inflammation," said physiology professor Sandra Haslam, co-author of the paper and director of the Breast Cancer and the Environment Research Center at MSU. "All of these processes may be relevant to the development of breast cancer."

Fact three: This GYN group is the same group that did not question the identification of the mass in my breast as "dense fibrous tissue." The mass was initially identified in 1993 (while I was still in law school) and then again in 1995 when I was referred to the current GYN group (after we moved to the Southwest). The mass at the time was negligible in size (as compared to the 6.2 cm malignant tumor that was excavated from my breast in August 2009). Rather, they went with the radiologist's report. I did not know enough at that time to question the veracity of the radiologist's report myself! Hindsight is proven once again to be 20/20!

Inter script - ILC (invasive lobular carcinoma) can really only be conclusively diagnosed through an MRI. No one offered or suggested an MRI beginning in 1993. I did not know to ask. Why would they think to do so? Why would I ask? As far as Dr. GYN and I knew I had no risk-factors to direct us to think in terms of breast cancer. My issue, however, is that when I became acutely symptomatic in early 2009 (and it took me nearly 3 months to get an appointment with Dr. GYN) with minor research I discovered the need for an MRI as a definitive diagnostic tool, as opposed to the conventional diagnostic mammogram. Dr. GYN did not send me for an MRI, he sent me for a diagnostic mammogram.

Fact four: I am now being "diagnosed" with Ovarian Remnant Syndrome (OSR) although, again, my research informs me that this can only be definitively diagnosed by an MRI. Again, Dr. GYN did not suggest doing this. Why is this important? Well, in my own research of how ILC metastasizes, the ovarian area is particular susceptible. The MRI may be the only way for me to put to rest the...my...question of what this "undefined residual tissue" really is.

Daily mantra: I MUST NEVER FORGET THAT I AM THE "GENERAL CONTRACTOR" OF MY OWN HEALTH & WELL-BEING

(oh...btw...I am now into 1966 in the Beatles Anthology! Fabulous escapism!)

Hmmm...Health Care Reform Needed...Ya Think???

******
...Long story short, I went directly to the radiologist and requested that he re-read the films and do an addendum to his findings. This request was accompanied by a full history of my 1981 oophorectomy. I am pleased to say that the radiologist did so in less than 24 hours -- and directly sent me the addendum to his report. Finding?...no, it is not an ovary that is present, but rather, "undefined residual tissue." And, yes, this residual tissue does measure larger than the one intact ovary. Now this needs to be explained because back in 1998 I had the residual scar tissue from the 1981 oophorectomy laparoscopically removed.

What now? I dunno? I have faxed this new info to my specialists to wait for their response, if any. ...

(Just as a refresher...I have been experiencing "non-specific" symptoms that no one seems to be able to define.)

So, my health care travails and travels took me to both a GI specialist (gastro-intestinal specialist) and my long-attended GYN's office. And. . ., in the arena of "interesting" neither failed to disappoint.

The GI (a very pleasant 60-ish guy with a wry sense of humour) attributed my "non-specific" symptoms, in part, to a .... displaced rib. What? Really? His learned opinion, after a physical exam, was that my "floating rib" (ya know, the one that belonged to our forefather, Adam) is displaced and is irritating my liver and stomach. Oh, Adam's Rib is the cause of the persistent pain in my side? Figures, doesn't it...pain can usually be traced back to a male ;+P. What about the unexplained weight-gain, chills and fatigue? "No, a displaced rib would not cause those symptoms." So, any thoughts on those? "No, not really." Oh? Well thank you for your time (?) Dr. GI gave me a brown-paper bag of pharmaceutical samples and said that all should resolve itself in 6-8 weeks. The samples were for heartburn. Heartburn is not one of my symptoms! I guess Dr. GI did not want me to leave empty-handed. Thoughtful.

Next stop? The other end of my abdomen...

My current GYN (who absorbed the practice of my first AZ GYN...(ewww, I so did not say absorbed!) and who has seen me through a couple of miscarriages (yet somehow missed the entry in my medical records regarding the oophorectomy. But he did see that his prior partner had done the subsequent laparoscopy for the residual scar tissue) duly considered the ultra-sound and PetScan results. He determined that I was one of those rare women who experience Ovarian Remnant Syndrome! What? Really? (I feel like its deja vu all over again. I just don't know for what!!)

Ovarian Remnant Syndrome (ORS): A rare condition where ovarian tissue is left in the pelvic cavity following the removal of ovaries and fallopian tubes causes pelvic pain. The tissue that is left behind can form cysts which can enlarge and pull on nearby adhesions causing pain. Pain can also occur when remaining ovarian tissue produces hormones that stimulate endometriosis.

My research tells me that the only way to accurately diagnosis OSR is an MRI and/or another laparoscopy. Dr. Onc had offered to do an MRI to explain the "undefined residual tissue." Dr. GYN did not offer the MRI. And, I must keep in mind that Dr. GYN and his partner/predecessor concurred (or rather, did not question) my prior mammograms' characterization of my breast cancer as solely "fibrous tissue."

The question in my mind is: is it necessary to do anything?

While I ponder that unceasing question, I have begun introducing bee pollen into my daily regimen. (As well as reading the "Beatles Anthology" from cover to cover - I'm up to the year 1965!) What the heck. It makes as much, if not more, sense than what I keep running into in the medical arena.

So for now, I will buzz on!

Listening for Footfalls

******
Having a Stage III cancer diagnosis, it is nearly impossible to not have moments (sometimes a daily moment) when the reality of this state of being crosses my mind. Typically, it is a fleeting acknowledgment generated by an "in your face" reminder (e.g., a la Susan B Komen!). Or, it is a mental-embracing when I find out that yet another person's life is being threatened with breast cancer.

But then, there are the other times...

The other times are when a persistent ache, symptom, discomfort, or anomaly continues for days or weeks. Then my thoughts turn to: what if? What if this is a symptom of the cancer having metastasized and that little tid-bit is/was undetected or misread on the PetScan? And then I think, PetScans are only snapshots of how you were doing, not how you ARE doing. And I think, my 6.2 cm tumor was most likely growing in my body for approximately 10 years (given the reported indolent nature of ILC) and no medical doctor picked it up. Indeed, my past screening mammogram readings mis-characterized the tumor as "fibrous tissue" - and this was with a palpable lump. It was only after my breast started become visible affected that a diagnostic mammogram was ordered. Sigh...but that's just boobie under the bridge. So, then I tell myself, I think way too much.

But then, again, I am reminded of the impreciseness of medical science...

Last week I got the results of (invasive) tests, conducted for the purpose of trying to define "persistent aches, symptoms, discomforts and anomalies." One of the tests matter-of-factly described the presence of a right ovary; and apparently that this right ovary is substantially larger than my left ovary. This would not be disturbing but for the fact that I HAD MY RIGHT OVARY REMOVED IN 1981! When I brought this minor inconsistency to the attention of my oncologist's office (yes, my third!) I was told: "they can only go by what the radiologist read." Oh...and by the way no, ovaries do not typically grow back!

Long story short, I went directly to the radiologist and requested that he re-read the films and do an addendum to his findings. This request was accompanied by a full history of my 1981 oophorectomy. I am pleased to say that the radiologist did so in less than 24 hours -- and directly sent me the addendum to his report. Finding?...no, it is not an ovary that is present, but rather, "undefined residual tissue." And, yes, this residual tissue does measure larger than the one intact ovary. Now this needs to be explained because back in 1998 I had the residual scar tissue from the 1981 oophorectomy laparoscopically removed.

What now? I dunno. I have faxed this new info to my specialists to wait for their response, if any.

And I sit here and think. Having a stage III cancer diagnosis, while not consuming (excuse the pun) my daily life still interjects an eerie component into my thinking. It's like my subconscious is ever vigilant in listening for silent, yet anticipated, footfalls.