Your Health vs. the Environment
In her new book, "The Secret History of the War on Cancer," University of Pittsburgh’s Devra Davis goes into the trenches to report on the lengthy “War on Cancer” and to access its failings, successes and the current status of the assault.
Devra Davis zips around her tiny office like a perpetual-motion machine. Director of the Center for Environmental Oncology at the University of Pittsburgh Cancer Institute and a professor in Pitt’s Graduate School of Public Health, this slim, enthusiastic woman kicks off her patent-leather mules, puts a foot onto the desk, then onto the wall, and finally onto a nearby chair.
She moves constantly. It isn’t just a physical thing. The head is working just as fast. She grabs a book to illustrate the latest thinking on a topic. She turns and rustles through a file for more evidence. For a moment, she settles cross-legged in a yoga pose on her office chair. Then she rushes from the room to have copies made. She doesn’t wait for an interview to begin with a question: She heads right into what she wants to talk about.
And it’s not about her latest book and focus for this article, The Secret History of the War on Cancer. Davis doesn’t talk about her Clinton administration appointment either, her work for the World Health Organization or even her sharing in the Nobel Peace Prize awarded to Al Gore and the U.N. Intergovernmental Panel on Climate Change for her work with the U.N. group. She talks about family. She lost both parents to cancer: Harry B. Davis and Jean Langer Davis.
Davis, 61, still has lots of family in the Pittsburgh area. Her home now is in Washington, D.C., with husband Richard Morgenstern, an economist and senior fellow at Resources for the Future and former deputy administrator at U.S. Environmental Protection Agency. She rents a flat in Shadyside. They have a son, Aaron Morgenstern, 31, a manager for a wholesale-food company in Washington; a daughter, Lea Davis Morgenstern, 28, a paralegal in California; a grandson, Davis; a granddaughter, Josephine; and a newborn granddaughter, Raleigh.
In her book, she points out that the “War on Cancer” has concentrated on finding and treating cancer while ignoring some of the things that cause it. In addition, the book alleges there has been a conflict of interest for the industries that produce products said to cause cancer and the research these companies fund. It’s a practice that continues to this day. Davis comments on many of the everyday encounters people have that could pose a health risk—cell phones, cosmetics, cleaning products and job-related hazards, to name a few. For the past eight months, Davis has promoted her book in interviews, lectures and book signings across the country and internationally.
“Twenty years ago,” she says, “nobody would have listened…. I think we’ve matured.” Her hometown of Donora, 20 miles down the Monongahela from Pittsburgh, was often darkened by pollution spewing from steel mills and zinc works. It has long preyed on this scientist, no doubt because of the cancer deaths of family members. She sees “the cancer patterns that we face today where one in two men and one in three women have been diagnosed with cancer in their lifetime [as a] statistic that compels us to change our patterns and lifestyles.” As a Jew, she says she takes seriously a religious principle, tikkun olan, which she translates as “to heal the world…leave the world better than you found it.”
Despite her good intentions, Davis has not had everyone concur with her findings in The Secret History of the War on Cancer. In fact, the book has received some negative reviews. One writer from The Lancet, a medical journal, expressed concern about the accuracy of the book. The writer is director of the International Agency for Research on Cancer (IARC), which is criticized in the book. Davis mentions a former IARC director who objected to the chummy link between the cell-phone industry and those studying brain cancer connected with cell-phone use.
In a review that appeared in The Pump Handle, a blog focusing on public health and the environment, Boston University School of Public Health professor Richard Clapp applauds Davis’ revelations, saying her book raises vital issues that remain relevant today.
Davis also poses questions such as: Are cell phones really safe? Should mammograms be so widely used? Why are cosmetics and personal-care products basically free to contain anything? What poisons do you have sitting around the house that you might find a safer substitute for? Is anybody looking out for us? Is anybody saving us from ourselves?
You don’t have to be a scientist to learn more about these issues Davis raises or to read The Secret History of the War on Cancer; it’s easily accessible to the lay reader.
From Donora to Squirrel Hill and beyond
To hear Davis tell the story of her intellectual journey, her academic life began at Taylor Allderdice High School in Squirrel Hill. At 14, Davis had moved with her family to that Pittsburgh neighborhood from Donora, where her father was a brigadier general in the Pennsylvania National Guard and worked in the mills as a chemist and machinist. He became a businessman in Pittsburgh while her mother, a homemaker, earned a degree in women’s studies at Pitt. Donora, however, remained on her radar: Its 1948 smog that killed 20 and sickened half of the town became the impetus for her 2002 book, When Smoke Ran Like Water: Tales of Environmental Deception and the Battle Against Pollution.
For Davis, “School was not like school for me. It was a candy land.” She found her Allderdice English teacher Wayne Sommerfeld amazing. “We used to fight all the time,” she says of their debates on conflicting ideas. “If you have someone to fight with, it really helps you to sharpen your skills.” By the time she finished her sophomore year in high school, her teachers sent her to the University of Pittsburgh to take courses while still attending high school. When she graduated from Allderdice, she was already a junior at Pitt. She earned a B.S. in physiological psychology and an M.A. in sociology at 20.
At that point, she recalls her mother warning her, “‘You had better stop now, or you won’t get a husband.’” Davis did not heed that advice and continued full speed ahead. She went on to the University of Chicago and earned a doctorate in science studies. That was followed by a master’s of public health in epidemiology at Johns Hopkins University. As a seasoned academic, Davis can back up whatever she speaks about or writes about with plenty of support.
Her reference to a “War on Cancer” harkens back to President Richard Nixon’s war on cancer, declared in 1971. Her book takes the reader behind the scenes to the often deadly battlefields that, she maintains, slowed the war down and literally left many dead—unnecessarily. “We were fighting the wrong war because we were only focusing on finding and treating the disease and ignoring things that we knew caused it—like smoking, benzene, asbestos, radiation,” says Davis, stating the main theme of her book.
Davis notes that the medical community has made real progress in “finding and treating the disease.” However, unless prevention occurs, people will continue to die and the system could be swamped financially. “The direct cost of cancer alone is $100 billion a year.”
If Davis were the general, the war on cancer would continue to emphasize diagnosis and treatment, which has seen some success, with some 10 million cancer survivors across the United States alone. In addition, she would pay much more attention to all the other things that cause cancer as well as the positive things people can do to improve their health. In the following section, Davis comments on some of the possible causes of cancer.
Davis claims there are 35 million attics in the United States today that may have an insulation called Zonolite, which contains tremolite, a form of asbestos. The authors of one study also raised the crayon scare. Many brands of crayons used a talc containing asbestos. In a pattern first set by the tobacco industry, the companies denied the claim, hired researchers who found the crayons safe, and continued producing them. Only after government scientists confirmed the asbestos contamination was a change made about a decade ago.
Between 2000 and 2006, the United States imported three times the amount of asbestos from Mexico, China and South America than it had previously. It turns up in car brakes, potting soil, kitty litter and insulation. Most industrial countries, including the European Union, Japan and Saudi Arabia, have banned asbestos.
“Canada is still exporting asbestos [a naturally occurring mineral] to India, where young kids are working without any protective equipment to make yarn and things that we know are going to cause them to die in 20 or 30 years.”
On Cell Phones
“I can’t tell you that cell phones are safe. I can’t tell you that they are harmful. But I can tell you that if you go to…The Bioinitiatives Report that we have good reasons for concern…. We are already committed to cell phones. We know that the cell signal, which is a microwave signal, reaches the brain. It travels deeper in younger people. That’s the reason why many governments—including the city of Bangalore, India—recommend that children not use cell phones except for emergencies. According to the BBC News, India has the fastest growing mobile-phone market in the world with more than 170 million subscribers. “I think you should use a cell phone with a speaker or with a hollow-tube or other type of earpiece to reduce exposure. I don’t have it on my body all day long,” says Davis.
“The newest studies from Sweden by eminent oncologist Dr. Lennart Hardell find that people who use cell phones for 10 years or more have doubled the risk of brain cancer. This isn’t one study. These combine data from about eight or nine studies … . The engineers are going to solve this problem by coming up with safer ways. But right now we don’t have any assurance, so I think prudent precaution is appropriate. Cell phones save lives, but I’m very concerned about children, especially these teenagers who have the phone on for hours at a time.” Davis stresses that the most immediate danger associated with cell phone use in the car is the risk of accidents. England, Sweden and Israel recommend that people under 18 refrain from cell phone use.
On Cleaning Products
“I think it’s important that you look under your sinks and realize that you can do a lot with baking soda, vinegar, Borax, lemon juice.” The Center for Environmental Oncology website notes that “we know that many products are harmful or poisonous because they have warnings on the labels. Many of the products that we use to clean our homes, cars and offices can cause serious illness or injury. These products can contain cancer-causing ingredients.”
On Cosmetics and Personal-Care Products
The Campaign for Safe Cosmetics has more than 500 companies around the world signed up to try to reduce their use of toxic ingredients. The campaign is composed of U.S. health and environmental groups promoting nontoxic personal-care products. “I think that it is scandalous that the FDA in the United States and the regulatory authorities in Canada do not even have the authority to know whether or not there are carcinogens in cosmetics,” says Davis. When the law was set, she notes, many exceptions were grandfathered in.
A chemical called 1,4-dioxane, which causes cancer in rats and mice, is outlawed for use in personal-care products in the European Union but can be found in baby shampoo in the United States. It also may be found in cosmetics, other shampoos and detergents that carry such listed ingredients as PEG, polyethylene, polyethylene glycol, polyoxyethylene.
On CT Scans
“There is no question that overuse of CT scans increases the risk of second cancers. There’s growing evidence of…increased rates of acoustic neuromas following childhood radiation. As a result, health professionals are calling for reducing the amount of inappropriate CT scans…. We’re using alternative technologies.”
Writing for the Center for Environmental Oncology newsletter, Davis, who notes that, like cell phones, CT scans can save lives, says, “Modern America’s annual exposure to radiation from diagnostic machines is equal to that released by a nuclear accident that spewed the equivalent of hundreds of Hiroshimas across much of Russia and Eastern Europe” at Chernobyl in 1986…. As Davis pointed out, “A group of Yale researchers, looking at current patterns, estimates that in one year, 700 people will die from cancers associated with CTs and 1,800 will die from radiation-induced cancer from abdominal examinations carried out when they were infants.”
Between 1948 and 1972, some pregnant women received DES, the first synthetic hormone, which was developed in Germany in the late-1930s. Doctors believed that it would prevent miscarriages. The medication increased the risk of breast cancer for these women many years later.
The United States declared estrogen a cause of human cancer in 2002 following the abrupt discontinuation of the hormone-replacement program in the Women’s Health Initiative, a national hormone-replacement therapy research program. Designed to promote healthy hearts, the program caused, among other things, a 26 percent increase in breast cancer. Some personal-care products, including some oils, nail polish, shampoos, conditioners and dyes, contain hormones or things that react like hormones.
On Job-related Cancers
“Even though we are now outsourcing…our most dangerous jobs, those people who work in small factories, who work as shoemakers, hairdressers, painters, carpenters, steelworkers and in a number of other professions, face an increased risk of cancer because of what they worked with decades ago,” says Davis.
“Pittsburgh has a legacy of pollution, which is part of the contribution to cancer because cancer takes decades to develop. Pittsburgh is growing in industries that are going to be able to improve our ability to find, detect and prevent cancer. But there’s no question that the past legacy has left an increasing cancer rate in Pittsburgh and other similar industrial areas around the world,”says Davis.
Davis concludes that all the facts of a person’s life can contribute to cancer—including where he or she lives and works, what he or she eats and drinks and whether or not he or she smokes. Work risks also extend into the neighborhoods surrounding factories and mills.
“Mammography screenings will save lives in women who are just prior to menopause. We need to develop a better technology for finding breast cancer early and doing something about it. We’re doing research to come up with a urine or blood test that would predict risk and allow us to find breast cancer earlier and intervene…. I am very concerned about mammograms being given to women younger than 40.” African-American women in this age group had double the amount of breast cancer between 1995 and 2000 as white women. The early exposure could start a cancer that won’t show up for decades.
The National Breast Cancer Coalition doesn’t take a stand for or against mammograms but suggests having a mammogram when specific symptoms, such as a lump, warrant it.
On Pap Tests
Part of The Secret History of the War on Cancer involves the long battle fought before Pap tests were accepted by the medical community. Doctors apparently were reluctant to have a technician make the call. “They [Pap tests] could have worked sooner,” says Davis, “if the American Cancer Society had allowed the tests to come into use.” In nations using Pap tests, cervical-cancer deaths dropped by 50 percent. Use of the test in the United States came 30 years after it was developed.
The tobacco industry set the standard for how to avoid regulation, she contends. “The basic formula is to manufacture doubt,” says Davis. Millions died while the tobacco industry fought controls to warn users of its dangers. Cigarette advertising in the 1960s represented one of every four dollars spent on ads. The tobacco industry meanwhile thrives today in India, China and Latin America.
Continuing the War
Regulation would seem to be an answer to some of the problems in the war on cancer. But, says Davis, “We’ve had eight years of pretty appalling lapses, gaps and subversion of the intent of government…. When you drill down to the level of the Consumer Product Safety Commission, OSHA [Occupational Safety and Health Administration], EPA [U.S. Environmental Protection Agency], there’s just been consistent failure to fund the agencies…so the federal budget becomes a very powerful instrument for undermining public policy…. You don’t have people to monitor pollution or enforce the laws.”
Fortunately, Davis also notes, the cancer story is not “all gloom and doom.” The Center for Environmental Oncology is researching such food items as broccoli, dark chocolate, cauliflower, red wine, fish oil and garlic, which can be “phenomenally powerful” in repairing damage to DNA, says Davis.
There’s some more room to be hopeful: The presence of DTD and other pesticides in breast tissue today is at its lowest level in modern times, says Davis. Also, there’s “less air pollution on average.” Locally, UPMC is currently plotting its own Green Revolution; maybe green roofs on its buildings, maybe little things like stopping cars idling outside its buildings, using less water and chemicals for cleaning. Meanwhile, Davis advises, all of us can control, what we can control, which includes our own diet and exercise.
Ann Curran is a contributing editor and regular feature writer for Pittsburgh Magazine.