By Elizabeth M. Whelan, Sc.D., M.P.H., Gilbert Ross, M.D.
Posted: Friday, April 8, 2005

EDITORIAL
Publication Date: April 8, 2005

Ever since ABC News anchor Peter Jennings announced last week that he had been diagnosed with lung cancer, we have observed an increased interest in the disease--particularly the probability of it occurring in former smokers.  We have spoken with dozens of former smokers and read reports of anxiety in this group, and, drawing on the American Council on Science and Health's past research, we offer facts and advice on lung cancer.  Our advice is tailored to three different groups: a) ex-smokers, b) current smokers, and c) non-smokers who are candidates to take up the habit.

Risks

First, some hard facts:

--Cigarette smoke is the leading cause of preventable death in America today, accounting for at least 450,000 premature deaths.

--Approximately 160,000 cases of lung cancer are diagnosed annually in the U.S., which means that on any given day (such as the day Mr. Jennings received his diagnosis) some 460 other Americans get the same bad news.

--Just over 90% of all lung cancers are causally linked with cigarette smoking. Indeed before cigarette smoking became popular around World War I, lung cancer was an exceedingly rare disease (tobacco was used relatively safely in the form of pipes, cigars, and snuff prior to that time).

--During the 1960s nearly 70% of American men smoked, and about 50% of American women were smokers.  We have dramatically reduced the prevalence of smoking in our country, with smokers giving up the habit and fewer young people taking up smoking--but the reality is that even among those who have quit, health risks associated with past smoking remain.  That explains why approximately 50% of the 160,000 diagnoses now made for lung cancer are made among former smokers.

--One popular argument the scientific community often makes to encourage smokers to quit stems from the theory that all of the health effects of smoking are reversible shortly after cessation, regardless of the duration or intensity of smoking exposure.  Unfortunately, this is just not true.

--Regarding lung cancer, smoking for about 25 years appears to trigger a biological switch that drives the growth of lung cells towards the development of lung cancer--even if the smoker quits.  Thus, while quitting is the best option for a smoker of any age, damage to the respiratory system, including those that can result in cancer, may continue to plague the ex-smoker for years after quitting.

--Smokers (one pack a day for twenty or more years) have a ten- to fifteen-fold greater risk of developing lung cancer compared to those who have never smoked.  The more you smoke--or smoked in the past--the greater your risk of lung cancer (and other smoking-related diseases).  Public health experts have long argued that risk declines with time after you stop, but this may be much more true for risks of heart disease than for risks of cancer, particularly with a very long history of heavy smoking.

The Case of Peter Jennings

Take the case of Peter Jennings.  News reports indicate he started smoking when he was thirteen years old (for him that would have been around 1951) and continued smoking heavily until the mid or late 1980s.  That would be more than thirty-one years of exposure to the risks of smoking.  It is unclear how much he smoked after giving up cigarettes in the 1980s (he acknowledges taking up smoking again after the 9/11/01 terrorist attacks).

Mr. Jennings, even if he was an ex-smoker after 2001, was at greatly elevated risk of lung cancer given the long history of exposure.  The question then is this: what are the lessons to be learned from Peter Jennings?  What can and should we do to reduce our own risk of being diagnosed with life-threatening lung cancer?

Advice for Risk Groups

For nonsmokers: Do not start smoking.  Do not delude yourself into believing that you can "smoke 'til I'm thirty" or "smoke until I want to have kids" and come away unscathed, returning to the same risk file as a never-smoker.  Smoking directly irritates and damages the respiratory tract.  Each year, a one-pack-a-day smoker smears the equivalent of a cup of tar over his or her respiratory tract.  This irritation and damage cause a variety of adverse effects, ones that can be reduced--but not entirely reversed--by quitting.

For current smokers: Quit now.  Get assistance if necessary.  Even if you have been smoking for many decades, you will be rewarded with health benefits, especially a rapid decline in risk from the number one cause of cigarette death: cardiovascular disease.

For (newly worried) former smokers: Be grateful you quit when you did.  If you have smoked for many years--maybe decades--and now realize you have an elevated risk of lung cancer, consider the fact that among long-term, current smokers, the chances of developing lung cancer are in the 10%-15% range.  If you quit ten or more years ago, your personal risk is below that range.

Screenings

What about regular lung cancer screenings?  Well, talk it over with your own physician--but be keenly aware of the limitations here.  Your physician may recommend a yearly chest X-ray.  This may or may not assist in diagnosing lung cancer at an early, curable stage.  (The American Cancer Society stopped recommending annual X-rays for smokers many years ago, although some physicians think such rays can be useful in finding early cancers.)

There has been some excitement in the medical community, and among the public, about screening using lower-dose CT scans--spiral or helical CTs--to enhance detection of early-stage lesions.  There are several studies now underway to see if such techniques will lead to an improvement in the real bottom line: survival rate.  Thus far, no study has shown an improvement in mortality rate from lung cancer in patient groups screened by chest X-ray or CT scan, but there have been some indications that larger-scale studies may show some beneficial impact.  Meanwhile, the fact is that many more benign lesions or indolent growths of no importance to lifespan get detected than dangerous, early-stage tumors--in other words, these CT type tests can yield lots of "false positives," causing needless anxiety and even needless surgery.  It seems counter-intuitive, but early detection has not proven to be helpful in saving lives from lung cancer...yet.

Whelan and Ross head the American Council on Science and Health, which runs the sites ACSH.org, HealthFactsAndFears.com, and theScooponSmoking.org.

View the original article here

Peliculas Online

Home > Health Issues >

Radiation Saves Lives of Breast Cancer Patients, Study Shows
?Women shouldn?t fear radiation therapy ? they should welcome its benefits?

Posted: Thursday, December 15, 2005

PRESS RELEASE
Publication Date: December 15, 2005

NEW YORK, NY -- December 15, 2005.  Radiation therapy for breast cancer patients following lumpectomy saves lives and should be used more often, despite the fears of many women about radiation.  So says the American Council on Science and Health, reacting to a study in the December 17, 2005 issue of the British medical journal the Lancet.
Women are often fearful of radiation's potential side effects, but the new Lancet study by Sir Richard Peto and colleagues at Oxford, re-examining studies of some 42,000 women, shows that the benefits outweigh the risks.  The practice of "watchful waiting" after
lumpectomies may be ill-advised.
"This new Lancet study erases any doubt about the value of radiation after lumpectomy," says American Council on Science and Health president Dr. Elizabeth Whelan, hailing the findings.  "Women shouldn?t fear radiation therapy -- they should welcome its benefits."  Some 25% of women forgo radiation therapy after lumpectomies, but it now seems likely that many of those individuals should receive radiation.
The American Council on Science and health is a non-profit consumer education group, advised by over 300 doctors and scientists, that works to put health risks and benefits in perspective.
Contact: Dr. Elizabeth Whelan, president, American Council on Science and Health (http://ACSH.org): Whelan@acsh.org 212-362-7044 x237

See also: Whelan's op-ed on the topic: http://www.acsh.org/factsfears/newsID.674/news_detail.asp

View the original article here

Peliculas Online

By Elizabeth M. Whelan, Sc.D., M.P.H.
Posted: Friday, May 14, 2010
Publication Date: May 14, 2010

The President’s Cancer Panel has released a report on the causes of cancer and how we might best avoid them. Among its recommendations: Take off your shoes before entering your home.

The panel’s 200-plus-page report is a scientific travesty that claims environmental chemicals have been routinely understated as a cause of cancer. Made up of just two members — Dr. LaSalle Leffall of Howard University and Dr. Margaret Kripke, professor emeritus at the M.D. Anderson Cancer Center in Houston —the panel concluded that there is “grievous harm” being done by chemicals and there is “a growing body of evidence linking environmental exposures [to chemicals] to cancer.”

If Dr. Leffall and Dr. Kripke had simply consulted a standard textbook on cancer epidemiology, they would have learned that lifestyle factors such as smoking, obesity, excessive alcohol consumption, and overexposure to sunlight are the underlying preventable causes of human cancer — not “chemicals” in air, water, and food.

The panel’s report, which was roundly criticized by the American Cancer Society and other experts on cancer causation, was constructed on a number of false premises:

1. It assumed that “chemicals” are dangerous by definition and our exposure to them should be limited. Well, that would indeed be a problem, since all things, natural and synthetic, are comprised of “chemicals.” When you have a cold, refreshing glass of water, you are drinking dihydrogen monoxide.

2. It assumes that our goal in cancer prevention should be to eliminate all exposure to “toxic” and “carcinogenic” agents. Sorry, that is impossible. Safe, natural foods come replete with toxins (such as the traces of naturally occurring arsenic in every potato) and “carcinogens,” defined as chemicals that cause cancer at high dose in laboratory animals (like the safrole in black pepper or the eatechol in a cup of coffee).

3. The panel appears to be oblivious to the concept of “dose” — as expressed in the classic toxicological premise “only the dose makes the poison.” Exposure to chemicals like vinyl chloride at high levels for long periods of time has indeed, decades ago, caused cancer in the workplace. Such true human carcinogens are always detected via careful collection of epidemiological data. But that level of occupational exposure has no relationship to environmental exposure to trace levels of chemicals.

4. The panel relies upon and endorses the so-called “precautionary principle,” which demands that every chemical be proven safe before it is used. How can you prove anything to be safe? You can’t. It’s like trying to prove a negative.

For example, the panel’s report repeatedly targets the chemical BPA as posing numerous health risks, including cancer. BPA is a ubiquitous industrial chemical — essential in the manufacture of many hard plastic products — and used in the lining of cans to prevent the development of foodborne illnesses, such as botulism. BPA has been used for over 50 years and subjected to thousands of safety evaluations. Expert panels from around the world (including our own Food and Drug Administration and Environmental Protection Agency) have concluded that BPA is safe as used. Yet the panel still raises anxieties about adverse health effects from this chemical. In other words, despite all the studies, under the panel’s “precautionary principle,” BPA still does not make the cut to be labeled “safe.” Under that standard, what chemical would ever get the government’s seal of approval?

The President’s Cancer Panel is an assault on the science of cancer epidemiology. Its findings — such as avoiding environmental cancer-causing agents by taking off your shoes and leaving the “carcinogens” you picked up on the way home at the doorstep — are ludicrous and, by distracting Americans from the proven cancer risk factors, are more likely to increase than decrease our nation’s cancer burden. This prestigious-sounding panel (which New York Times columnist Nicholas Kristof dubbed “the Mount Everest of the medical mainstream” — it isn’t) urges us to eat organic foods, filter our water, and microwave only using ceramic or glass, rather than plastic — instead of confronting us with the truth: At least 35 percent of cancer deaths this year can be causally linked to cigarette smoking, and another significant percentage can be traced to other lifestyle factors such as obesity. The exact contribution of environmental chemicals to our nation’s cancer toll has not been calculated — but today the best estimate of that contribution is close to zero.

– Dr. Elizabeth M. Whelan is president of the American Council on Science and Health.

Originally published on National Review Online's Critical Condition blog , May 14, 2010. 

View the original article here

Peliculas Online

By Elizabeth M. Whelan, Sc.D., M.P.H., and Dr. Henry I. Miller
Posted: Wednesday, June 2, 2010
Publication Date: June 2, 2010

Originally published on Forbes.com, June 2, 2010 .

President Barack Obama's cancer panel has recently released a report on the supposed causes of cancer and how to avoid them. The subject is important--cancer is the second leading cause of death in the United States--and the report could have been useful. Instead it is a travesty, a paragon of political correctness and unscientific, naive speculation and misinterpretation.

The 200-page document produced by the "panel"--which consists entirely of two scientists lacking expertise in cancer epidemiology--is a rehash of myths and misapprehensions about the causes of cancer. The report concluded that "grievous harm" results from exposure to chemicals and that there is "a growing body of evidence linking environmental exposures [to chemicals] to cancer."

If the authors had only bothered to consult a standard textbook on cancer epidemiology, they would have learned that lifestyle factors such as smoking, obesity, excessive alcohol consumption and overexposure to sunlight--not chemicals in air, water and food--are the underlying causes of most preventable human cancers.

They could also have referred to the summary statement from one of their own previous meetings, "Strategies for Maximizing the Nation's Investment in Cancer," held in San Diego in 2007, which concluded: "Similar to the previous meeting in this series, participants stressed that the greatest reduction in cancer mortality could be achieved by eliminating tobacco use; they vocalized disappointment in the lack of political will to eradicate this killer. Smoking remains the single largest preventable cause of cancer. ... Significant impact on morbidity and mortality could also be achieved by 'following the evidence' and applying what we know--screening and early detection of cancer; better preventive interventions and treatments for those cancers with the highest morbidity and mortality (e.g., breast, colon, lung, prostate); and expanded access to cancer care."

But instead of following the available evidence, the current panel relied on several specious premises.

First, it assumed that chemicals, by definition, are dangerous, and that our exposure to them should be limited, even at huge cost. That is puzzling because all things, natural and synthetic, including our own bodies, are composed of chemicals.

Second, it assumed that the goal of cancer prevention should be to eliminate all exposure to toxic and carcinogenic agents. The very idea is puerile, not to mention impossible. Safe, natural foods are replete with toxins. Nutmeg contains myristicin, which in high doses can induce convulsions, palpitations and generalized body pain; licorice has glycyrrhizic acid, which if consumed in large amounts can give rise to dangerously high blood pressure; soy-based products such as tofu contain high levels of plant-based estrogens that could affect hormonal balance.

Many foods also contain carcinogens--chemicals that cause cancer at high dose in laboratory animals--such as safrole in cinnamon. The American Council on Science and Health has actually constructed a "holiday dinner menu" of common foods that are replete with toxins and carcinogens .

Third, the panel appeared to be oblivious to the critical relationship of dose--as expressed in the classic toxicological principle "the dose makes the poison"--to risk. Exposure to chemicals like vinyl chloride at high levels for long periods of time did indeed, decades ago, cause cancer in the workplace, as did chimney sweeps' exposure to soot. The existence of such true human carcinogens is detected via careful collection of epidemiological data, but those high levels of occupational exposure are quite different from environmental exposure to trace levels of chemicals.

Fourth, the panel relied on and endorsed the so-called precautionary principle, which puts the burden of proving what amounts to absolute safety on the makers and purveyors of almost any product. It is not a principle at all but merely a highly risk-averse, unrealistic philosophical premise demanding that every activity and product be proven safe before it is undertaken or used. But how can you prove anything is completely safe? It amounts to trying to prove a negative. Critics can always say you didn't test in enough species, or for long enough, or at a high enough dose.

A perfect example of the shortcomings of the precautionary principle is the concern raised in the report about the chemical BPA. BPA is a ubiquitous industrial chemical that is essential in the manufacture of many hard plastic products, and it has been used in the lining of cans to prevent the development of foodborne illnesses like botulism. BPA has been used for more than half a century and has been subject to thousands of safety evaluations, with expert panels from around the world (including our own Food and Drug Administration and Environmental Protection Agency) concluding it is safe as used. Yet the panel still raises anxieties about supposed risks. In other words, in spite of all the studies, under the panel's "precautionary principle," BPA still does not qualify as "safe." According to that standard, what chemical could?

The president's cancer panel's report is an assault on the science that underlies cancer epidemiology. Some of its recommendations--such as avoiding environmental cancer-causing agents by taking off your shoes and leaving at the doorstep the "carcinogens" you picked up on the way home--are ludicrous. By distracting Americans from proven cancer risks, they will more likely increase rather than decrease our nation's cancer burden, to say nothing of the public's anxiety.

This prestigious-sounding panel offers advice that owes more to celebrity-babble on Oprah than to sound science: Eat organic foods, filter your water, use only ceramic or glass, rather than plastic, in the microwave. However, according to the National Cancer Institute's statistics, smoking accounts for 29% to 31% of cancer deaths, diet for 20% to 50%, infectious disease for 10% to 20%, ionizing and ultraviolet light for 5% to 7%, occupational exposure (from high dose exposures to vinyl chloride, benzene, etc.) for 2% to 4% and pollution (such as radon gas) for 1% to 5%.

The truth is that few chemicals are as toxic as the report of the president's cancer panel, which will only fuel the Obama administration's and activists' ill-advised, unscientific vendetta toward chemicals.

Henry I. Miller, a physician and molecular biologist, is a fellow at Stanford University's Hoover Institution. He writes a bi-weekly column for Forbes.

Elizabeth Whelan is president of the American Council on Science and Health.

View the original article here