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Environmental connections to public health >>

Awakening to Cancer's Environmental Roots

Thursday, April 29, 2010

By Sandra Steingraber, Ph. D., Ecologist, author, cancer survivor, and internationally recognized expert on the environmental links to cancer and reproductive health

When I was diagnosed with bladder cancer in 1979, at the age 20, I drafted a list of goals. The first thing I would do, once I was sprung from the hospital, would be to pay a visit to Claire's Boutique in the mall. There I would get my ears pierced. Next, I would hit the university library. There I would answer the question, Why me?

Neither task was difficult to accomplish, but one had a more predictable outcome than the other.

The ear-piercing achieved exactly what I thought it would: it upset my mother. Her reaction--arising from the particular religious practices of her German-American family--allowed me to be angry with her. And anger allowed me to rebuff her attempts to bond with me over what she saw as a shared medical experience.

I couldn't have walked away from her otherwise. Mom was in treatment for breast cancer. There she was in her wig, her platelet count decimated by chemotherapy, distraught about my earlobes. I had predicted this. I knew that she would see the earrings as an unnecessary mutilation. As if we don't have enough problems already, Sandy, that we can't control.

Those words provided the pretext I needed to storm out of the house and head back to college, forty-five miles and a world away. I had lost the script to my life. I knew how to play the role of the supportive, unrebellious daughter alongside my mother's brave performance as a cancer patient who could calmly accept bad news and carry on. But I didn't know how to be a co-cancer patient.

In the library, I turned my attention to the medical literature on bladder cancer. What did we know about causation? Questions posed by my diagnosing physician--had I ever worked with vulcanized rubber?--led me to believe that environmental exposures must be part of the collective story. They were. There was a trove of data going back to the nineteenth century. Dyes, rubber manufacturing, chlorinated water, air pollutants, dry-cleaning solvents: all were linked to bladder cancer. If not mine, then somebody's.

But, outside of the isolated world of epidemiology and toxicology, there was very little recognition of this evidence. The word carcinogen never appeared in any of the pamphlets on cancer in my doctors' waiting rooms. The medical intake forms I was forever filling out asked detailed questions about the history of cancer in my family but none about, say, chemical contaminants in my hometown drinking water.

I'm adopted. The wells periodically contain trace amounts of dry-cleaning solvent.

As we approach the fortieth anniversary of Earth Day--and the forty-eighth anniversary of Silent Spring's publication--we are still far from a mature acknowledgement of cancer's environmental agents. But there are signs of an awakening awareness. Provinces and municipalities across Canada have banned the cosmetic use of pesticides on the grounds that they are linked to childhood cancers. The European Union has banned carcinogens from cosmetics. Here in the United States, calls grow louder for reform of the flaccid Toxic Substances Control Act, which has proved itself unable to eliminate suspected carcinogens from the marketplace. And I can now find the words carcinogen and environment in the waiting-room literature.

But, for me, the most telling sign of the times is this: my hometown hospital invited me to give a lecture on environmental carcinogens before an audience of physicians concerned about the proposed expansion of a hazardous-waste landfill. Mom came with me. I was the one wearing earrings.

Sandra Steingraber is the author of Living Downstream, newly published in second edition by Da Capo Press to coincide with the release of the documentary film adaptation. This essay is one in a weekly series by Sandra - published at www.livingdownstream.com - exploring how the environment is within us.

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