As the number of women and men diagnosed with breast cancer continues to rise, an independent committee of medical researchers, community stakeholders and advocates are urging for more research that zeroes-in on preventive and environmental causes of the disease.
The Interagency Breast Cancer and Environment Research Coordinating Committee, which authored the 270-page report “Breast Cancer and the Environment: Prioritizing Prevention,” outlined seven recommendations, including increasing preventive research, intensifying the study of chemicals, promoting collaboration across agencies and organization, and training the next generation of interdisciplinary researchers.
Established by Congress in 2008, the committee emphasized the need to bring preventive-related research to the same level of early diagnosis and cure-related breast cancer funding.
“Our mantra is prevention,” stressed Michele Forman, co-chair of the committee, and professor University of Texas at Austin’s Nutritional Sciences department. Environmental factors, which can have a reaction in mixtures, are often found in the soil, air, food and consumer products. Those exposures can begin to impact an individual’s health starting in the womb and affect people’s health differently at different stages of life. The report broadly defined environment from industrial pollutants to alcohol use.
Some 227,000 women and 2,200 men were expected to be diagnosed with cancer in 2012, with the 2013 figures believed higher, according to the report. Most of the funding has been for diagnosis and cure. Prioritizing rather than reducing the funds in other areas of breast cancer research is necessary, Jeanne Rizzo, president and chief executive office with Breast Cancer Fund, told calhealthreport.org.
She said its essential to research and inform the public how cultural factors or behaviors can impact different racial and ethnic groups. “Risks for breast cancer varies by race and ethnicity, leading the study’s authors to recommend more participation of underrepresented groups to be included in studies.”
Incidences of the disease are highest for white and black women, followed by those who are Hispanic and Asian-American. Still, black women are more likely than white or Hispanic women to be diagnosed with aggressive tumors, likely the result of being diagnosed in advance stages of the disease and barriers to access to optimal health care treatments. Recent studies have indicated that black women are more likely to die of the disease than any other demographic.
“We’re finding that a lot of the personal care products that are marketed to African-American women are very highly concentrated in endocrine disruptors,” Rizzo said. Endocrine disruptors are chemicals that have been linked to cause cancerous tumors, birth defects and developmental disorders.
But one of the challenges for researchers and the public alike is that fewer than 10 percent of an estimated 84,000 chemicals that are currently in use have been tested. The report urges research to close the knowledge gap on how such chemicals affect breast glands.
When it comes to breast cancer, funding dollars have historically been larger for diagnosis and cure-related research, Rizzo said. Currently, only about 10 percent of spending by the two largest federal agencies that focus on breast cancer research has been specifically for environment and prevention-related research, authors of a new report say.
Between 2008 and 2010, the National Institutes of Health spent $357 million on preventive and environmental-related research, about 16 percent of all financing for the disease. The Defense Department, the only other federal organization that allocates sizable funds for breast cancer-related research, allocated even less. From 2006 to 2010, the agency spent about $52.2 million on prevention-oriented research, roughly 8.6 percent of the money allocated to breast cancer.
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Q&A: Prioritizing Prevention and Environmental Risks Research Can Lead To Fewer New Breast Cancer Cases
Jeanne Rizzo, a registered nurse and president and CEO of Breast Cancer Fund, an advocacy group that works to prevent breast cancer by eliminating exposure to toxic chemicals and radiation link to the disease, spoke with calhealthreport.org about why funding for preventive-related research has not received adequate funding, how the public can be better engaged, among other topics. Below are edited excerpts of her conversation with calhealthreport.org.
We just learned that two largest federal agencies that spend sizable amounts on breast cancer research are allocating relatively small percentages on prevention and environmental-related research. Why is that the case?
The environmental health science has grown over the last few decades. We went through the 60s and 70s putting all types of chemicals into the world without testing them fully, and certainly not for whether or not they cause cancer. At the same time, you had chemicals coming into the market without the level of pre-market testing needed. At some point, people began to ask questions.
At the same time, breast cancer rates began going up. The breast cancer movement began in earnest with women and families who had cancer asking why it wasn’t diagnosed early enough or saying that the surgeries were radical and horrible and treatment was extremely toxic. The reinvestment moved into how we can keep these women alive then how can we treat them. The argument went, ‘If we get it early enough then maybe they won’t get breast cancer and die.’ So that movement began and that was the health movement. How do we take care of people. The environmental movement was beginning to understand how there were toxic chemicals in our world but the environmental health movement–the idea that these exposures were creating health outcomes–is really only 15 to 20 years old. Studies were being done on external pollutions, such as air pollution and water quality. But we weren’t looking at the ubiquitous chemicals in the environment and their complex interactions.
But in the mid-90s breast cancer advocates began to raise questions. About a decade ago there were between 400-500 studies and now there are thousands as people began to see these correlations.
The study calls for collaboration, which in general, can be very difficult. Where are you seeing pressure points among organizations that do collaborate or areas that are working particularly well?
When it comes to collaboration, some in the environmental health are already working together in several areas, such as how to deal with chemicals, policy, the right to know and advocating fore more proportional funding for environmental sciences. We certainly advocate that in coalition.
Do you get a sense that more funding will spent on the environmental risks since there’s more information now?
We’d have to look at the sources of funding to understand where someone is going to place their priorities. That’s why the federal government needs to lead the way because the federal government funds come from us, the public.
Talk about the public aspect of this. How is the public and ordinary citizens being engaged with what researchers are learning from these studies?
We need to bring the science to everyday life. There’s a higher rate of breast cancer in pre-menopausal African-American women. We have to ask what are the unique exposures? Researchers are finding that a lot of the personal care products that are marketed to African-American women are very highly concentrated in endocrine disruptors. If there’s a cancer journal report on chemicals and health, it‘s our job to make sure it doesn’t sit on the shelf.
