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June 1, 2000
Breast Cancer: Cause and Controversy
Difficult Questions, Elusive Answers
What is the source of breast cancer in Marin?
"I just don't know," Dotto said, offering such possibilities as the high stress Marin lifestyle, full of fast cars and pressure-cooker commutes despite a reputation for hot tub spiritualism.
"Maybe something in the water, or air, I don't know," she continued. "I'd love to find out. Whatever it is, why does it affect some people and not others? I have two girls now and I would love it if somebody could figure it out before they are of the age when they have to start worrying."
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I certainly think its possible there's something in the environment that plays a role in breast cancer. But I don't have a culprit in mind." | |
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Looking for risk
"Right now we know that we have a high rate of breast cancer compared to other places. We don't have any conclusive evidence why that is," says Levien. "This is not a Marin epidemic, we just happen to have the highest rate."
Based on the latest evidence, cancer rates in Marin are about as depressingly high as one would expect given the demographics of the community and the prevalence of known risk factors for the disease.
But medical experts are hoping some cutting-edge research will provide more answers.
One project now underway will take a look at how adolescent risk factors may contribute to cancers diagnosed in middle age.
"A number of studies suggest that there are times in the lives of females when breast tissue is more susceptible to insult and injury," said Dr. Georgianna Farren, a local physician and researcher affiliated with the University of California at San Francisco, and working in collaboration with Marin Breast Cancer Watch.
That's why Farren decided to look at more than just the current lifestyles of Marin women. She is conducting in-depth interviews with 600 women, including 300 breast cancer cases and 300 controls who are free of the disease, to find out whether the women with cancer had exposures or experiences in adolescence that may help explain how the disease process got started.
Going in-depth
Her study plan illustrates the difficulty of getting clear answers. To figure out what may be giving people cancer today, Farren has to peer several decades into the past, and had to do an eight-month pilot study just to be sure her questionnaire and interview methods would be effective.
She is examining a catalog of known and possible cancer risks, including socioeconomic status; age of menarche; rate of body development; alcohol and tobacco use; major life events and "stressers" such as a pregnancy, illness or death of a parent or sibling; pesticide exposure; education; medications taken and illnesses survived.
For women in their 60s and 70s being diagnosed with breast cancer around the turn of the millennium, perhaps the stress of living through World War II is somehow involved, although that would not be simple to understand, let alone measure.
"I don't think it gave them breast cancer," Farren said. "The idea is it made them more susceptible later in life."
As for environmental toxins, Farren noted, "I certainly think it's possible there's something in the environment that plays a role in breast cancer. But I don't have a culprit in mind."
Levien is adamant that no stone be left unturned. Her view, not uncommon, is that the female breast is a kind of "canary in the coal mine," a sensitive chemical filter now showing the effects of unhealthy technology.
"Almost everything we've been doing since World War II has been killing us," she declared.
Next: Toxic Threat?
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Breast Cancer: CAUSE & CONTROVERSY by Carl Hall photographs by Pico  SIDEBARS: Photo Gallery: Breast cancer survivors carry on. (Pico) Long Island: A mammoth research effort and its critics. (Hall) Risk factors offer questions and answers. (Wilson)
Toxic Links: How do we know if a chemical is dangerous? (Wilson)
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