Subject: Re: Why is testicular cancer increasing?

From: [email-masked] (Lee Green MD MPH)
Date: 30 Oct 1994 23:11:39 GMT

In article <[email-masked]>,
[email-masked] (Gregory W. Froehlich) wrote:

> In article <[email-masked]>
> [email-masked] (Gary Davis) writes:
> 
> > Does anyone have any further information on this potentially catastrophic
> > problem?
> > 
> 
> I'd start by asking myself if I had any reason to think that population
> statistics on prevalence of testicular cancer, etc. were collected any
> differently today than 50 years ago. (Almost certainly).
> 
> Then I'd ask whether the diagnostic methods for testicular carcinoma
> are different now than 50 years ago (They are).
> 
> Then I'd ask, how might these differences cloud my perception of what's
> going on? (And then try to take those biases into account).
> 
> ------------------
> Greg Froehlich, MD
> White River Junction, VT

I'll second those, good suggestions all.  Comparisons of disease incidence
over time are fraught with methodological peril.  That understood, the
leading hypothesis IF the effect is real is dioxins.  It turns out they
have estrogenic effects in extremely tiny concentrations, and they're
byproducts of a wide variety of manufacturing processes.  Their effect
apparently occurs during critical stages of embryological development.

-- 
Lee Green MD MPH        Disclaimer: Information for general interest
Family Practice         and discussion only.  I can't examine you via
University of Michigan  the Internet, so you should ALWAYS consult
[email-masked]       your  personal physician.  These posts are my
                        personal doings, not a service of nor the
                        responsibility of the University of Michigan.

---

From: [email-masked] (Russ Brown)
Date: Wed, 2 Nov 94 17:59:31 GMT

In article <[email-masked]>,
>apparently occurs during critical stages of embryological development.

Although the "environmental justice" folks may wrinkle their brows at
the news, we need to consider that:

          Testicular Cancer Incidence (cases per 100,000 per yr)

             1973-74            1987-88

Whites         3.3                4.7 
Blacks         0.9                0.7

These data would cast some doubt on an environmental etiology.  If the
cause were related to the environment, it would follow that white males
were being placed at higher risk than black males.  That hypothesis is,
of course, at odds with the currently fashionable idea that minority
communities are being selectively targetted by polluting industries.

----------------------------------------------
Data from:  NIH 91-2789

---

From: dougb@sc736 (Doug Bank)
Date: Tue, 1 Nov 1994 19:30:57 GMT

In article <[email-masked]>, [email-masked] (Gary Davis) writes:
> 
>  I've seen two very informative television documentaries concerning the 
> apparent increase in male testicular cancer, which formally was not only
> rare, but was confined to a few men who had undescended testicle, usually
> not in the inguinal canal, but in the abdomem.

Speaking as someone who has had this cancer, where did you see these
documentaries?  Any names or channels?

> Does anyone have any further information on this potentially catastrophic

Here is an article you may find helpful:

                  Copyright 1993 Sentinel Communications Co.
                              THE ORLANDO SENTINEL

                        October 10, 1993 Sunday, 3 STAR

Headline: Studies Find Toxic Link To Breast Cancer;
Doctors Now Suspect That Chemicals May Be Responsible For
One-Third Of The Cases Reported In The United States.

BYLINE: By Delthia Ricks of The Sentinel Staff

   The search for breast cancer's cause has been one futile quest after
another.

   Despite decades of study, dietary  fat  doesn't seem to cause it. Heredity
plays only a small role. Even an esoteric investigation of women's whorly
fingerprint patterns a decade ago didn't pan out.

   Now there's evidence of a link in the food you eat, the tap water you drink
and the yard you spray for bugs and weeds.

   Growing numbers of breast-cancer scientists suspect that the chemicals used
in agriculture, industry and lawn care may be responsible for as much as
one-third of all the breast cancer in the United States today.

   Environmental poisons have long been linked to cancer, but usually to
leukemia, lymphoma and relatively rare tumors.

   Recent studies suggest, however, that a large family of chemicals -
especially a group known as organochlorine pesticides - may also play a role in
triggering breast cancer, the most common type of cancer in women.

   The studies have found that the chemicals don't simply kill tissue - they may
also masquerade as the female hormone estrogen and linger in the body, setting
the stage for  cancer.

   The chemicals first infiltrated our ground water and food chain decades ago;
while some have been banned, they can remain active in the environment for
years.

   Increasingly sophisticated tests are allowing doctors to identify the
chemicals in breast tumors and pre-cancerous cysts:

   Last year, doctors retrieved the makings of a miniature toxic dump from the
breast tumors of 20 women. The joint study by  cancer  specialists in Michigan
and Connecticut found traces of DDT, an organochlorine banned in 1973; DDT's
breakdown product, DDE; Dieldrin, another pesticide limited by federal law to
nonagriculturual uses; and polychlorinated biphenyls - PCBs - the electrical
insulator banned in 1978.

   Earlier this year, Dr. Mary Wolff, an epidemiologist at Mount Sinai School of
Medicine in New York, reported in the Journal of the National Cancer Institute
that DDE was the primary poison in blood samples taken from women who later
developed breast cancer.  Wolff concluded that women with high blood levels of
DDE are up to four times as likely to develop breast  cancer  as those without
the poison in their blood.

   Two months ago, researchers at Columbia University found organochlorine
pesticides in breast cysts removed from patients at New York's Presbyterian
Medical Center.

   Such discoveries have set the scientific community astir because they could
explain the vast number of breast  cancers  that have no direct link to heredity
or known risk factors such as obesity or alcoholism.

   "The reason we're pursuing this is because it makes a lot of sense," said Dr.
Devra Davis, a toxicologist at the U.S. Department of Health and Human Services
in Washington. "It ties a lot of things together, and allows us to link a lot of
information that had been unrelated. The evidence supporting all of this gets
stronger every day."

   Dr. Rebecca Moroose, an Orlando oncologist, believes researchers may be on
the trail of a significant breast- cancer  risk.

   "I think this definitely is entitled to a lot of investigation," she said.
"But I also think there will not be just one answer to the breast  cancer
dilemma. This could be a co-factor. There may be a number of factors that
interact, such as a genetic predisposition and environmental stimulation - and a
hormone change."

   Estrogen, produced by the ovaries, is responsible for the development of
female sex characteristics; it regulates the menstrual cycle and stimulates the
thickening of the uterine lining.                                               

   Estrogen's three forms - estrone, estradiol and estriol - all have affinities
for cells in the reproductive tract, the breasts and the brain.  There they
hitch themselves to cells at sites called receptors, much as a key fits a lock
to open a door.

   The problem is, toxins with similar chemical characteristics can act like
passkeys and fit the same locks.

   These "xeno-estrogens" may cruise the bloodstream, lodge in breast tissue and
unlock cells, causing them to multiply and become cancerous. Researchers
speculate that the same xeno-estrogens may also play a role in ovarian cancer
as well as in prostate and testicular cancer in men.

   Atrazine, one of the most widely used pesticides in U.S. farming, and
heptachlor, another organochlorine, appear to have estrogenic effects, Davis
said.

   Scientists have suspected for years that natural estrogen can lead to
cancer under certain circumstances, though they're still not sure how. Working
with poisons, Davis said, may solve two mysteries at once - how xeno-estrogens
cause cancer, and how that process mimics estrogen when the natural hormone
goes awry.

   Statistics show that the number of breast cancer cases diagnosed each year
has more than doubled since 1973. And epidemiologists say that's just part of a
larger upward trend that began in the United States, Canada and Western Europe
in the early 1930s.

   According to the American  Cancer  Society, an estimated 11,300 Florida women
will develop breast cancer this year, compared with 6,600 new cases reported
in 1986.

   No pesticide has yet been banned because of a supposed link to breast
cancer.  Atrazine, an organochlorine suspected of estrogenic effects, is used
widely on sugar-cane fields in South Florida. And homeowners statewide apply a
range of toxic compounds to their lawns and gardens.

   "The preliminary studies in breast cancer show that such chemicals may
influence breast-cell multiplication," said Dr. Clark Heath, vice president
for epidemiology at the American Cancer Society's headquarters in Atlanta.

   "But answering these questions definitively will be a matter of a lot of
basic research," he added. "It's a very complicated area."

-- 
Doug Bank                       Secure Design Center
[email-masked]          Motorola Communications Sector
[email-masked]                   Schaumburg, Illinois
[email-masked]       708-576-8207

---

From: [email-masked] (kellmeyer steven l)
Date: 2 Nov 1994 16:16:38 GMT

[email-masked] (Esther Massimini) writes:

>Gary Davis ([email-masked]) wrote:

>: hypospadias are common!
>The PDR lists hypospadias as a possible side effect if one becomes
>pregnant while on (or within 3 months of stopping) the pill. In parenting
>forums I have seen several mothers posting on this as well...

>: The documentaries concentrated on studies showing such problems not only
>: among humans, but also fish and alligators and so forth.
>: It also estimated male fertility to be about 50 % of what it was 100 years
>: ago. In other words men on average produce fewer sperm and more deformed
>: sperm than 100 years ago.

>: The answers seem elusive, however some chemical that simulates estrogen
>: in the environment is thought responsible.

>It's the environment IMHO.  Look at the increase in breast cancers. I
>think eventually these will all be shown to have a common root....

According to the front page article in my paper last week, a woman's chances
of getting breast cancer increase by 50% if she's had an abortion. One may
argue whether there is a common root between this and the use of the pill.
I realize that everyone will immediately say that the study was not 
conclusive, even one of the author's said not to allow it to influence your
decisions until it's been replicated, etc.  I will only note that it's 
unusual for the press to add these qualifications to any study which shows
an increase of 50% in the risk for breast cancer. They generally just go
hog-wild predicting the end of the world as we know it. As I recall, silicone
breast implants were taken off the market for a much less clear link. 
Isn't it odd that no one is pushing for abortion to be taken off the market?
I'm sure someone will count this as moralizing, but I would really like to
know why silicone doesn't enjoy the same protection abortion does.

>-- 
>Esther M. Massimini		   --  [email-masked]   
>(Mommy to Amanda Christine 6/29/88 OR  				
>and Armand James 2/7/90)           --  [email-masked]

Steve	    
-- 
Steve Kellmeyer             [email-masked]
"It is a very great poverty to decide that a child must die 
that you may live as you wish"           --Mother Theresa

---

From: [email-masked] (Russ Brown)
Date: Wed, 2 Nov 94 18:08:24 GMT

In article <[email-masked]>,
>know why silicone doesn't enjoy the same protection abortion does.
For women under 45, the reported increase in risk  was from 0.1% to 0.15%. 
The media did not report the confidence range or the number of cases used to
develop the "50%" increase.