Myth or Fact?
Don’t Heat Plastic in the Microwave or Put Plastic Water Bottles in the Freezer

The email about plastics and cancer first began circulating in 2002. At that point, the only expert quoted was Dr. Fujimoto. In 2004, a new paragraph attributing the information to Johns Hopkins was added. In March 2007, it was relabeled “Cancer Update From Johns Hopkins.”

In March 2007, Johns Hopkins posted a note on its website which explained that it had never issued this Cancer Update. In addition, Rolf Halden, an assistant professor in the Department of Environmental Health Sciences at Johns Hopkins, answered a series of questions about the claims made in this email. You can read the Q&A “Researcher Dispels Myth of Dioxins and Plastic Water Bottles” here [link to: http://www.jhsph.edu/PublicHealthNews/articles/Halden_dioxins.html

These are the facts:
Dioxins are chemicals that have been found to be associated with an array of health problems, including some types of cancer, lowered sperm count, and endocrine disruption.

However, as Halden explains in the Q&A, plastics do not contain dioxins. In addition, freezing actually works against the release of chemicals, because chemicals do not diffuse as readily in cold temperatures. So even if plastic bottles did contain dioxins—which they don’t—freezing them wouldn’t be a problem.

Cooking with plastics is a slightly different story, but not because of dioxins. The problem is actually due to another group of chemicals, called phthalates, which companies sometimes add to plastic to make it flexible. (Not all plastic products contain phthalates. For example, phthalates are not used in plastic beverage bottles, plastic food wrap, or plastic food containers made in the U.S.)

Studies have shown that phthalates act like endocrine disruptors in humans and animals. According to Halden, when plastics that contain phthalates are heated, it is possible for the phthalates to be released into the food or beverage being heated. For this reason, says Halden, the only plastic products that should be used in a microwave are those that are designed for that purpose. If you’re not sure if the plastic container is safe, choose ceramic or heat-resistant glass.

You can learn more about the origins of this email and the information it contains here.

 

Myth or Fact?
Breast Cancer Hospitalization Bill—Important Legislation for All Women

It is true, as it says on the Lifetime website, that in 2003, "Lifetime Television delivered more than 5 million petition signatures to Capitol Hill urging Congress to ban ‘drive-through’ mastectomies—the practice in which women are forced out of the hospital sometimes only hours after breast cancer surgery." And it is true that legislation has been introduced, called the Breast Cancer Protection Act of 2003, which would require insurance companies to cover a 48-hour minimum stay for mastectomy patients and a 24-hour stay for a woman undergoing a lymph node dissection. Though previous versions of this legislation have stalled in committee, there are now bipartisan cosponsors for the Breast Cancer Patient Protection Act of 2005 (S 910/HR 1849), which may help this bill move forward.

What is not true:
  1. There has never been an insurance company that required same-day mastectomies. This is an urban myth that has spun out of control.
  2. Not all women need to stay overnight in the hospital after breast cancer surgery, and it isn't necessarily bad to go home the same day. It depends on the individual woman's situation.
  3. This is not a decision that Congress should make. We really don't want Congress involved in medical decision-making. Legislators should not be deciding how long we should stay in the hospital.



 

Myth or Fact?
All Women Should Have an Annual CA 125 Test to Detect Ovarian Cancer

The cancer antigen 125 (CA 125) test measures a sugar protein that may be released when cells in the fallopian tubes, uterus, cervix, or the lining of the chest and abdominal cavities are inflamed or damaged.

Ovarian cancer cells often produce an excess of this sugar protein. The problem is that elevated levels of the protein are also found in women in the first trimester of pregnancy as well as in women who are menstruating or who have endometriosis. Also, not all women with ovarian cancer have high levels of CA 125. In early stage ovarian cancer, the CA 125 level may not be elevated, and about 20 percent of women with advanced ovarian cancer never have elevated CA 125 levels.

Because the CA 125 test can be elevated when cancer is not present, and be low when cancer is present, it can result in both false positive and false negative results. This is why the American Cancer Society does not recommended that the CA 125 test be used as a screening test for ovarian cancer. Your doctor is not denying you this test because she doesn't really care about your health. Rather, she knows that the results will not provide information that can either diagnose or rule out ovarian cancer.

There are times when the CA 125 test should be used. Women with a strong family history of breast or ovarian cancer are believed to be at highest risk for developing the disease—as well as developing it before the age of 50—and doctors do recommend CA 125 testing for this group of women. The CA 125 test also is a regular part of the follow-up of women who have already been diagnosed with ovarian cancer. For these women, CA 125 testing can provide information about whether a recurrence has occurred or if the tumor is responding to the cancer treatment.

The best way for a woman to increase her chances of having ovarian cancer found early is to have an annual pelvic exam as well as an annual rectovaginal exam in which the physician inserts fingers in the rectum and vagina simultaneously. Women also need to be aware of the early symptoms of ovarian cancer, which include abdominal pressure, bloating or discomfort, abdominal swelling, nausea, indigestion or gas, urinary frequency, constipation or diarrhea, abnormal bleeding, unusual fatigue, and shortness of breath, and should contact their doctor if these symptoms just don't go away.

The lack of a screening test and the difficulty in diagnosing ovarian cancer are the reasons why 75 percent of women are diagnosed in later stages of the disease, when it is harder to treat. So even though ovarian cancer is relatively rare—approximately 25,000 new cases are diagnosed annually—it is the gynecological cancer with the highest mortality rate.

It is frustrating that there currently is not a screening test—like the Pap test for cervical cancer or mammography for breast cancer—to detect ovarian cancer early. But the CA 125 test is not the answer to the problem. It is just not a good screening test, and it should not be promoted as if it were.

Additional Information:
Ovarian Cancer National Alliance
The National Ovarian Cancer Coalition
American Cancer Society: All About Ovarian Cancer




 

Myth or Fact?
Bras Can Cause Breast Cancer

Bras—plain or underwire—do not cause breast cancer. In fact, lymphatic fluid from the breast drains directly back toward the chest wall and the armpit, not underneath the breast where the bra might be tight. If you don't like wearing a bra, don't wear one. But don't think that if you don't wear a bra it will keep you from getting breast cancer, or that if you do wear one, it will increase your breast cancer risk.




 

Myth or Fact?

Antiperspirants Cause Breast Cancer

Antiperspirants do not cause breast cancer. And we have the research to prove it.

Researchers at the Fred Hutchinson Cancer Research Center in Seattle, Washington, conducted a study on antiperspirants and breast cancer precisely because they knew this had been an ongoing concern for many women. The results were published in the October 16, 2002, issue of the Journal of the National Cancer Institute.

The researchers interviewed 813 women ages 24 to 74 who had been diagnosed with breast cancer between 1992 and 1995. They also interviewed 793 women in that age group who had not been diagnosed with breast cancer. The researchers asked all of the women whether they used antiperspirants or deodorant, if they shaved, and whether they applied an antiperspirant or deodorant within one hour of shaving.

Of the women who had been diagnosed with breast cancer, 25 percent regularly used an antiperspirant and 41 percent regularly used a deodorant. Of the women who did not have breast cancer, 30 percent regularly used an antiperspirant while 38 percent regularly used a deodorant. Since there was virtually no difference in use between the two groups, these findings do not support the hypothesis that antiperspirants or deodorants increase breast cancer risk.

The rumor about antiperspirants spread quickly because many women found it easy to believe the theories about why antiperspirants could cause breast cancer. The first theory was that using an antiperspirant or deodorant to block sweat stopped your body from sweating out toxins, which kept these toxins in the body near the breast. A second theory proposed that a toxin in the antiperspirant itself caused breast cancer. This was supported by the fact that women in less developed countries who sweat freely have lower rates of breast cancer.

Let's attack these arguments point by point. First of all, sweat is not one of the major ways to rid the body of toxins. It is a way to cool you down when you are hot and to secrete pheromones (subliminal scents that attract the opposite sex). Whether it makes sense to block this function with antiperspirants is a societal question.

Secondly, while it is true that breast cancer is less common in developing countries, it is also true that in Europe, where antiperspirants are not widely used, the rate of breast cancer is higher than it is in the US.

Third, there is no evidence that antiperspirants are toxic. Why then do they tell you not to use them before a mammogram? The reason is that most antiperspirants contain aluminum, which shows up as little specks on a mammogram and can be confused with microcalcifications.

It would be great if there were a known cause of breast cancer so that we could easily avoid it, but it isn't an antiperspirant.


Reference:

Mirick DK, Davis S, Thomas DB. Antiperspirant Use and the Risk of Breast Cancer. Journal of the National Cancer Institute 2002 Oct 16;94(20):1578–80.




 

Myth or Fact?
Paget's Disease Is a New Kind of Breast Cancer

When precancerous cells are seen in the breast, it is called ductal carcinoma in situ (DCIS). When these cells are found in the nipple, it is called Paget's disease. Paget's disease was named after a physician named Paget who discovered and named two other unrelated conditions: Paget's disease of the bone and Paget's disease of the eyelid.

Both DCIS and Paget's disease are called precancers because the disease that is present is not capable of spreading throughout the breast or to any other part of the body. They need to be treated because if left untreated it is possible for the disease to change from precancerous to cancerous. And it is important that they be thoroughly examined by a breast specialist to be certain that they are not associated with a real cancer deeper in the breast.

One of the key symptoms of Paget's disease is an itchy nipple that appears crusty, red, and peeling. If your nipple is itchy and scaly it is most likely to be eczema of the nipple, especially if it is on both breasts. But if the condition does not get better, it is important to get a skin biopsy.

Paget's disease of the breast, when biopsied, will show cancer cells growing into the skin of the nipple. Sometimes it is associated with cancer inside the breasts, sometimes not. It is often associated with DCIS. We now think that there are probably two forms of Paget's: one that is associated with invasive cancer, and one that only involves the nipple.

If invasive cancer were present, the treatment would be the same as that of any other type of invasive cancer. For example, if the invasive portion of the cancer is far from the nipple, a mastectomy may be called for. If the disease involves only the nipple, and the lymph nodes show no signs of cancer (which is usually the case), then having the nipple and areola removed is probably all that is necessary. In the past the primary treatment for Paget's disease has been mastectomy, but it has been my experience that most women would prefer to keep the breast, even without the nipple. Furthermore, since there appears to be no evidence of improved survival with mastectomy, I strongly recommend considering the less drastic surgery.

Paget's disease is serious. And it needs to be investigated, but the patient described in the Internet email legend undoubtedly had a deeper and more dangerous cancer at the time the Paget's disease appeared.