the summer between my sophomore and junior years in college, I was diagnosed
with a type of bladder cancer called transitional cell carcinoma. It is
something I have in common with at least one beluga whale in the St. Lawrence
St. Lawrence slants through the Canadian province of Quebec and flares
open like a trumpet as it pours itself into the North Atlantic. The neck
of the Gulf of St. Lawrence is one of the world's deepest, longest estuaries.
About 500 beluga whales, a remnant of the thousands that once lived here,
inhabit this transition zone between river and ocean.
are small, toothed whales. Their skin is pure white. Transitional cell
carcinoma among the belugas was first discovered during an autopsy of
a carcass that washed ashore in 1985. It was a particularly provocative
finding because workers in nearby aluminum smelters, which release their
wastes into the St. Lawrence, had also been found to have an elevated
incidence of this type of bladder cancer.
hematuria, or noticeable blood in the urine, is the usual way bladder
cancer presents itself. In my case, gross hematuria arrived as I was finishing
a morning shift at a truck-stop diner. After making my final rounds with
the ketchup bottles and syrup dispensers, I stopped in the restroom. Turning
to flush, I froze. My urine looked like cherry Kool-Aid. I stood there
a long time.
cancer is only one of several cancers striking the beluga population of
the St. Lawrence. Aluminum smelters and other industries lining the river
basin have contaminated the region's waters with benzo[a]pyrene, a potent
1988, a team of veterinarians found tumors in the bodies of four dead
whales that had washed up over a period of ten months along a polluted
stretch of the river. The immature breast ducts of one young female showed
an abnormal proliferation called ductal hyperplasia - a condition considered
a strong risk factor for breast cancer in women.
date, cancers identified in the beluga include bladder, stomach, intestinal,
salivary gland, breast and ovarian. The prevalence of intestinal cancer
is especially high. Of 73 stranded whales autopsied since 1983, 15 had
cancerous tumors somewhere in their bodies, and one-third were intestinal
tumors. No cases of cancer have been reported in belugas inhabiting the
less-contaminated Arctic Ocean.
though belugas have been protected from hunting since the 1970s, their
numbers have failed to rebound. Chemical analyses of their blubber have
detected PCBs, DDT, chlordane and toxaphene - at some of the highest levels
ever recorded in a living organism. All four chemicals are endocrine disrupters,
as well as probable carcinogens. All were banned decades ago. All are
PCBs and DDT, chlordane and toxaphene do not have a history of use in
the St. Lawrence basin. And yet these two chemicals are found in the waters
and sediments of the estuary, presumably because they are carried into
the seaway by winds blowing up from the southern US, where both were once
used heavily. The St. Lawrence basin drains a 500,000-square-mile area
and any contaminant that rains down within its vast perimeter is, sooner
or later, flushed into the estuary.
is another route of exposure. Beluga whales love to eat eels, which run
through the deep Lawrentian channel on their autumn migration from Lake
Ontario to the warm waters of the Sargasso Sea.
eels may be the reason the belugas are contaminated with Mirex, a now-banned
organochlorine pesticide that was once used against fire ants. There is
no Mirex in the water of the lower St. Lawrence nor in its sediments and
hardly any in the bodies of the estuary's other marine mammals. But there
is Mirex in the flesh of St. Lawrence eels.
are two sources of Mirex: a pesticide-manufacturing plant near Niagara
and a river called the Oswego, where Mirex was once accidentally spilled.
The eels are the apparent courier between these contaminated sites and
the beluga whales living 600 miles away.
Cancer in the Eye
in a brilliant yellow-green light, they look like bats floating in a perfectly
round pond. I have seen many micrographs of cancerous tissue - reproduced
neatly in atlases of human tumor cell lines or in the shiny pages of medical
journals - but never before have I stared at living cancer cells.
compare that one to this one."
first petri dish is removed and replaced by another, and I look again
through the microscope. In this second watery landscape, the cells look
more like fallen leaves some drift together in large masses, others in
here's dish number three."
they are everywhere. A mosaic of islands and jutting peninsulas. Pieces
of a crazy quilt tossed into a lake. A raft of vines tangled with shards
of crockery. There is no one way to describe them.
three different petri dishes contain estrogen-sensitive breast cancer
cells derived from a human cell line called MCF-7. The first dish is the
control: It contains no estrogen. The third dish was inoculated with estradiol,
the most potent known form of human estrogen. It is also the dish with
the most luxuriant growth.
is the second dish, the one with the intermediate growth rate, that reveals
the significant finding. Its culture medium has been laced with trace
amounts of endosulfan, an organochlorine pesticide. These three dishes
are part of a series of experiments showing that endosulfan - introduced
in 1954 and now widely used on salad crops - is estrogenic. Like the hormone
it mimics, endosulfan stimulates breast cancer cells to divide and multiply.
have shown that endosulfan can act in concert with other xenoestrogens
- chemicals foreign to the body that act like estrogens. Like raindrops
eroding a boulder, quantities of weakly estrogenic chemicals too small
to exert observable effects on their own, have a significant impact when
combined. Furthermore, some xenoestrogens may have the ability to interact
with naturally occurring estrogens and amplify their effect. If confirmed,
this would imply that "safe" levels of exposure to individual estrogen-mimicking
chemicals may not exist.
Banned but Unbound
MCF-7 cells, Boston-based cell biologists Ana Soto and Carlos Sonnenschein
have identified estrogenic activity in a variety of pesticides. Some,
like endosulfan, are still in use. Others, such as dieldrin and toxaphene,
are now banned.
toxaphene - fat-soluble and stubbornly persistent - should prove estrogenic
is particularly frightening. Identified as an animal carcinogen in 1979
and banned in 1982, toxaphene was once the most heavily used US insecticide.
It was used in extraordinary quantities against boll weevils in cotton
fields. In 1950, northern Alabama cotton fields received an average of
63 pounds per acre.
Carson denounced toxaphene as an indiscriminate killer of fish and, in
Silent Spring, she detailed the die-offs of crappies, bass and sunfish
in southern streams and farm ponds. Ironically, toxaphene rose to even
greater popularity after DDT fell into disfavor.
field researchers linked toxaphene to reproductive damage in seals and
documented its ongoing accumulation in the muscle fat of Arctic and Baltic
salmon, Soto and Sonnenschein decided to test its effects on human breast
cancer cells. Not only does toxaphene cause MCF-7 cells to proliferate,
the pair discovered, but it does so at levels well within the range of
concentrations now found in the flesh of some salmon.
changes in the growth rate of breast cancer cells in a Boston laboratory
may help elucidate the reasons for reproductive failures among sea mammals
living thousands of miles away. And this evidence, in turn, may provide
reasons for rising cancer rates among humans.
breast cancer, bladder cancer can recur at any time. After lying quiescent
for years - sometimes decades - it can reappearing inexplicably. "Once
a year for life" is the National Cancer Institute's guideline regarding
cystoscopic examination of the bladder in patients, beginning five years
five years, my checkups became annual and I was no longer tethered so
tightly to the medical system. This change was almost unnerving - as though
it were normal to think of the interior landscape of one's body as a study
site that required constant data collection.
accepted a fellowship in Costa Rica, where I be came involved in a field
study of ghost crabs - delicate creatures that occupy burrows along the
Pacific beaches at the edge of the rainforest. At the study's conclusion,
the night before we were to fly out, I had a vivid dream:
am walking by the ocean and discover a pale orange crab, big as a whale,
washed up on the beach. It is dying. I lie down next to it and slowly
it wraps a great, clawed arm around me. Reaching my arm over its carapaced
body, I return the embrace. I am not afraid. As if in the final frame
of a movie scene, giant letters appear in the sky above us, spelling out
a single word - G-R-A-C-E.
those of us who had spent days out in the tropical sun trying to monitor
the movements of these reclusive, lightning-fast animals, the dream was
hugely funny. ("Sleep with any arthropods last night, Steingraber?") Not
until I returned home did I connect the dream to the end of five intense
years of monitoring the possible movements of cancer. Ghost crabs.
mean to say two things here. First, even if the cancer never comes back,
one's life is utterly changed. Second, in all the years I have been under
medical scrutiny, no one has ever asked me about the environmental conditions
where I grew up, even though bladder cancer in young women is highly unusual.
was once asked if I had ever worked with dyes or had ever been employed
in the rubber industry. (No and no.) Other than these two questions, no
doctor, nurse, or technician has ever shown interest in probing the possible
causes of my disease - even when I have introduced the topic. From my
conversations with other cancer patients, I gather that such lack of curiosity
in the medical community is the norm.
Lifestyles or Chemical Inevitability?
1990, at the International Forum for the Future of the Beluga, the conservationist
Leone Pippard of the Canadian Ecology Advocates asked the following questions:
me, does the St. Lawrence beluga drink too much alcohol and does the St.
Lawrence beluga smoke too much and does the St. Lawrence beluga have a
bad diet… is that why the beluga whales are ill?… Do you think you are
somehow immune and that it is only the beluga whale that is being affected?
increasing in incidence, bladder cancer is associated with a few lifestyle
habits - especially cigarette smoking - as well as with more than a few
occupations including dyeworkers, tiremakers, janitors, mechanics, miners,
printers, hairdressers, painters, truck drivers, drill press operators
US males, bladder cancer is significantly higher in counties with chemical-manufacturing
plants. In 1984, bladder cancer was found in excess among inhabitants
of Clinton County, Pennsylvania, where a 46-acre toxic waste site is contaminated
with aromatic amines and benzene. In Massachusetts, bladder cancer has
been linked to exposure to perchloroethylene from drinking-water pipes.
In Taiwan, an investigation of bladder cancer deaths among children and
adolescents found that almost all those afflicted lived within a few miles
of three large petroleum and petrochemical plants.
a woman with cancer who grew up in a county with 15 hazardous waste sites,
several carcinogen-emitting industries and public water wells that, from
time to time, showed detectable levels of toxic chemicals, I am less concerned
about whether the cancer in my community is more directly connected to
the dump sites, the air emissions, the occupational exposures, or the
am more concerned that the uncertainty over details is being used to call
into doubt the fact that profound connections do exist between human health
and the environment. I am more concerned that uncertainty is too often
parlayed into an excuse to do nothing until more research can be conducted.
a survivor of cancer and as a member of the most poisoned generation to
come of adult age, I am more concerned that cooler heads did not prevail
in the calm prosperity of peacetime, when careful consideration and a
longer view on public health were once again permissible and necessary.
am sorry that no one asked, "Is this the industrial path we want to continue
along? Is this the most reasonable way to rid our dogs of fleas and our
trees of gypsy moths? Is this the safest material for a baby's pacifier
or for a tub of margarine?" And I am sorry that those who did ask such
questions were not heard.
Steingraber, Ph.D., is a professor of biology and the co-author of The
Spoils of Famine. She also serves on the National Action Plan on Breast
Cancer. Excerpted from Living Downstream: An Ecologist Looks at Cancer
and the Environment ©1997 by Sandra Steingraber. Reprinted by permission
of Addison-Wesley Longman. All Rights Reserved.
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