Breast cancer rates have risen steadily since the 1940’s. A woman’s lifetime risk has nearly tripled in the last 40 years. Last year, approximately 200,000 American women were diagnosed with invasive breast cancer, and another 60,000 with in situ breast carcinoma. Breast cancer was the cause of death for roughly 40,000 American women in 2005. Incidence continues to climb despite billions spent on breast cancer research.
While much attention is focused on genetics, less than 1 in every 10 cases of breast cancer is in women with a genetic predisposition. Up to half of all breast cancers are in women with no known risk factors. This disease arises from a complex mix of factors, including hormonal influences, genetics, and exposures to external agents that affect gene expression. The latter are sorely overlooked in mainstream medical thinking.
Between 80,000 and 100,000 synthetic chemicals are in use today. More than 90% have never been tested for their effects on human health. Many persist in the environment, and accumulate in fatty tissue like the breasts, where they can remain for decades. CDC studies show that Americans of all ages carry a body burden of at least 148 synthetic chemicals, some of those banned more than 20 years ago. According to a recent summary of more than 350 studies, a significant body of evidence links exposure to radiation and synthetic chemicals to increased breast cancer risk (Evans N, ed. State of the Evidence—What Is the Connection Between the Environment and Breast Cancer? Breast Cancer Fund, San Francisco, CA, 2006).
Phthalates and parabens are widely used chemicals in cosmetics and skin care products applied daily by millions of women. Both can alter hormonal function, and we believe they may be a major contributor to the rise in breast cancer.
Parabens are used as preservatives to help makeup stay fresh and to enhance skin absorption. Recently studies have found intact measurable parabens in human breast tumors (Darbre PD, et al. J Appl Toxicol. 2004; 24: 5–13). Phthalates are plasticizers, used in cosmetics to add texture and luster. They make our skin look smoother after applying lotion. They also make hair sprays and nail polish more flexible and disperse fragrance.
The FDA doesn’t regulate these chemicals in cosmetic and beauty aids, nor does it require manufacturers to disclose them as ingredients. The so-called “trade secrets loophole” allows manufacturers to conceal them under generic terms such as “fragrance.”
While there are no studies directly linking parabens, and phthalates to breast cancer, there are many studies showing that they can alter hormone function. Phthalates significantly increase cell proliferation in human breast cancer tissue and also inhibit tamoxifen-induced apoptosis (Kim IY, et al. J Toxicol Environ Health. 2004 Dec; 67(23–24): 2025–2035).
Sunscreens are also a concern. People are using more of these products to reduce their risk of skin cancer. But given the types of compounds found in many sunscreens, are we simply trading one form of cancer for another? Swiss researchers who tested six frequently used sunscreen ingredients found that five had estrogenic activity in breast cancer cells, and three showed estrogenic activity in animals. Sunscreens contain some chemicals that are not only estrogenic but also lipophilic, meaning they bioaccumulate (Schlumphf M, et al. Environmental Health Perspectives. 2001; 109: 239–244).
While the amount of each chemical in a cosmetic product may seem minute, consider that the typical US woman applies 12 products every day. Together, this represents a staggering average of 168 synthetic ingredients. Multiple exposures add up, and some chemicals may amplify adverse actions of others.
What is being done? The European Union (EU) has taken an international lead in protecting the public. Since October 2004, cosmetics manufactured and sold in the EU are prohibited from containing any chemical known to be a carcinogen, mutagen or reproductive toxicant. In the US, the Campaign for Safe Cosmetics asked hundreds of companies to sign their Compact for the Global Production of Safe Health and Beauty Products, which includes a pledge that all products will meet EU standards within three years.
So far, 175 companies have signed on, including The Body Shop, Burt’s Bee’s, Kiss My Face and Avalon Natural products. Not surprisingly, major players like Avon, Estée Lauder, L’Oreal, Revlon, and Proctor & Gamble have refused to sign. The Environmental Working Group, based in Washington, DC, has a searchable online database (www.ewg.org/reports/skindeep) that allows consumers to search 10,000 beauty products and their rank in terms of levels of harmful ingredients.
With one exception, all the articles read in preparation for this column called for further research on potential links between body care ingredients and breast cancer. The one dissenting article concluded that after, “a thorough review of the scientific literature on parabens,” an increased risk of breast cancer was “biologically implausible.” However, two of the three authors were compensated by the Cosmetic, Toiletry and Fragrance Association (CTFA), and the third served previously as a CTFA consultant.
Given how little we really know about the biological effects of parabens, phthalates and other synthetic chemicals, but how much we know about breast cancer incidence, it is reasonable to be cautious. We do have choices when it comes to cosmetics and beauty aids, and synthetic-free alternatives are available. It makes sense to search for products that are pure, safe, natural and organic.
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Monica Scheel, MD specializes in natural and conventional treatment of skin problems. She focuses on whole body health—mind, body and spirit. Michael Traub, ND, is past-president of the American Association of Naturopathic Physicians. They both practice in Kailua-Kona, Hawaii.
