Population and breast cancer

Several books have drawn attention to the severe economic and social problems linked to having too few children.

Philip Longman, in his book "The Empty Cradle," concentrates on the economic disadvantages of a rapidly falling birth rate. Fears of a "population bomb" aside, modern economics have depended on ever-growing populations. New businesses flock to areas where population is growing, and social security systems depend on growing numbers of taxpayers to finance welfare for each retiring generation. He notes that it may seem counter intuitive to worry about too few children at a time when the world population is still growing by around 75 million a year. Fertility rates, however, have plummeted in recent years and no industrialized nation has enough children being born to sustain its population. U.N.data show that currently 59 countries, accounting for 44% of world population, are not producing enough children to avoid population decline.


Another book, "The Coming Generational Storm," by Laurence Kotikoff and Scott Burns focuses on the fiscal crunch facing the United States due to the costs of an aging population, accusing politicians of deliberately ignoring the long-term financial burdens in favor of short-term political interests. According to the authors, the difference between the US government;s future receipts and expenditures will be in the order of $45 trillion.


In their book, "Bare Branches: The Security Implications of Asia's Surplus Male Population. " Valerie Hudson and Andrea den Boer observe that China and India, with 38% of the world's population, have surpluses of young males far beyond what any natural forces could produce. Noting that female infanticide was practiced in many cultures and epochs, Asian culture has had a particularly marked preference for male offspring and modern technology has allowed this preference to be applied more radically than in the past. The book puts the number of women eliminated in seven Asian countries at just over 90 million with India and China respectively accounting for 43% and 45% of this total.


And even if the future isn't as bleak as these authors describe, mainstream economics opinion is in agreement that the dramatic fall in fertility will pose severe problems for the world's economy. Peter Heller, in his book, "Who Will Pay?" points out that society may well rue the day it embraces the logic of the family planning movement.


The Women's Global Network for Reproductive Rights (WGNRR)  stands firm against population control policies but is also against hazardous contraceptives while advocating for abortion rights and the reduction of maternal mortality & morbidity.  


In her presentation on "Breast cancer and the Environment" years ago, Professor Devra Lee Davis pointed out that the proportion of male births in Canada and the USA have been in steady decline since the 1970's. According to her study, had the sex ration not dropped, at least 38,000 more baby boys would have been born in the USA and 8,600 more in Canada. This observation was part of the human evidences pointing to the proliferation of environmental xenoestrogens that has resulted in the feminization of nature and consequently the rapid rise of breast cancer, especially in areas of toxic waste dumping (California, New York and Florida). Today, 1 in every 8 women in the USA will get breast cancer.

In arriving at our own country's population program, health concerns (particularly breast cancer) must be at equal footing with economic matters. Whatever population size may best serve our country's specific needs, the PBCN is totally against the use of hormonal contraceptives in any form because it places women at high risk of getting breast cancer. Instead, the use of condom is highly recommended. A woman's health and safety (whether with or without child) is foremost as her reproductive system is so complex and intricate that makes her most vulnerable to the environmental factors causing breast cancer.


The Philippine government has unknowingly been implementing an effective population control program by distributing breast cancer causing hormonal contraceptives nationwide and thereby causing the death of thousands of women annually from the breast cancer epidemic. The country today has the highest incidence rate of breast cancer in Asia and the 10th highest worldwide. Today, 1 in every 13 women will get breast cancer in the Philippines!
 

Ang Hinaharap (Upfront)

Breast cancer is the leading cause of death of women in the entire world today. More than a million women are afflicted every year with North America having the highest incidence rate with one out of eight women getting the disease. Next comes the northeastern European countries followed by Australia and New Zealand. Our country should be proud because we are in the Top Ten Breast Cancer Hotspots of the world! In fact, we have the highest incidence rate in Asia - much, much higher than China or Japan.

Yet we are not a highly industrialized as the USA, nor are we agriculturally productive as Australia, nor do we have a huge wide area of land with a population as that of China. In fact our country is even an archipelago surrounded by the China Sea and Pacific Ocean. 

The Hereditary Factor is Misleading

If we are to believe medical science, Filipinos must then have a genetic predisposition for breast cancer. Despite our different dialects, we must somehow be related to one another to have a high degree of hereditary factor because breast cancer is afflicting all women from as far north as Batanes to as far south as Tawi-Tawi.  In fact, breast cancer today tops all cancers for both men and women. Because of this epidemic situation, our Department of Health has had a Breast Cancer Desk for more than 15 years – unfortunately just that - a desk.

So, does it have something to do with urbanization? Nope! The Cordillera Autonomous Region and the National Capitol Region both have cancer as the 3^rd leading cause of mortality. Population density? Nope! CAR has the lowest in the country with less than a hundred per square km., while the NCR has almost 15,000/ sq.km. Poverty? Nope! In the NCR, cities with the high concentrations of urban poor have similar incidence rates of cancer as cities with the low concentrations of urban poor.  Education? Nope! We have as much affliction among well-educated women as uneducated women. Being childless? Not at all! Having children does not prevent breast cancer, as several cases have been diagnosed shortly after having given birth..

What about Religion? Maybe so, but it isn’t because of spirituality. Muslims don’t eat pork while Christians do and this could probably be a reason why the former are less afflicted. So maybe cancer comes with what we eat? Actually, mounting evidences in the past decade of breast cancer advocacy in North America have clearly established the environmental link to breast cancer with as much as 80% of breast cancer cases having been due to the environmental – meaning what we eat, what we drink and what we breath.

  

Breast cancer is a hormonal disease, particularly involving estrogen. There have been identified specific chemical groups that are estrogen copycats. Since most of the estrogen receptor sites are located in the breast area, the lifetime exposure of a woman to foreign environmental estrogens increases her chances of getting breast cancer. It takes 5-10 years before the first symptoms appear. The longer a woman lives in a toxic environment, the greater the risk of getting breast cancer. So do we chop off the breasts once a woman is born? Do we just remove all her reproductive organs as a preventive measure? Do we just find ways for her glands to stop the production of estrogen? To what extent will we interfere with a woman’s body?

Medicine and science has never been challenged as it is today.  The advent of breast cancer advocacy, which puts forward a patient’s perspective as opposed to a non-patient’s point of view has resulted in a shifting paradigm.

Breast Cancer is Unacceptable

What is causing breast cancer in the Philippines? Enough evidence exists to raise serious concern on the environmental link to breast cancer to make this a priority for investigation and evidence-based regulatory action.

Why is cancer the leading cause of death in Central Luzon? Why does Pampanga, particularly Angeles City have the highest incidence rate of breast cancer in the entire country? The undetermined volume of “Agent Orange”, a chemical used in the Vietnam War by the United States were stocked and flown from the US Air Base. The legacy of Agent Orange has affected the reproductive health of the people of Pampanga, particularly women and children resulting in numerous cases of leukemia, child birth defects and breast cancer. Dioxin is one of the most toxic substance ever created by humans.

What about the Cordillera Autonomous Region? Despite being in the highlands, the soil, water and air supply have been severely affected by many years of mercury and cyanide from gold mining and the continuing practice of pesticides in the vegetable growing areas. At least 10 tons of mercury are released by the entire mining industry annually into the environment. Guihulngan, a very small and sleepy town 100 kms north of Dumaguete has a very high rate of breast cancer. Just across this sleepy town is Atlas Mining, now shut down due to environmental damages. The 6.9 MG earthquake that hit Guihulngan on February 2012 have most likely released and further caused the spread of mercury and cyanide that had accumulated over the years in the water table of this town. Expect an increase of breast cancer in Guihulngan and nearby areas in the coming years!

And the National Capitol Region? Surrounded by the one of the most polluted and contaminated bodies of waters in the entire world – Manila Bay, Pasig River and Laguna Lake – it wouldn’t be difficult to understand why breast cancer has become an epidemic. San Francisco and New York have the highest rates of breast cancer in the world and numerous studies have shown the toxicity of their bodies of water, primarily caused by toxic dump sites five decades ago. The typhoon on August 2012 brought back to the tourist boulevard of Manila Bay all the trash for the world to see.   

What is even most particular to the Philippines is the government’s population control program of oral and inject able contraceptives.  Thousands upon thousands of women have been put to great risk with the early and prolonged use of the pill, undeniably a risk factor for breast cancer. Furthermore, numerous women are required chest x-rays for pre-employment, pre-enrollment and annual check-up’s as against selective screening. The supposed minimal amount of radiation cannot be discounted because it is never dose-related but a matter of timing of exposure. These periodic amounts radiation of women’s breasts have put so many at great risk.   

Population, Poverty and Pollution

As our country grapples with a sinking economy that has impoverished the vast majority of our people, health safety has become a class privilege in the pursuit of work. Thousands of migrants to urban settlers have had to live in subhuman conditions, eat unhealthy foods, drink contaminated water and toil in unsafe working environments. Thousands of the rural population have had to allow the devastation of their bays, rivers and mountains by various industries.

From being an environmentally sound archipelago just a century ago with natural resources so vast and plenty, the Philippines is fast becoming an ecological disaster whose signs are now clearly seen in it’s people health, with breast cancer as the tip of the iceberg.

Wherever and whenever in the country the PBCN has conducted symposiums, the matter of health and the environment has not only clarified misconceptions but has also empowered women in taking strong actions to prevent their daughters from getting breast cancer.

“Ang Hinaharap ay Ipaglalaban!” 

With the establishment in 1997 of the Philippine Breast Cancer Network, which advocates a preventive approach towards the eradication of breast cancer, the landscape of breast cancer in the Philippines has significantly changed. Identifying and eliminating the causes of breast cancer has now become more urgent than seeking the cure.

Corollary to this, government and industry will sooner or later adhere to the Precautionary Principle – that of acting upon evidence rather than waiting for absolute proof. The medical profession will also sooner or later adhere to the patient’s Right to Informed Consent – that of full disclosure of all information and options, and most importantly, total respect for her decision.

Numerous scientific studies showing the environmental have already been presented in more than five World Conferences on Breast Cancer held in North America since 1997. Just a few days ago, the US Senate has passed the Safe Chemicals Act which shifts the burden of proof from government agencies to producers and manufacturers to prove their products are safe for public use and consumption.

In the Philippines? The current President would rather lift the ban on mining and simply provide funds for women who will get breast cancer!

Is this having more fun in the Philippines or is it just being funny in the Philippines?

Breast Cancer is no fun at all !!!

Another breast cancer program to surely fail.

It has now been more than14 years since the PBCN significantly changed the landscape of breast cancer advocacy in the Philippines. Since then, almost all hospitals have organized support groups and have launched various activities every October. A year ago, the Department of Health (DOH) and the Philippine Cancer Society, Inc. (PCSI) launched a program for medicine access for indigent patients with early stage breast cancer in a bid to improve survival rates in our country. But just like many programs in the past, it will surely fail.

                             

In her own words, the PCSI Executive Director said that cancer is an expensive disease and only when early detection is linked to cost-effective treatment can they stop women from dying. The Patient Navigation Program is meant to show that breast cancer is curable and shall be implemented in the East Avenue Medical Center (EAMC) in Quezon City, the Jose Reyes Memorial Medical Center (JRMMC) and Philippine General Hospital (PGH) both in Manila and in the Rizal Medical Center (RMC) in Pasig City.

Though survival is of great concern, the matter of a cure has been the subject of decades of efforts, funding, research since the 1970's worldwide. To this very day, there is no known cure no matter how much money one has, anywhere in the world. Thus, it is not only a matter of providing care and treatment for indigents but for all women - rich or poor. So what assurance can the DOH and PCSI give that their program can increase survival rates when all their past breast cancer programs have been failures?

In a Senate Hearing last year on pending breast cancer bills all focused on early detection, the head of the PGH Cancer Institute said that women die of cancer because of poverty. Does this make any sense at all? Then, the representative of the Philippine College of Surgeons said that breast cancer can be prevented if women have early pregnancy or multiple pregnancies. He even went further saying that even prophylactic mastectomies could be considered. Is this guy serious???  The PBCN was firm in putting forward placing priority in the prevention of the disease. The Philippines has the 10th highest incidence of breast cancer in the world and the highest in Asia. Rather than focusing our country's meager resources and limited capabilities in futile programs such as the above, it would be far more beneficial to embark on efforts on how breast cancer can be avoided by our women!

Breast cancer is an environmental disease and only by identifying and eliminating environmental causes can there be a declining incidence of breast cancer in our country. The first and immediately doable are for the Department of Health to:

1. STOP mandatory annual chest x-rays for all government employees and make it optional for companies and schools during pre-employment and pre-enrollment. This alone will drastically reduce breast cancer because all women regardless of health status are being unnecessary exposed regularly to at least 1,000 millirads of radiation.

2. STOP the use of hormonal contraceptives in its population control program because breast cancer is a hormonal disease. Women will not be placed at risk of breast cancer when the use of other methods such as condoms and rhythm method are encouraged instead.  

3. STOP operations of air-water-soil contaminating industries regardless of environmental clearances - specially identified mining operations that continue to spill cyanide and mercury in the waterways of our country.

Only when government and society finally understands and recognizes that the state of our environment is directly linked to public health can our mothers, sisters, wives, daughters, relatives and friends be spared from breast cancer.