ACAT brings breast cancer prevention speaker to Nome
Dr. Ted Schettler, Science Director of the Science and Environmental Health Network , presented a lecture in Nome on Thursday, April 28. Schettler’s invitation to Nome was part of the Alaska Community Action on Toxics’s annual Breast Cancer Prevention Lecture series. Vi Waghiyi, Environmental Health and Justice Program Director with ACAT, is originally from Savoonga. During the Cold War, the U.S. Air Force built two stations on St. Lawrence Island. Several years later, residents of Gambell and Savoonga began to experience health problems, including cancer, neurological issues and miscarriages. They were all traced back to exposure to polychlorinated biphenyl (PCB) that leaked from the military sites. “Because of our reliance on subsistence foods, we are one of the most highly contaminated populations on the planet,” Waghiyi said.
Tests done on residents of Savoonga reveal that their bodies contain seven times the level of PCBs found in the general population. PCBs interfere with the thyroid hormone, which affects neurological development. Waghiyi said that, in 2014, seven people in her immediate family had cancer. “That’s why I do this, you know, it’s very personal,” she said. “Civil society needs to question why, why this and why that, because nobody’s informing us.”
ACAT was established in the late 1990s in response to demands by St. Lawrence Island residents that the military be held accountable for their health problems. “We need to educate our tribal leaders, healthcare providers, administrators, teachers…there needs to be systemic change,” said Waghiyi.
The question Schettler explored was why cancer, especially breast cancer, is so prevalent in Alaska Native women. A common misconception, he said, is that genetics determine whether a woman will get cancer or not. The correlation between smoking and lung cancer is well known, but there is no single cause for breast cancer. There are a few known factors that put women at risk for developing breast cancer. In addition to family history some other known causes include a delayed first pregnancy or no pregnancy, and dense breast tissue.
But these known risks still don’t account for all cases, nor do they explain why the rate of breast cancer has increased. “Commonly we are left with a big question mark. Why has it increased from a one in 25 chance to a one in eight chance that a woman will get breast cancer? (There are) a lot of whys,” Schettler said.
Schettler studies how the environment surrounding a woman affects her genes, and therefore her risk of developing breast cancer. “What are some of the other things in our lives and in our communities and in our society that might help to explain why breast cancer continues to go up, and why we see as much of it as we do?” Schettler wondered.
Diseases, including cancer, can be linked to what happens outside of the body, and what goes into the body, through a phenomenon called epigenetics. Every cell contains the same DNA sequence, but some cells form skin, others form heart tissue and so on. Epigenetics is the way cells read the DNA code, or gene. Outside factors cause our genes to “turn on,” or read certain codes. “It shows us the interaction between genes and our environment,” said Schettler. Factors such as diet and exercise can change gene sequences. In his lecture, Schettler spoke about diet, exercise, chemicals and vitamin D.
Schettler focused on dietary pattern rather than macronutrients, because in reality people don’t eat a meal of only fat, or only protein. It is safe to believe, Schettler said, that trans fat, saturated fat and some animal fats can increase the risk of developing breast cancer. A high ratio of Omega 6, found in corn, to Omega 3, found in salmon, can also raise the risk level. Another problem we face today is that the majority of store-bought meat comes from animals raised on corn, which in turn enters our system.
Schettler stressed that he had not found any research regarding the relationship between a traditional Alaska Native diet and breast cancer, but said that wild game may be better than store-bought. The animals eat natural foods growing in the tundra, not corn or soy.
Fruits and vegetables lower the risk of developing breast cancer, as does whole soy. In general, Schettler said, a Mediterranean diet, full of fresh fruits, vegetables and healthy fats, is best. Processed foods lack the good chemicals whole foods can contain, and sometimes actually contain harmful chemicals such as preservatives. Schettler added that this diet also helps prevent prostate, colon and pancreatic cancer.
Canned foods can be detrimental because the resin used to line the container contains bisphenol A, which can leach into the food. Bisphenol A is an endocrine disruptor. This type of chemical interferes with the hormone system and is an area of emerging interest, according to Schettler. In studies in which pregnant animals were exposed to bisphenol A, female babies were born with mammary glands that developed in a way that made them more susceptible to breast cancer.
Women who work in factories are often exposed to cancer causing chemicals. “To be exposed to chemical contaminants without our consent, that’s just so wrong,” Waghiyi said. She added that there are over 80,000 chemicals on the market, but only a fraction of those are tested for their safety. The chemicals are not only harmful to the women who are directly exposed to them, but also to their unborn children.
ACAT tested samples of traditional food for pesticides, PCBs and heavy metals to better understand how the contaminants were being absorbed. “It was very shocking that the marine mammals, our main food, are so loaded with global contaminants, “ Waghiyi said. Contaminants from the lower-48 get transferred in air and water currents and end up in the Arctic and South Pole. “We’re a sink, they have nowhere else to go,” said Waghiyi. Ice melting due to climate change increases exposure, exacerbating the problem.
Waghiyi is also worried that it will be hard to pass down traditional knowledge, and an entire way of life will be lost. “[T]he introduction of the western diet and western culture, and the military contamination and being contaminated without our consent with global contaminants are affecting the health and well-being of our children,” Waghiyi said.
“People who are living on St. Lawrence Island and elsewhere in this area are left with a very tough choice because the traditional diet traditionally has been healthy, but now it’s contaminated in many places,” Schettler said.
Due to its remote location, 70 to 80 percent of homes on St. Lawrence Island eat mostly traditional foods. “We believe that traditional food and breast milk are still best, however, we have a right to know what is in our lands and waters that are ending up in our bodies and affecting our well being,” said Waghiyi.
The loss of a culture, and historical trauma, can also affect the health of Alaska Natives. Alaska has high rates of domestic violence, child abuse and alcoholism. Experts have linked this, among other factors, to the loss of traditional culture.
Trauma can affect how cells read genes, and therefore victims of abuse have a higher likelihood of developing diseases such as diabetes. “There’s no question that (adverse childhood experiences) are linked to all kinds of bad health outcomes,” Schettler said, cancer included. High levels of stress, even during childhood, can raise the risk of cancer. After a breast cancer diagnosis, stress impedes recovery. When the body is stressed, it releases a hormone called cortisol, which is linked to cancer related deaths.
Breast cancer is receptive to hormones, chemicals that travel through the blood into organs and tissues. Hormones affect several different functions, including the metabolism of food and growth and development. Once women begin to menstruate, they produce estrogen from their ovaries. The more estrogen a woman produces, and therefore is exposed to, the higher the risk of breast cancer. The more periods a woman has throughout her life, the more at risk she is.
Oral contraceptives prevent ovulation, and pregnancy, because they contain a combination of estrogen and progestin. These hormones stop the woman’s egg from fully developing each month. While it would seem that taking estrogen, which is linked to cancer, would be a bad idea, it is not as harmful as one would expect. Schettler said women who take birth control pills only have a higher risk of cancer while they are actually taking the contraceptives.
Exercise reduces the estrogen hormone, and can cause epigenetic changes. Exercise is also important for weight maintenance, and obesity is another risk factor for cancer. “It’s pretty clear that more exercise helps to prevent breast cancer.”
Schettler recognizes that it can be hard to exercise during Alaska’s long, cold and dark winters. To get in the recommended 30 to 60 minutes of moderate activity a day, he recommends home workouts, such as running in place, calisthenics or weight lifting.
Low levels of vitamin D are linked to cancer. Vitamin D is most commonly absorbed through sunlight. Alaska’s long winters leave residents with more than pale skin—many also have vitamin D deficiencies. A way to remedy this would be to take vitamin D supplement pills.
Dr. Schettler, who lives in California, also delivered lectures in Anchorage and Fairbanks. The presentations are funded by the Alaska Run for Women. Dr. Schettler’s lecture was named after his book, “The Ecology of Breast Cancer: The Promise of Prevention and the Hope for Healing.”