What chemical exposures caused my cancer? Maybe all of them

In January this year I was diagnosed with Stage 4 pancreatic cancer by oncologists at UW Hospital.  I have outlived their original prognosis by a couple months, but will likely not live through the end of the year. I am paralyzed from the chest down to my feet by a tumor that metastasized from my pancreas to my spine, compressing my spinal nerves. So I have been bed-bound for nearly 8 months. It is a fate I wouldn’t wish on my worse enemy. It is indescribably awful.

Though my mother also died of pancreatic cancer, the oncologists who diagnosed my cancer said their genetic tests didn’t indicate that my cancer was hereditary. They speculated that it was likely from “exposures.” What exposures? They didn’t say.

For most of my life, I was physically active, ate mostly organic food, drank only moderately and never smoked. Several friends and colleagues, knowing that I spent the last nearly 30 years of my life working to prevent exposures to toxic chemicals, have asked me what chemical exposures I think may have caused my cancer.

I don’t know.  Thinking through my life…

I was born and raised in Green Bay, Wisconsin, as was my mother. The lower part of the bay and Fox River became Superfund sites due to high levels of PCBs discharged by the paper mills along the river. I grew up unknowingly swimming in, drinking, breathing and eating these PCBs in fish from the bay. PCBs are “probable carcinogens” and have been associated with numerous other serious health effects. Or was it the DDT sprayed in our neighborhood to treat Dutch Elm disease when I was growing up? Was it the agricultural pesticides used on farmlands around the home we moved to when I was 12, south of Green Bay (also right on the Fox River)? Was it the fish my college boyfriend and I caught and ate from islands off Santa Barbara where (we later learned) Monsanto dumped waste barrels of DDT years prior? The lab I worked in at UC Santa Barbara with a professor and grad students who were very sloppy with radioactive materials used in the research (I left the lab after learning this)? The PCE, TCE, dioxins and other carcinogens I breathed while living near Madison Kipp-Corporation before we moved to Madison’s northside? The PFAS in my drinking water? The pesticides Dane County sprayed all around my house on Lake View Hill?

Or was it any of the other thousands of chemicals I was exposed to in my food, water, consumer products and environment during my lifetime?  Many were endocrine disrupting chemicals, which would also make me more susceptible to cancer (see below).

Many chemical exposures combined are likely to blame

It is extremely difficult, if not impossible, for scientists to conclusively connect one kind of chemical exposure to one kind of cancer. And it is probably pointless to search for just one chemical culprit. As this 2019 article states: “Most of us are exposed to a cocktail of environmental toxins on an ongoing daily basis….”

My in utero and childhood exposures to PCBs likely played the most critical contributing roles to my later cancer, but my numerous exposures to carcinogens after that also contributed. Most of these chemicals build up in the body over time, and act in additive and/or synergistic ways.

In other words, all of these chemical exposures likely contributed to my cancer.

Our risk assessment and chemical regulatory system is broken

Complicating matters, most of the thousands of chemicals that have been produced, even if they are carcinogens, have not been studied for the carcinogenicity and/or their potential to disrupt hormones. As the 2019 article also states:

“Since the 1970s, more than 87,000 chemicals have been approved for commercial use. Yet of those thousands of chemicals, only just over one thousand have been formally examined and graded for their carcinogenic potential. Of those, five hundred have been found worthy of being graded on a cautiously worded scale ranging from “known” carcinogens to “possibly” carcinogenic. In addition to carcinogenic substances, a new field has emerged researching how environmental toxins cause endocrine or hormonal disruption. A class of these compounds known as endocrine-disrupting chemicals (EDCs) can be found in our food, our environment, and in the products we put on our bodies. Rather than being directly linked to causing cancer, like substances such as asbestos, EDCs influence our health by mimicking or enhancing or changing metabolic regulation. These compounds interfere with hormone production and metabolism in ways that may—especially over the long term—create biological conditions that make us more susceptible to cancer and other diseases.“

So why aren’t we all dead?

Some people I’ve interacted with during my years of academic and activist work to prevent exposures to environmental chemicals seem not to believe that they are killing anyone. Related to that sadly common perspective, here’s an excerpt from the August 16, 2023 New York Times Magazine cover story on PFAS, an endocrine disruptor and carcinogen that is found virtually everywhere:

“I’ve heard some people say, ‘Well, if everybody is exposed to PFAS, how come we aren’t all dead?’” Jamie DeWitt, a professor of pharmacology and toxicology at the Brody School of Medicine at East Carolina University, told me. In fact, she says, “People actually are dying.” DeWitt cited a report in The Lancet that calculated that about nine million people each year die from chronic diseases caused by environmental pollutants of all kinds. “We need prevention,” DeWitt says. “And that means acknowledging that environmental exposures lead to diseases.”

I couldn’t agree more.