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She is currently working on \u003cem>Dreams of Dust\u003c/em>, @dreamsofdust, a multimedia project that documents stories of climate migration in California’s Central Valley, previously funded by the California Humanities. Her completed projects include \u003cem>\u003ca href=\"http://www.facesoffracking.org/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Faces of Fracking\u003c/a>,\u003c/em> an investigation into the impact of fracking on the people and places of California, and \u003cem>\u003ca href=\"http://sarahcraig.visura.co/gulf-disaster-2\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">The Gulf Disaster\u003c/a>,\u003c/em> stories on the lives of fishermen in the aftermath of the BP spill. Her work has been published by Marketplace, KQED's Bay Curious and Q'ed Up podcasts, KQED's California Report Magazine, KALW's Crosscurrents, Grist.org, High Country News, Earth Island Journal, and others. Sarah received a B.A. in Geography at Vassar College and attended the \u003ca href=\"http://www.salt.edu/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Salt Institute of Documentary Studies\u003c/a> in Portland, ME. She recently received an Excellence in Journalism Award from the NorCal Society of Professional Journalists for her documentary radio piece, \u003ca href=\"http://kalw.org/post/215-will-water-come#stream/0\">\"Will the Water Come.\"\u003c/a> Email: scraig@kqed.org Twitter: @sarahcraigmedia Website: sarahcraigmedia.com","avatar":"https://secure.gravatar.com/avatar/97f17950c828429d3df9f2907412a50b?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Sarah Craig | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/97f17950c828429d3df9f2907412a50b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/97f17950c828429d3df9f2907412a50b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/scraig"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"news_11498766":{"type":"posts","id":"news_11498766","meta":{"index":"posts_1591205157","site":"news","id":"11498766","score":null,"sort":[1501284820000]},"guestAuthors":[],"slug":"healing-americas-forgotten-nuclear-refugees-is-one-womans-mission","title":"Healing America’s Forgotten Nuclear Refugees Is One Woman's Mission","publishDate":1501284820,"format":"image","headTitle":"The California Report | KQED News","labelTerm":{"term":72,"site":"news"},"content":"\u003cp>Nestled in Orange County, among the Starbucks, strip malls and highways, there’s a tiny immigrant community with an enormous historical burden.\u003c/p>\n\u003cp>They come from the Marshall Islands, an archipelago in the South Pacific made up of 2,000 small tropical atolls. And they have the unfortunate distinction of having the\u003ca href=\"https://assets.documentcloud.org/documents/3902548/A-Community-of-Contrasts-NHPI-US-2014.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> lowest per capita income of any racial and ethnic group \u003c/a>in the entire United States.\u003c/p>\n\u003cp>In Southern California, the Marshallese settled in Costa Mesa. Some of the adults work as baggage handlers at nearby airports. Others work at a medical device company, sewing pig valves onto heart stents. Although poor, they are knit together by their faith and their history.\u003c/p>\n\u003cp>Greta Briand is the pastor’s wife, a volunteer health educator and a respected elder among the Marshallese. The children call her “bubu\" -- Marshallese for “grandmother.\"\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcrmag/2017/07/Marshallese.mp3\" Image=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/BriandTalking-800x576.jpg\" Title=\"Healing America’s Forgotten Nuclear Refugees Is One Woman's Mission\" program=\"The California Report\"]\u003c/p>\n\u003cp>Briand started training as a health educator 12 years ago. She wanted to help her community deal with \u003ca href=\"http://www.migrationpolicy.org/article/marshall-islanders-migration-patterns-and-health-care-challenges\" target=\"_blank\" rel=\"noopener noreferrer\">alarming rates \u003c/a>of cancer, heart disease and diabetes. Marshall Islanders have the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358182/\" target=\"_blank\" rel=\"noopener noreferrer\">second-highest rate of diabetes\u003c/a> in the world, and they also suffer from thyroid cancer, breast cancer, and cancers of the blood, stomach and colon.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These illnesses, Briand says, can be traced back 70 years, to the immediate aftermath of World War II, when the U.S. occupied the atolls of the Marshall Islands and used them as a nuclear proving ground.\u003c/p>\n\u003cp>Over the course of 12 years, the U.S. detonated 67 nuclear bombs there.\u003c/p>\n\u003cp>\"I always call it nuke. They nuke us!\" she says. \"And we never had these kind of diseases before. And I do believe it was because we were exposed to radiation. It was too strong.\"\u003c/p>\n\u003cp>Briand’s own family has suffered. Her older and younger sisters are cancer survivors, of breast and thyroid, respectively. Both these cancers are on an official list from the Nuclear Claims Tribunal of \u003ca href=\"https://assets.documentcloud.org/documents/3902551/Humanitarian-Impacts-of-Nuclear-War.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">37 cancers and diseases linked to nuclear weapons testing\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11599022\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11599022\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/GretaFlower800-800x905.jpg\" alt=\"Greta Briand wears a traditional blossom in her hair. It’s woven together with the leaves of palm fronds.\" width=\"800\" height=\"905\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-160x181.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-240x272.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-375x424.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-520x588.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Greta Briand wears a traditional blossom in her hair. It’s woven together with the leaves of palm fronds. \u003ccite>(Courtesy of Melody Seanoa)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Nuclear Refugees in California\u003c/h3>\n\u003cp>Greta Briand, now almost 70, came to California when she was a teenager, to work and to go to college. She was among the first group who came to Costa Mesa, which became the first Marshallese community in the U.S. Over the years, thousands of Marshallese followed her to America, uprooted and displaced by the U.S. nuclear testing.\u003c/p>\n\u003cp>Today, there are more than 23,000 Marshallese living in the U.S., \u003ca href=\"https://assets.documentcloud.org/documents/3902543/A-Community-of-Contrasts-NHPI-CA-2014.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">and about 2,000 in California.\u003c/a> They were able to come because of an agreement made between the Marshall Islands and the U.S. -- the \u003ca href=\"http://uscompact.org/about/cofa.php\">Compact of Free Association\u003c/a>. The Compact allows Marshallese to work and live freely on U.S. soil for as long as they want, but does not convey citizenship.\u003c/p>\n\u003cp>Briand originally planned to return to the Marshall Islands after she got her degree. But one reason she stayed was the health issues in her community. She wanted to help.\u003c/p>\n\u003cp>\"You go to everybody's home, every home has a person sick -- or two -- with diabetes, cancer, heart disease,\" she says.\u003c/p>\n\u003cp>But the effects of the radiation and fallout may extend even farther. According to researchers, it’s possible that the radiation from the nuclear weapons tests \u003ca href=\"http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/beir_vii_final.pdf\">can cause genetic damage\u003c/a> that can be inherited. The possibility haunts Greta.\u003c/p>\n\u003cp>“If I don’t have it, my grandkids ...,” she breaks off tearfully. “My grandkids -- or my great-grandkids -- might have cancer. And it just breaks my heart. But that's why we got to live each day, because you know we don't know what will happen tomorrow.”\u003c/p>\n\u003cfigure id=\"attachment_11599024\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11599024\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/BriandFuneral-800x975.jpg\" alt=\"Greta Briand attends a Marshallese funeral and scatters dirt over a grave. Her younger sister, Delta Garstang, far right, is a thyroid cancer survivor.\" width=\"800\" height=\"975\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-800x975.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-160x195.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-1020x1243.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-1180x1438.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-960x1170.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-240x293.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-375x457.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-520x634.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Greta Briand attends a Marshallese funeral and scatters dirt over a grave. Her younger sister, Delta Garstang, far right, is a thyroid cancer survivor. \u003ccite>(Courtesty of Melody Seanoa)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>One Voice for Many Needs\u003c/h3>\n\u003cp>Jane Pang, an advocate at the\u003ca href=\"http://www.pacifichealthpartners.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> Pacific Islander Health Partnership\u003c/a> in Orange County, trained Briand to recognize and combat the barriers that prevent many Marshallese from getting treatment.\u003c/p>\n\u003cp>\"They don't understand the medical challenges. They don't understand the symptoms,” Pang said of the Marshallese. “It’s difficult for them to understand, because they have very little education in terms of health. They personally will not know what to ask for, and that's why Greta was so valuable. She was such an excellent voice.\"\u003c/p>\n\u003cp>Greta holds health classes in women’s homes, or at the church, to teach women how to do breast self-exams. She also encourages them to go to the doctor regularly, because of the health risks posed by the nuclear tests.\u003c/p>\n\u003cp>\"I was thinking about what happened to us, and I know if I don't say anything, nobody will.\"\u003c/p>\n\u003cp>Briand is the only Marshallese resident in Costa Mesa who is trying to help her peers navigate the U.S. health system. She’s up against a lot. Aside from severe poverty, there’s a language barrier. One in four Marshallese households don’t speak English.\u003c/p>\n\u003cp>Marshallese culture also stigmatizes illness. Briand says this applies to any sickness: “You don't tell anybody,” she says. “Whenever a person is sick, they always think that they did something wrong and God is punishing them.\"\u003c/p>\n\u003cfigure id=\"attachment_11599138\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11599138\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/CastleBravo800-800x815.jpg\" alt=\"This is an archival photo of Castle Bravo, 3.5 seconds after detonation. at a a distance of 75 nautical miles from ground zero. This bomb was the largest and dirtiest bomb ever detonated by the U.S. It was so large you can still see the crater from space. \" width=\"800\" height=\"815\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-160x163.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-240x245.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-375x382.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-520x530.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-64x64.jpg 64w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">This is an archival photo of Castle Bravo, 3.5 seconds after detonation. at a a distance of 75 nautical miles from ground zero. This bomb was the largest and dirtiest bomb ever detonated by the U.S. It was so large you can still see the crater from space. \u003ccite>(National Security Archive)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>A Childhood Among the Bombs\u003c/h3>\n\u003cp>To understand the root of the Marshallese health problems today, it’s important to go back to the late 1940s, when the Cold War began. At that time, the nuclear arms race was heating up and the U.S. needed a place, far from the populated mainland, to test bigger and more destructive nuclear weapons. Some of the 67 nuclear weapons tested in the Marshall Islands were detonated underwater, and some were dropped from airplanes. Some of the islands were completely destroyed.\u003c/p>\n\u003cp>When Briand was 5, she witnessed the largest and most radioactive of these bombs from her home island of Likiep. It was called \u003ca href=\"http://nsarchive.gwu.edu/nukevault/ebb459/\" target=\"_blank\" rel=\"noopener noreferrer\">Castle Bravo \u003c/a>and it had a nuclear force equivalent to 1,000 times the force of the bomb dropped on Hiroshima.\u003c/p>\n\u003cp>[contextly_sidebar id=\"lNX7qsQ8QEPRGkn5Tily0XyQahdDkc3H\"]\u003c/p>\n\u003cp>\"It was like, the sky was beautiful with orange color,\" Briand says. “And we thought it was something beautiful. We didn't know it was poison!\"\u003c/p>\n\u003cp>After the detonation, dangerous clouds of radioactive, pulverized coral dust drifted across her island, coating homes and people.\u003c/p>\n\u003cp>Briand isn’t alone. Castle Bravo remains the most remembered bomb test on the islands -- and everyone received documented levels of fallout from the blast.\u003c/p>\n\u003cp>Kon Kon Wasay, 82, was a teenager when she saw the bomb. She remembers that she was outside playing with six other girls and one boy. “All of a sudden, we hear this loud noise and it looked like something evaporating.”\u003c/p>\n\u003cp>Afterward, her friends all got sick. They have all passed away from thyroid cancers and other diseases.\u003c/p>\n\u003cfigure id=\"attachment_11498781\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11498781\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/06/bikini-800x612.jpg\" alt=\"\" width=\"800\" height=\"612\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-800x612.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-160x122.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-1020x780.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-1180x902.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-960x734.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-240x183.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-375x287.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-520x398.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini.jpg 1800w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The U.S. Navy filming Commodore Wyatt “consulting” the Bikinians about their evacuation on March 6, 1946. \u003ccite>(National Security Archive)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>'Something Good for Mankind'\u003c/h3>\n\u003cp>The U.S. was able to conduct these nuclear tests because it had occupied the Marshall Islands since World War II. After defeating the Japanese, who had previously occupied the archipelago, the U.S. military moved in, permanently.\u003c/p>\n\u003cp>Before the tests began, military governor Commodore Ben H. Wyatt took a sea plane to Bikini Island to talk to the islanders. \u003ca href=\"https://www.youtube.com/watch?v=zri2knpOSqo\" target=\"_blank\" rel=\"noopener noreferrer\">Footage from a Navy propaganda film\u003c/a> shows Wyatt speaking to their leader, Chief Juda, through a translator named James.\u003c/p>\n\u003cp>“All right now, James, will you tell them that the United States government now wants to attempt to turn this great destructive force into something good for mankind, and that these experiments here at Bikini are the first step in that direction.”\u003c/p>\n\u003cfigure id=\"attachment_11597358\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11597358 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/BikiniWyattCrop-1-800x535.jpg\" alt=\"\" width=\"800\" height=\"535\">\u003cfigcaption class=\"wp-caption-text\">Commodore Ben H. Wyatt, the military governor of the Marshall Islands, traveled to Bikini in 1946 to tell them about a plan to detonate nuclear weapons. \u003ccite>(National Security Archive)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The film then portrays the people leaving their islands willingly. But the Marshallese didn't have a choice. The U.S. moved them from island to island, using them as cheap laborers on the military bases.\u003c/p>\n\u003cp>“They never asked permission,” says Barbara Rose Johnston, an anthropologist in Santa Cruz who has studied the effects of the nuclear tests on Marshallese culture.\u003c/p>\n\u003cp>“They just dictated: We're taking over, we're doing our test here. And in the years since, they never did any full disclosure of the extent of what they were doing, how, and why,\" she says. \"The culture of the time did not think of the Marshallese as equal people.”\u003c/p>\n\u003cfigure id=\"attachment_11597359\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11597359 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/bikini-evacuation-edit-800x619.jpg\" alt=\"\" width=\"800\" height=\"619\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-800x619.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-160x124.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-1020x789.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-1180x912.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-960x742.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-240x186.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-375x290.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-520x402.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit.jpg 1782w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Marshallese evacuate from their island of Bikini in 1946. \u003ccite>(National Security Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Johnston has unearthed \u003ca href=\"https://assets.documentcloud.org/documents/3902551/Humanitarian-Impacts-of-Nuclear-War.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">previously classified documents revealing an invasive medical program called Project 4.1\u003c/a> that the U.S. performed on some Marshallese to learn how radiation damages the human body.\u003c/p>\n\u003cp>Over the course of four decades and 72 research trips to the islands, U.S. medical teams examined the Marshallese using X-rays and photography, and took samples of blood, urine and tissue. Some Marshallese even received radioisotope injections and underwent experimental surgery.\u003c/p>\n\u003cp>Since that time, the U.S. government has formally recognized some of the harm caused by the bombings, and the U.S. government pays for health care and government assistance on the Marshall Islands. But those programs aren't available to the Marshallese who have migrated to California and other states, and many remain poor and isolated.\u003c/p>\n\u003cp>As the sole health educator in Costa Mesa, Greta Briand is the only one connecting the dots, explaining to her people how the nuclear history of the past created the medical problems of the present.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>The 23,000 Marshallese who live in the United States have settled most heavily in Arkansas, California, Hawaii, Missouri, Washington and Oregon. In some of those states, the unique migration status of the Marshallese means they are ineligible for Medicaid. Sarah Craig has also reported on a community in Enid, Oklahoma, where most of the Marshallese are uninsured. One Enid resident, Terry Mote, is fighting to improve health care for his people. The story won the Untold Story Award from Narrative.ly. You can see her photos and \u003ca href=\"http://narrative.ly/how-years-of-ruthless-nuclear-testing-in-the-south-pacific-forged-americas-most-impoverished-ethnic-group/\" target=\"_blank\" rel=\"noopener noreferrer\">read the whole story here.\u003c/a>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"More than 70 years ago, the U.S. began testing dozens of nuclear weapons on the Marshall Islands. In California, their community is still hurting.","status":"publish","parent":0,"modified":1501290428,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":42,"wordCount":1837},"headData":{"title":"Healing America’s Forgotten Nuclear Refugees Is One Woman's Mission | KQED","description":"More than 70 years ago, the U.S. began testing dozens of nuclear weapons on the Marshall Islands. In California, their community is still hurting.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Healing America’s Forgotten Nuclear Refugees Is One Woman's Mission","datePublished":"2017-07-28T23:33:40.000Z","dateModified":"2017-07-29T01:07:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11498766 https://ww2.kqed.org/news/?p=11498766","disqusUrl":"https://ww2.kqed.org/news/2017/07/28/healing-americas-forgotten-nuclear-refugees-is-one-womans-mission/","disqusTitle":"Healing America’s Forgotten Nuclear Refugees Is One Woman's Mission","path":"/news/11498766/healing-americas-forgotten-nuclear-refugees-is-one-womans-mission","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nestled in Orange County, among the Starbucks, strip malls and highways, there’s a tiny immigrant community with an enormous historical burden.\u003c/p>\n\u003cp>They come from the Marshall Islands, an archipelago in the South Pacific made up of 2,000 small tropical atolls. And they have the unfortunate distinction of having the\u003ca href=\"https://assets.documentcloud.org/documents/3902548/A-Community-of-Contrasts-NHPI-US-2014.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> lowest per capita income of any racial and ethnic group \u003c/a>in the entire United States.\u003c/p>\n\u003cp>In Southern California, the Marshallese settled in Costa Mesa. Some of the adults work as baggage handlers at nearby airports. Others work at a medical device company, sewing pig valves onto heart stents. Although poor, they are knit together by their faith and their history.\u003c/p>\n\u003cp>Greta Briand is the pastor’s wife, a volunteer health educator and a respected elder among the Marshallese. The children call her “bubu\" -- Marshallese for “grandmother.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audio","attributes":{"named":{"src":"http://www.kqed.org/.stream/anon/radio/tcrmag/2017/07/Marshallese.mp3","image":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/BriandTalking-800x576.jpg","title":"Healing America’s Forgotten Nuclear Refugees Is One Woman's Mission","program":"The California Report","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Briand started training as a health educator 12 years ago. She wanted to help her community deal with \u003ca href=\"http://www.migrationpolicy.org/article/marshall-islanders-migration-patterns-and-health-care-challenges\" target=\"_blank\" rel=\"noopener noreferrer\">alarming rates \u003c/a>of cancer, heart disease and diabetes. Marshall Islanders have the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358182/\" target=\"_blank\" rel=\"noopener noreferrer\">second-highest rate of diabetes\u003c/a> in the world, and they also suffer from thyroid cancer, breast cancer, and cancers of the blood, stomach and colon.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These illnesses, Briand says, can be traced back 70 years, to the immediate aftermath of World War II, when the U.S. occupied the atolls of the Marshall Islands and used them as a nuclear proving ground.\u003c/p>\n\u003cp>Over the course of 12 years, the U.S. detonated 67 nuclear bombs there.\u003c/p>\n\u003cp>\"I always call it nuke. They nuke us!\" she says. \"And we never had these kind of diseases before. And I do believe it was because we were exposed to radiation. It was too strong.\"\u003c/p>\n\u003cp>Briand’s own family has suffered. Her older and younger sisters are cancer survivors, of breast and thyroid, respectively. Both these cancers are on an official list from the Nuclear Claims Tribunal of \u003ca href=\"https://assets.documentcloud.org/documents/3902551/Humanitarian-Impacts-of-Nuclear-War.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">37 cancers and diseases linked to nuclear weapons testing\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11599022\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11599022\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/GretaFlower800-800x905.jpg\" alt=\"Greta Briand wears a traditional blossom in her hair. It’s woven together with the leaves of palm fronds.\" width=\"800\" height=\"905\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-160x181.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-240x272.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-375x424.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/GretaFlower800-520x588.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Greta Briand wears a traditional blossom in her hair. It’s woven together with the leaves of palm fronds. \u003ccite>(Courtesy of Melody Seanoa)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Nuclear Refugees in California\u003c/h3>\n\u003cp>Greta Briand, now almost 70, came to California when she was a teenager, to work and to go to college. She was among the first group who came to Costa Mesa, which became the first Marshallese community in the U.S. Over the years, thousands of Marshallese followed her to America, uprooted and displaced by the U.S. nuclear testing.\u003c/p>\n\u003cp>Today, there are more than 23,000 Marshallese living in the U.S., \u003ca href=\"https://assets.documentcloud.org/documents/3902543/A-Community-of-Contrasts-NHPI-CA-2014.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">and about 2,000 in California.\u003c/a> They were able to come because of an agreement made between the Marshall Islands and the U.S. -- the \u003ca href=\"http://uscompact.org/about/cofa.php\">Compact of Free Association\u003c/a>. The Compact allows Marshallese to work and live freely on U.S. soil for as long as they want, but does not convey citizenship.\u003c/p>\n\u003cp>Briand originally planned to return to the Marshall Islands after she got her degree. But one reason she stayed was the health issues in her community. She wanted to help.\u003c/p>\n\u003cp>\"You go to everybody's home, every home has a person sick -- or two -- with diabetes, cancer, heart disease,\" she says.\u003c/p>\n\u003cp>But the effects of the radiation and fallout may extend even farther. According to researchers, it’s possible that the radiation from the nuclear weapons tests \u003ca href=\"http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/beir_vii_final.pdf\">can cause genetic damage\u003c/a> that can be inherited. The possibility haunts Greta.\u003c/p>\n\u003cp>“If I don’t have it, my grandkids ...,” she breaks off tearfully. “My grandkids -- or my great-grandkids -- might have cancer. And it just breaks my heart. But that's why we got to live each day, because you know we don't know what will happen tomorrow.”\u003c/p>\n\u003cfigure id=\"attachment_11599024\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11599024\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/BriandFuneral-800x975.jpg\" alt=\"Greta Briand attends a Marshallese funeral and scatters dirt over a grave. Her younger sister, Delta Garstang, far right, is a thyroid cancer survivor.\" width=\"800\" height=\"975\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-800x975.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-160x195.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-1020x1243.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-1180x1438.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-960x1170.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-240x293.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-375x457.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/BriandFuneral-520x634.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Greta Briand attends a Marshallese funeral and scatters dirt over a grave. Her younger sister, Delta Garstang, far right, is a thyroid cancer survivor. \u003ccite>(Courtesty of Melody Seanoa)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>One Voice for Many Needs\u003c/h3>\n\u003cp>Jane Pang, an advocate at the\u003ca href=\"http://www.pacifichealthpartners.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> Pacific Islander Health Partnership\u003c/a> in Orange County, trained Briand to recognize and combat the barriers that prevent many Marshallese from getting treatment.\u003c/p>\n\u003cp>\"They don't understand the medical challenges. They don't understand the symptoms,” Pang said of the Marshallese. “It’s difficult for them to understand, because they have very little education in terms of health. They personally will not know what to ask for, and that's why Greta was so valuable. She was such an excellent voice.\"\u003c/p>\n\u003cp>Greta holds health classes in women’s homes, or at the church, to teach women how to do breast self-exams. She also encourages them to go to the doctor regularly, because of the health risks posed by the nuclear tests.\u003c/p>\n\u003cp>\"I was thinking about what happened to us, and I know if I don't say anything, nobody will.\"\u003c/p>\n\u003cp>Briand is the only Marshallese resident in Costa Mesa who is trying to help her peers navigate the U.S. health system. She’s up against a lot. Aside from severe poverty, there’s a language barrier. One in four Marshallese households don’t speak English.\u003c/p>\n\u003cp>Marshallese culture also stigmatizes illness. Briand says this applies to any sickness: “You don't tell anybody,” she says. “Whenever a person is sick, they always think that they did something wrong and God is punishing them.\"\u003c/p>\n\u003cfigure id=\"attachment_11599138\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11599138\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/CastleBravo800-800x815.jpg\" alt=\"This is an archival photo of Castle Bravo, 3.5 seconds after detonation. at a a distance of 75 nautical miles from ground zero. This bomb was the largest and dirtiest bomb ever detonated by the U.S. It was so large you can still see the crater from space. \" width=\"800\" height=\"815\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-160x163.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-240x245.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-375x382.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-520x530.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/CastleBravo800-64x64.jpg 64w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">This is an archival photo of Castle Bravo, 3.5 seconds after detonation. at a a distance of 75 nautical miles from ground zero. This bomb was the largest and dirtiest bomb ever detonated by the U.S. It was so large you can still see the crater from space. \u003ccite>(National Security Archive)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>A Childhood Among the Bombs\u003c/h3>\n\u003cp>To understand the root of the Marshallese health problems today, it’s important to go back to the late 1940s, when the Cold War began. At that time, the nuclear arms race was heating up and the U.S. needed a place, far from the populated mainland, to test bigger and more destructive nuclear weapons. Some of the 67 nuclear weapons tested in the Marshall Islands were detonated underwater, and some were dropped from airplanes. Some of the islands were completely destroyed.\u003c/p>\n\u003cp>When Briand was 5, she witnessed the largest and most radioactive of these bombs from her home island of Likiep. It was called \u003ca href=\"http://nsarchive.gwu.edu/nukevault/ebb459/\" target=\"_blank\" rel=\"noopener noreferrer\">Castle Bravo \u003c/a>and it had a nuclear force equivalent to 1,000 times the force of the bomb dropped on Hiroshima.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"It was like, the sky was beautiful with orange color,\" Briand says. “And we thought it was something beautiful. We didn't know it was poison!\"\u003c/p>\n\u003cp>After the detonation, dangerous clouds of radioactive, pulverized coral dust drifted across her island, coating homes and people.\u003c/p>\n\u003cp>Briand isn’t alone. Castle Bravo remains the most remembered bomb test on the islands -- and everyone received documented levels of fallout from the blast.\u003c/p>\n\u003cp>Kon Kon Wasay, 82, was a teenager when she saw the bomb. She remembers that she was outside playing with six other girls and one boy. “All of a sudden, we hear this loud noise and it looked like something evaporating.”\u003c/p>\n\u003cp>Afterward, her friends all got sick. They have all passed away from thyroid cancers and other diseases.\u003c/p>\n\u003cfigure id=\"attachment_11498781\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11498781\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/06/bikini-800x612.jpg\" alt=\"\" width=\"800\" height=\"612\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-800x612.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-160x122.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-1020x780.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-1180x902.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-960x734.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-240x183.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-375x287.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini-520x398.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2017/06/bikini.jpg 1800w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The U.S. Navy filming Commodore Wyatt “consulting” the Bikinians about their evacuation on March 6, 1946. \u003ccite>(National Security Archive)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>'Something Good for Mankind'\u003c/h3>\n\u003cp>The U.S. was able to conduct these nuclear tests because it had occupied the Marshall Islands since World War II. After defeating the Japanese, who had previously occupied the archipelago, the U.S. military moved in, permanently.\u003c/p>\n\u003cp>Before the tests began, military governor Commodore Ben H. Wyatt took a sea plane to Bikini Island to talk to the islanders. \u003ca href=\"https://www.youtube.com/watch?v=zri2knpOSqo\" target=\"_blank\" rel=\"noopener noreferrer\">Footage from a Navy propaganda film\u003c/a> shows Wyatt speaking to their leader, Chief Juda, through a translator named James.\u003c/p>\n\u003cp>“All right now, James, will you tell them that the United States government now wants to attempt to turn this great destructive force into something good for mankind, and that these experiments here at Bikini are the first step in that direction.”\u003c/p>\n\u003cfigure id=\"attachment_11597358\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11597358 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/BikiniWyattCrop-1-800x535.jpg\" alt=\"\" width=\"800\" height=\"535\">\u003cfigcaption class=\"wp-caption-text\">Commodore Ben H. Wyatt, the military governor of the Marshall Islands, traveled to Bikini in 1946 to tell them about a plan to detonate nuclear weapons. \u003ccite>(National Security Archive)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The film then portrays the people leaving their islands willingly. But the Marshallese didn't have a choice. The U.S. moved them from island to island, using them as cheap laborers on the military bases.\u003c/p>\n\u003cp>“They never asked permission,” says Barbara Rose Johnston, an anthropologist in Santa Cruz who has studied the effects of the nuclear tests on Marshallese culture.\u003c/p>\n\u003cp>“They just dictated: We're taking over, we're doing our test here. And in the years since, they never did any full disclosure of the extent of what they were doing, how, and why,\" she says. \"The culture of the time did not think of the Marshallese as equal people.”\u003c/p>\n\u003cfigure id=\"attachment_11597359\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11597359 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/07/bikini-evacuation-edit-800x619.jpg\" alt=\"\" width=\"800\" height=\"619\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-800x619.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-160x124.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-1020x789.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-1180x912.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-960x742.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-240x186.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-375x290.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit-520x402.jpg 520w, https://ww2.kqed.org/app/uploads/sites/10/2017/07/bikini-evacuation-edit.jpg 1782w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Marshallese evacuate from their island of Bikini in 1946. \u003ccite>(National Security Archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Johnston has unearthed \u003ca href=\"https://assets.documentcloud.org/documents/3902551/Humanitarian-Impacts-of-Nuclear-War.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">previously classified documents revealing an invasive medical program called Project 4.1\u003c/a> that the U.S. performed on some Marshallese to learn how radiation damages the human body.\u003c/p>\n\u003cp>Over the course of four decades and 72 research trips to the islands, U.S. medical teams examined the Marshallese using X-rays and photography, and took samples of blood, urine and tissue. Some Marshallese even received radioisotope injections and underwent experimental surgery.\u003c/p>\n\u003cp>Since that time, the U.S. government has formally recognized some of the harm caused by the bombings, and the U.S. government pays for health care and government assistance on the Marshall Islands. But those programs aren't available to the Marshallese who have migrated to California and other states, and many remain poor and isolated.\u003c/p>\n\u003cp>As the sole health educator in Costa Mesa, Greta Briand is the only one connecting the dots, explaining to her people how the nuclear history of the past created the medical problems of the present.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>The 23,000 Marshallese who live in the United States have settled most heavily in Arkansas, California, Hawaii, Missouri, Washington and Oregon. In some of those states, the unique migration status of the Marshallese means they are ineligible for Medicaid. Sarah Craig has also reported on a community in Enid, Oklahoma, where most of the Marshallese are uninsured. One Enid resident, Terry Mote, is fighting to improve health care for his people. The story won the Untold Story Award from Narrative.ly. You can see her photos and \u003ca href=\"http://narrative.ly/how-years-of-ruthless-nuclear-testing-in-the-south-pacific-forged-americas-most-impoverished-ethnic-group/\" target=\"_blank\" rel=\"noopener noreferrer\">read the whole story here.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11498766/healing-americas-forgotten-nuclear-refugees-is-one-womans-mission","authors":["11327"],"programs":["news_72"],"categories":["news_19906","news_457","news_8","news_13"],"tags":["news_160","news_21080","news_17286","news_17041"],"featImg":"news_11598957","label":"news_72"},"news_11574201":{"type":"posts","id":"news_11574201","meta":{"index":"posts_1591205157","site":"news","id":"11574201","score":null,"sort":[1500649523000]},"guestAuthors":[],"slug":"the-painful-side-of-positive-health-care-marketing","title":"The Painful Side of Positive Health Care Marketing","publishDate":1500649523,"format":"audio","headTitle":"News Fix | KQED News","labelTerm":{"term":6944,"site":"news"},"content":"\u003cp>Lori Wallace is sitting on a couch with her 11-year-old son and his new pet snake. It’s burrowing under his armpit, as if it were afraid. But Wallace says it’s not.\u003c/p>\n\u003cp>“If he was terrified,” Wallace said, “he would be balled up. See, that is why they are called ball pythons. When they are scared, they turn into a little ball.”\u003c/p>\n\u003cp>Wallace is dying of breast cancer, but a stranger couldn’t tell. She has a pixie haircut and a warm tan. She’s vibrant and chatty and looks you right in the eyes when she talks. Wallace doesn’t shy away from what’s happening to her. She shows me her cracked feet. They bleed from the chemotherapy pills she takes.\u003c/p>\n\u003cp>She says she used to be a hopeful person, someone who believed you could fight through any misfortune. Then, seven years ago, she was diagnosed with breast cancer. Wallace was 39. Her son was 4. She couldn’t believe it.\u003c/p>\n\u003cp>Wallace, who lives in San Jose, says the chemotherapy treatment makes her brain foggy. She is now in her fifth round. Wallace is Stage 4, metastatic. The cancer has spread throughout her body. It’s going to kill her, she tells me.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The median survival of a woman with metastatic breast cancer is 33 months,” Wallace says. “My 33 months would have been Dec. 6 last year. So I am on bonus time right now.”\u003c/p>\n\u003cp>As Wallace’s cancer has progressed, she has become more critical of what she sees as excessive positivity in health care marketing. It’s everywhere: TV ads, radio commercials, \u003ca href=\"https://serpninja.io/\">search engine campaigns\u003c/a>, billboards. The advertisements feature happy, healed patients and tell stories of miraculous recoveries. The messages are optimistic, about people beating steep odds. Wallace says the ads spread false hope, and for a patient like her they are a slap in the face.\u003c/p>\n\u003cp>A couple of decades ago you would not have seen ads like this. Hospitals and clinics did not advertise much to customers. Now, they are spending more and more each year on marketing.\u003c/p>\n\u003cp>Wallace pulls up an ad on her computer from \u003ca href=\"http://possible.ucsfbenioffchildrens.org\">UCSF Benioff Children’s Hospital\u003c/a>. It says “Amid a thousand maybes and a million nos, we believe in the profound and unstoppable power of yes.”\u003c/p>\n\u003cp>There is a similar kind of optimism at the heart of a lot of Bay Area health provider campaigns. Kaiser Permanente ads are constructed around the word “Thrive”; for Sutter Health it’s “Smile Out.” Wallace says the subtext of the ads is that those like her who get sick and will die maybe just aren’t being positive enough.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I have said yes to every possible treatment. And the cancer doesn't care.' \u003ccite>Lori Wallace\u003c/cite>\u003c/aside>\n\u003cp>“I didn’t say yes to cancer,” Wallace says. “I have tried everything I can. I have done clinical trials. I have said yes to every possible treatment. And the cancer doesn't care.”\u003c/p>\n\u003cp>Karuna Jaggar is executive director of Breast Cancer Action. She says health care providers are following in the footsteps of other companies.\u003c/p>\n\u003cp>“It's the basics of marketing,\" Jaggar says. \"In order to sell products or services, you have to sell hope.\"\u003c/p>\n\u003cp>She says health care advertisers are now adopting the kind of optimistic messaging that really began in force with the pink ribbons and rosy depictions of breast cancer.\u003c/p>\n\u003cp>“Thirty years ago, breast cancer was the poster child of positive thinking,” Jaggar says. “Look good, feel better, don't let breast cancer get you down. Fight strong and be cheerful while you do it.”\u003c/p>\n\u003cp>Thirty or 40 years ago health care providers marketed to physicians more than consumers. The ads were drier, more factual, says Guy David, a professor of health care management at the University of Pennsylvania.\u003c/p>\n\u003cp>“When the ads are more consumer-facing as opposed to professional-facing, the content tends to be more passionate,” David says.\u003c/p>\n\u003cp>The ads tug at emotions, just like other advertising that’s trying to win over consumers. With increasing health care costs and choices, patients are shopping around for care. Tim Calkins is a professor of marketing at Northwestern University. He says these days hospitals have to sell themselves.\u003c/p>\n\u003cp>“Right now in health care if you don't have some leverage, if you don't have a brand people care about, if you don't have a reason for people to pick you over competitors, well then you are in a really tough spot,\" Calkins says.\u003c/p>\n\u003cp>Calkins says hospitals are spending more than ever on advertising and, as with other products, it’s filled with lots of promises. He says you don’t see the same promises in the pharmaceutical industry. Their ads are regulated by the FDA, which is why they have to list all those side effects and show scientific backing for their claims.\u003c/p>\n\u003cp>“Hospitals aren't held to any of those standards at all,” Calkins says. “So a hospital can go out and say this is where miracles happen. And here's Joe. Joe was about to die. And now Joe is going to live forever.”\u003c/p>\n\u003cp>Lori Wallace is not going to live forever. Before cancer, she says, she would have been attracted to the messages of hope. Now Wallace says she needs realism, acceptance of both the world’s beauty and its harshness. She wrote an essay about that for the women in her breast cancer support group.\u003c/p>\n\u003cp>The essay is titled “Fuck Silver Linings and Pink Ribbons.” Wallace reads me the whole piece from start to finish. We are sitting at the kitchen table. Her son is nearby with his pet snake.\u003c/p>\n\u003cp>Toward the middle of the essay Wallace writes, “My ovaries are gone and without them my skin is aging at hyperspeed. I have hot flashes and cold flashes. My bones ache. My libido is shot and my vagina is a desert.” The essay is open, funny and unflinching, just like Wallace.\u003c/p>\n\u003cp>Before I leave, she reads me the final paragraph. “I will try to be thankful for every laugh, hug and kiss, and other things, too. That is if my chemo brain allows me to remember.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“That’s what I wrote,” Wallace says. “That's what I wrote. Brutal honesty.”\u003c/p>\n\n","blocks":[],"excerpt":"Lori Wallace is dying of cancer, and she is tired of health care provider ads that tell stories of miraculous recoveries.","status":"publish","parent":0,"modified":1631134247,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":1103},"headData":{"title":"The Painful Side of Positive Health Care Marketing | KQED","description":"Lori Wallace is dying of cancer, and she is tired of health care provider ads that tell stories of miraculous recoveries.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"The Painful Side of Positive Health Care Marketing","datePublished":"2017-07-21T15:05:23.000Z","dateModified":"2021-09-08T20:50:47.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11574201 https://ww2.kqed.org/news/?p=11574201","disqusUrl":"https://ww2.kqed.org/news/2017/07/21/the-painful-side-of-positive-health-care-marketing/","disqusTitle":"The Painful Side of Positive Health Care Marketing","audioUrl":"http://www.kqed.org/.stream/anon/radio/RDnews/2017/07/HealthCareMarketing.mp3","path":"/news/11574201/the-painful-side-of-positive-health-care-marketing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lori Wallace is sitting on a couch with her 11-year-old son and his new pet snake. It’s burrowing under his armpit, as if it were afraid. But Wallace says it’s not.\u003c/p>\n\u003cp>“If he was terrified,” Wallace said, “he would be balled up. See, that is why they are called ball pythons. When they are scared, they turn into a little ball.”\u003c/p>\n\u003cp>Wallace is dying of breast cancer, but a stranger couldn’t tell. She has a pixie haircut and a warm tan. She’s vibrant and chatty and looks you right in the eyes when she talks. Wallace doesn’t shy away from what’s happening to her. She shows me her cracked feet. They bleed from the chemotherapy pills she takes.\u003c/p>\n\u003cp>She says she used to be a hopeful person, someone who believed you could fight through any misfortune. Then, seven years ago, she was diagnosed with breast cancer. Wallace was 39. Her son was 4. She couldn’t believe it.\u003c/p>\n\u003cp>Wallace, who lives in San Jose, says the chemotherapy treatment makes her brain foggy. She is now in her fifth round. Wallace is Stage 4, metastatic. The cancer has spread throughout her body. It’s going to kill her, she tells me.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The median survival of a woman with metastatic breast cancer is 33 months,” Wallace says. “My 33 months would have been Dec. 6 last year. So I am on bonus time right now.”\u003c/p>\n\u003cp>As Wallace’s cancer has progressed, she has become more critical of what she sees as excessive positivity in health care marketing. It’s everywhere: TV ads, radio commercials, \u003ca href=\"https://serpninja.io/\">search engine campaigns\u003c/a>, billboards. The advertisements feature happy, healed patients and tell stories of miraculous recoveries. The messages are optimistic, about people beating steep odds. Wallace says the ads spread false hope, and for a patient like her they are a slap in the face.\u003c/p>\n\u003cp>A couple of decades ago you would not have seen ads like this. Hospitals and clinics did not advertise much to customers. Now, they are spending more and more each year on marketing.\u003c/p>\n\u003cp>Wallace pulls up an ad on her computer from \u003ca href=\"http://possible.ucsfbenioffchildrens.org\">UCSF Benioff Children’s Hospital\u003c/a>. It says “Amid a thousand maybes and a million nos, we believe in the profound and unstoppable power of yes.”\u003c/p>\n\u003cp>There is a similar kind of optimism at the heart of a lot of Bay Area health provider campaigns. Kaiser Permanente ads are constructed around the word “Thrive”; for Sutter Health it’s “Smile Out.” Wallace says the subtext of the ads is that those like her who get sick and will die maybe just aren’t being positive enough.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I have said yes to every possible treatment. And the cancer doesn't care.' \u003ccite>Lori Wallace\u003c/cite>\u003c/aside>\n\u003cp>“I didn’t say yes to cancer,” Wallace says. “I have tried everything I can. I have done clinical trials. I have said yes to every possible treatment. And the cancer doesn't care.”\u003c/p>\n\u003cp>Karuna Jaggar is executive director of Breast Cancer Action. She says health care providers are following in the footsteps of other companies.\u003c/p>\n\u003cp>“It's the basics of marketing,\" Jaggar says. \"In order to sell products or services, you have to sell hope.\"\u003c/p>\n\u003cp>She says health care advertisers are now adopting the kind of optimistic messaging that really began in force with the pink ribbons and rosy depictions of breast cancer.\u003c/p>\n\u003cp>“Thirty years ago, breast cancer was the poster child of positive thinking,” Jaggar says. “Look good, feel better, don't let breast cancer get you down. Fight strong and be cheerful while you do it.”\u003c/p>\n\u003cp>Thirty or 40 years ago health care providers marketed to physicians more than consumers. The ads were drier, more factual, says Guy David, a professor of health care management at the University of Pennsylvania.\u003c/p>\n\u003cp>“When the ads are more consumer-facing as opposed to professional-facing, the content tends to be more passionate,” David says.\u003c/p>\n\u003cp>The ads tug at emotions, just like other advertising that’s trying to win over consumers. With increasing health care costs and choices, patients are shopping around for care. Tim Calkins is a professor of marketing at Northwestern University. He says these days hospitals have to sell themselves.\u003c/p>\n\u003cp>“Right now in health care if you don't have some leverage, if you don't have a brand people care about, if you don't have a reason for people to pick you over competitors, well then you are in a really tough spot,\" Calkins says.\u003c/p>\n\u003cp>Calkins says hospitals are spending more than ever on advertising and, as with other products, it’s filled with lots of promises. He says you don’t see the same promises in the pharmaceutical industry. Their ads are regulated by the FDA, which is why they have to list all those side effects and show scientific backing for their claims.\u003c/p>\n\u003cp>“Hospitals aren't held to any of those standards at all,” Calkins says. “So a hospital can go out and say this is where miracles happen. And here's Joe. Joe was about to die. And now Joe is going to live forever.”\u003c/p>\n\u003cp>Lori Wallace is not going to live forever. Before cancer, she says, she would have been attracted to the messages of hope. Now Wallace says she needs realism, acceptance of both the world’s beauty and its harshness. She wrote an essay about that for the women in her breast cancer support group.\u003c/p>\n\u003cp>The essay is titled “Fuck Silver Linings and Pink Ribbons.” Wallace reads me the whole piece from start to finish. We are sitting at the kitchen table. Her son is nearby with his pet snake.\u003c/p>\n\u003cp>Toward the middle of the essay Wallace writes, “My ovaries are gone and without them my skin is aging at hyperspeed. I have hot flashes and cold flashes. My bones ache. My libido is shot and my vagina is a desert.” The essay is open, funny and unflinching, just like Wallace.\u003c/p>\n\u003cp>Before I leave, she reads me the final paragraph. “I will try to be thankful for every laugh, hug and kiss, and other things, too. That is if my chemo brain allows me to remember.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“That’s what I wrote,” Wallace says. “That's what I wrote. Brutal honesty.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11574201/the-painful-side-of-positive-health-care-marketing","authors":["253"],"programs":["news_6944"],"categories":["news_457","news_8"],"tags":["news_21267","news_2275"],"featImg":"news_11574202","label":"news_6944"},"stateofhealth_323065":{"type":"posts","id":"stateofhealth_323065","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"323065","score":null,"sort":[1493312653000]},"guestAuthors":[],"slug":"hype-offers-hope-and-risks-to-cancer-patients","title":"Hype Offers Hope -- and Risks -- to Cancer Patients","publishDate":1493312653,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help.\u003c/p>\n\u003cp>The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence.\u003c/p>\n\u003cp>Michael Uvanni was in awe when he visited the University of Texas MD Anderson Cancer Center in Houston, one of the world’s most respected cancer hospitals. It was like seeing the Grand Canyon, said Uvanni, 66, of Rome, N.Y. “You never get used to the size and scope.”\u003c/p>\n\u003cp>Even the MD Anderson logo on buses and buildings — with “Cancer” crossed out in red, above the words “Making cancer history” — made the family’s battle seem winnable.\u003c/p>\n\u003cp>“I thought they were going to save him,” said Uvanni, an interior designer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Patients and families are bombarded with the news that the country is winning the war against cancer. The news media hypes research results to attract readers. Drug companies promise “a chance to live longer” to boost sales. Hospitals woo paying customers with ads that appeal to patients’ fears and hopes.\u003c/p>\n\u003cp>“I’m starting to hear more and more that we are better than I think we really are,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. “We’re starting to believe our own bullshit.”\u003c/p>\n\u003cp>The consequences are real — and they can be deadly. Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.\u003c/p>\n\u003cp>“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” Brawley said. Some choose a medicine that “has a lot of hype around it and unfortunately lose their chance for a cure.”\u003c/p>\n\u003cp>Although scientists have made important strides in recent years, and many early-stage cancers can now be cured, most of those with advanced cancer eventually die of their disease.\u003c/p>\n\u003cp>For Uvanni, hope gave way to crushing disappointment when his brother’s health declined and he died from metastatic melanoma in 2014.\u003c/p>\n\u003cp>“You get your hopes up, and then you are dropped off the edge of a cliff,” said Uvanni. “That’s the worst thing in the world.”\u003c/p>\n\u003cp>Caregivers like Uvanni can suffer prolonged grief and guilt if their loved ones are riddled with side effects and don’t survive as long as the family expected, noted Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College.\u003c/p>\n\u003cp>For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great plagues, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health & Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.\u003c/p>\n\u003cp>Hyping early scientific results — based on lab tests or animal studies — can attract investors that allow researchers to continue their work. Positive results can lead biotech firms to be bought out by larger drug companies.\u003c/p>\n\u003cp>“It’s in the interest of almost every stakeholder in the health system to be optimistic about these therapies,” said Dr. Walid Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.\u003c/p>\n\u003cp>Of course, there is plenty of money to be made.\u003c/p>\n\u003cp>The U.S. spent nearly $88 billion treating cancer in 2014, with patients paying nearly $4 billion out-of-pocket, according to the American Cancer Society Cancer Action Network. Spending on cancer, a disease that most afflicts the aging, is predicted to soar as people live longer.\u003c/p>\n\u003cp>“While many people are trying to make patients’ lives healthier and longer and better, there are others that are exploiting their vulnerability,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center.\u003c/p>\n\u003cp>Others argue that the excitement about cancer research is justified. A spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry group, said cancer patients have good reason for optimism.\u003c/p>\n\u003cp>“We continue to see great strides in identifying the genetic mutations and related factors that can drive the seemingly random formation of abnormal cells in cancer,” spokeswoman Holly Campbell said in a statement. “In the last decade, we’ve seen a number of scientific advances transform the landscape of many cancers.”\u003c/p>\n\u003cp>\u003cstrong>Promises To Cure Abound\u003cbr>\n\u003c/strong>\u003cbr>\nEven the country’s top scientists sometimes get carried away.\u003c/p>\n\u003cp>In 1998, Nobel laureate James Watson — who co-discovered the structure of DNA — told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.\u003c/p>\n\u003cp>In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” by better understanding tumor genetics.\u003c/p>\n\u003cp>Last year, when President Barack Obama announced the Cancer Moonshot, which aims to accelerate and better coordinate research, he said, “Let’s make America the country that cures cancer once and for all.”\u003c/p>\n\u003cp>In a recent interview, von Eschenbach acknowledged he didn’t communicate his goal well.\u003c/p>\n\u003cp>“We all fall into that trap,” said von Eschenbach, now a senior fellow at the Milken Institute, a health and public policy think tank. “We’re offering what we have, but making it appear that it’s more than what it is.”\u003c/p>\n\u003cp>It’s easy to see how patients’ hopes are raised, said Timothy Turnham, former executive director at the Melanoma Research Foundation, an advocacy group. Researchers are frequently overly enthusiastic about early discoveries that have little chance of leading to a new drug.\u003c/p>\n\u003cp>“There is a disconnect between what researchers think is statistically significant and what is really significant for patients,” Turnham said. “Patients hear ‘progress,’ and they think that means they’re going to be cured.”\u003c/p>\n\u003cp>\u003cstrong>A Marketing Blitz\u003cbr>\n\u003c/strong>\u003cbr>\nUvanni said his brother’s experience was nothing like the sunny images in TV commercials, in which smiling cancer patients hug their grandchildren, hike in the mountains and lead dance classes.\u003c/p>\n\u003cp>A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers, as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived just 3.2 months longer than others.\u003c/p>\n\u003cp>A TV ad for Merck’s Keytruda features reassuring images of a smiling, healthy patient hugging her family — not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial claims the drug provides “a chance for a longer life. It’s Tru.”\u003c/p>\n\u003cp>“Your heart sinks when you see those ads,” Uvanni said. Seeing the family depicted in the ad, he said “makes you wonder if they’re going down the same path that we did.”\u003c/p>\n\u003cp>The Keytruda ad notes that 71 percent of patients given the drug were alive “at the time of patient follow-up,” compared with 58 percent of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.\u003c/p>\n\u003cp>“It’s not false; it’s just incomplete,” said pharmacist Harold DeMonaco, a visiting scientist at the Massachusetts Institute of Technology in Boston. “They don’t give patients or the patients’ family enough information to make a reasonable decision.”\u003c/p>\n\u003cp>In an interview, Merck senior vice president Jill DeSimone said that the company aims to be responsible with its advertising, noting that the Keytruda ad reminds patients to talk to their doctors. “The physician is the ultimate decider on treatment,” DeSimone said.\u003c/p>\n\u003cp>In a statement, Bristol-Myers’ senior vice president Teresa Bitetti said that Opdivo ads play “an important role in educating patients about new treatment options and fostering informed conversations between patients and their doctors.”\u003c/p>\n\u003cp>Hospitals also have drawn criticism for overstating their success in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”\u003c/p>\n\u003cp>The company’s current commercials — dozens of which are featured on their website — boast of offering “genomic testing” and “precision cancer treatment.”\u003c/p>\n\u003cp>The commercials don’t tell patients that these tests — which aim to pair cancer patients with drugs that target the specific mutations in their tumors — are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4 percent of patients with a drug, according to Prasad’s 2016 article in Nature. Because these drugs only manage to shrink a fraction of tumors, Prasad estimates that just 1.5 percent of patients actually benefit from precision oncology.\u003c/p>\n\u003cp>In a statement, Cancer Treatment Centers of America said, “We use national media to help educate cancer patients and their families about the latest diagnostic tools and treatment options. … All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with federal guidelines.”\u003c/p>\n\u003cp>Spending on ads for hospitals that treat cancer soared 220 percent from $54 million in 2005 to $173 million in 2014, according to a 2016 article in JAMA Internal Medicine. Ads for Cancer Treatment Centers of America accounted for nearly 60 percent of all total cancer center advertising.\u003c/p>\n\u003cp>\u003cstrong>Targeting Melanoma\u003cbr>\n\u003c/strong>\u003cbr>\nFor more than a decade, the Food and Drug Administration approved no new treatments for metastatic melanoma. Patients typically died within a year of diagnosis.\u003c/p>\n\u003cp>Since 2011, however, the FDA has approved 11 new treatments, including several immunotherapies, which aim to harness the immune system to fight cancer. Last year, doctors leading a clinical trial announced that the median survival of patients taking the drug Keytruda had grown to two years. Forty percent of patients were alive three years later, according to the clinical trial, presented at the American Society of Clinical Oncology.\u003c/p>\n\u003cp>Researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer and others.\u003c/p>\n\u003cp>Such success has led doctors to label cancer immunotherapy as a “game changer.” Newspapers and magazines call it a “breakthrough.” And hospitals laud them as “a miracle in the making.”\u003c/p>\n\u003cp>Yet these treatments — which were initially assumed to be gentler than chemotherapy — can provoke fatal immune system attacks on the lungs, kidneys, heart and other organs.\u003c/p>\n\u003cp>And there are no approved immunotherapies for tumors of the breast, colon, prostate and pancreas.\u003c/p>\n\u003cp>Only about 10 percent of all cancer patients can expect to benefit from immunotherapy, Prasad said.\u003c/p>\n\u003cp>Uvanni’s brother — who tried immunotherapy, as well as a number of other approved and experimental treatments — survived 3½ years after his diagnosis. That might lead many oncologists to describe his story as a success.\u003c/p>\n\u003cp>Uvanni sees no reason to celebrate. He wanted more than short-term survival for his brother.\u003c/p>\n\u003cp>“I thought we were going to have a treatment where we’d at least have a good block of quality time,” Uvanni said.\u003c/p>\n\u003cp>But treatments meant to control the cancer only made him sick. Some caused flu-like symptoms, with fever, chills and shakes. Others left him nauseated, unable to eat or move his bowels. Others caused dangerous infections that sent him to the emergency room.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I hope that if something like that happens to me,” Uvanni said, “I would be strong enough to say no to treatment.”\u003c/p>\n\n","blocks":[],"excerpt":"Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.","status":"publish","parent":0,"modified":1493338808,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":56,"wordCount":2090},"headData":{"title":"Hype Offers Hope -- and Risks -- to Cancer Patients | KQED","description":"Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hype Offers Hope -- and Risks -- to Cancer Patients","datePublished":"2017-04-27T17:04:13.000Z","dateModified":"2017-04-28T00:20:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"323065 https://ww2.kqed.org/stateofhealth/?p=323065","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/27/hype-offers-hope-and-risks-to-cancer-patients/","disqusTitle":"Hype Offers Hope -- and Risks -- to Cancer Patients","nprByline":"\u003cstrong>\u003ca href=\"http://khn.org/news/author/liz-szabo/\" target=\"_blank\">Liz Szabo \u003c/strong>\u003c/a>\u003c/br>Kaiser Health News","path":"/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help.\u003c/p>\n\u003cp>The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence.\u003c/p>\n\u003cp>Michael Uvanni was in awe when he visited the University of Texas MD Anderson Cancer Center in Houston, one of the world’s most respected cancer hospitals. It was like seeing the Grand Canyon, said Uvanni, 66, of Rome, N.Y. “You never get used to the size and scope.”\u003c/p>\n\u003cp>Even the MD Anderson logo on buses and buildings — with “Cancer” crossed out in red, above the words “Making cancer history” — made the family’s battle seem winnable.\u003c/p>\n\u003cp>“I thought they were going to save him,” said Uvanni, an interior designer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Patients and families are bombarded with the news that the country is winning the war against cancer. The news media hypes research results to attract readers. Drug companies promise “a chance to live longer” to boost sales. Hospitals woo paying customers with ads that appeal to patients’ fears and hopes.\u003c/p>\n\u003cp>“I’m starting to hear more and more that we are better than I think we really are,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. “We’re starting to believe our own bullshit.”\u003c/p>\n\u003cp>The consequences are real — and they can be deadly. Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.\u003c/p>\n\u003cp>“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” Brawley said. Some choose a medicine that “has a lot of hype around it and unfortunately lose their chance for a cure.”\u003c/p>\n\u003cp>Although scientists have made important strides in recent years, and many early-stage cancers can now be cured, most of those with advanced cancer eventually die of their disease.\u003c/p>\n\u003cp>For Uvanni, hope gave way to crushing disappointment when his brother’s health declined and he died from metastatic melanoma in 2014.\u003c/p>\n\u003cp>“You get your hopes up, and then you are dropped off the edge of a cliff,” said Uvanni. “That’s the worst thing in the world.”\u003c/p>\n\u003cp>Caregivers like Uvanni can suffer prolonged grief and guilt if their loved ones are riddled with side effects and don’t survive as long as the family expected, noted Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College.\u003c/p>\n\u003cp>For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great plagues, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health & Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.\u003c/p>\n\u003cp>Hyping early scientific results — based on lab tests or animal studies — can attract investors that allow researchers to continue their work. Positive results can lead biotech firms to be bought out by larger drug companies.\u003c/p>\n\u003cp>“It’s in the interest of almost every stakeholder in the health system to be optimistic about these therapies,” said Dr. Walid Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.\u003c/p>\n\u003cp>Of course, there is plenty of money to be made.\u003c/p>\n\u003cp>The U.S. spent nearly $88 billion treating cancer in 2014, with patients paying nearly $4 billion out-of-pocket, according to the American Cancer Society Cancer Action Network. Spending on cancer, a disease that most afflicts the aging, is predicted to soar as people live longer.\u003c/p>\n\u003cp>“While many people are trying to make patients’ lives healthier and longer and better, there are others that are exploiting their vulnerability,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center.\u003c/p>\n\u003cp>Others argue that the excitement about cancer research is justified. A spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry group, said cancer patients have good reason for optimism.\u003c/p>\n\u003cp>“We continue to see great strides in identifying the genetic mutations and related factors that can drive the seemingly random formation of abnormal cells in cancer,” spokeswoman Holly Campbell said in a statement. “In the last decade, we’ve seen a number of scientific advances transform the landscape of many cancers.”\u003c/p>\n\u003cp>\u003cstrong>Promises To Cure Abound\u003cbr>\n\u003c/strong>\u003cbr>\nEven the country’s top scientists sometimes get carried away.\u003c/p>\n\u003cp>In 1998, Nobel laureate James Watson — who co-discovered the structure of DNA — told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.\u003c/p>\n\u003cp>In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” by better understanding tumor genetics.\u003c/p>\n\u003cp>Last year, when President Barack Obama announced the Cancer Moonshot, which aims to accelerate and better coordinate research, he said, “Let’s make America the country that cures cancer once and for all.”\u003c/p>\n\u003cp>In a recent interview, von Eschenbach acknowledged he didn’t communicate his goal well.\u003c/p>\n\u003cp>“We all fall into that trap,” said von Eschenbach, now a senior fellow at the Milken Institute, a health and public policy think tank. “We’re offering what we have, but making it appear that it’s more than what it is.”\u003c/p>\n\u003cp>It’s easy to see how patients’ hopes are raised, said Timothy Turnham, former executive director at the Melanoma Research Foundation, an advocacy group. Researchers are frequently overly enthusiastic about early discoveries that have little chance of leading to a new drug.\u003c/p>\n\u003cp>“There is a disconnect between what researchers think is statistically significant and what is really significant for patients,” Turnham said. “Patients hear ‘progress,’ and they think that means they’re going to be cured.”\u003c/p>\n\u003cp>\u003cstrong>A Marketing Blitz\u003cbr>\n\u003c/strong>\u003cbr>\nUvanni said his brother’s experience was nothing like the sunny images in TV commercials, in which smiling cancer patients hug their grandchildren, hike in the mountains and lead dance classes.\u003c/p>\n\u003cp>A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers, as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived just 3.2 months longer than others.\u003c/p>\n\u003cp>A TV ad for Merck’s Keytruda features reassuring images of a smiling, healthy patient hugging her family — not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial claims the drug provides “a chance for a longer life. It’s Tru.”\u003c/p>\n\u003cp>“Your heart sinks when you see those ads,” Uvanni said. Seeing the family depicted in the ad, he said “makes you wonder if they’re going down the same path that we did.”\u003c/p>\n\u003cp>The Keytruda ad notes that 71 percent of patients given the drug were alive “at the time of patient follow-up,” compared with 58 percent of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.\u003c/p>\n\u003cp>“It’s not false; it’s just incomplete,” said pharmacist Harold DeMonaco, a visiting scientist at the Massachusetts Institute of Technology in Boston. “They don’t give patients or the patients’ family enough information to make a reasonable decision.”\u003c/p>\n\u003cp>In an interview, Merck senior vice president Jill DeSimone said that the company aims to be responsible with its advertising, noting that the Keytruda ad reminds patients to talk to their doctors. “The physician is the ultimate decider on treatment,” DeSimone said.\u003c/p>\n\u003cp>In a statement, Bristol-Myers’ senior vice president Teresa Bitetti said that Opdivo ads play “an important role in educating patients about new treatment options and fostering informed conversations between patients and their doctors.”\u003c/p>\n\u003cp>Hospitals also have drawn criticism for overstating their success in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”\u003c/p>\n\u003cp>The company’s current commercials — dozens of which are featured on their website — boast of offering “genomic testing” and “precision cancer treatment.”\u003c/p>\n\u003cp>The commercials don’t tell patients that these tests — which aim to pair cancer patients with drugs that target the specific mutations in their tumors — are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4 percent of patients with a drug, according to Prasad’s 2016 article in Nature. Because these drugs only manage to shrink a fraction of tumors, Prasad estimates that just 1.5 percent of patients actually benefit from precision oncology.\u003c/p>\n\u003cp>In a statement, Cancer Treatment Centers of America said, “We use national media to help educate cancer patients and their families about the latest diagnostic tools and treatment options. … All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with federal guidelines.”\u003c/p>\n\u003cp>Spending on ads for hospitals that treat cancer soared 220 percent from $54 million in 2005 to $173 million in 2014, according to a 2016 article in JAMA Internal Medicine. Ads for Cancer Treatment Centers of America accounted for nearly 60 percent of all total cancer center advertising.\u003c/p>\n\u003cp>\u003cstrong>Targeting Melanoma\u003cbr>\n\u003c/strong>\u003cbr>\nFor more than a decade, the Food and Drug Administration approved no new treatments for metastatic melanoma. Patients typically died within a year of diagnosis.\u003c/p>\n\u003cp>Since 2011, however, the FDA has approved 11 new treatments, including several immunotherapies, which aim to harness the immune system to fight cancer. Last year, doctors leading a clinical trial announced that the median survival of patients taking the drug Keytruda had grown to two years. Forty percent of patients were alive three years later, according to the clinical trial, presented at the American Society of Clinical Oncology.\u003c/p>\n\u003cp>Researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer and others.\u003c/p>\n\u003cp>Such success has led doctors to label cancer immunotherapy as a “game changer.” Newspapers and magazines call it a “breakthrough.” And hospitals laud them as “a miracle in the making.”\u003c/p>\n\u003cp>Yet these treatments — which were initially assumed to be gentler than chemotherapy — can provoke fatal immune system attacks on the lungs, kidneys, heart and other organs.\u003c/p>\n\u003cp>And there are no approved immunotherapies for tumors of the breast, colon, prostate and pancreas.\u003c/p>\n\u003cp>Only about 10 percent of all cancer patients can expect to benefit from immunotherapy, Prasad said.\u003c/p>\n\u003cp>Uvanni’s brother — who tried immunotherapy, as well as a number of other approved and experimental treatments — survived 3½ years after his diagnosis. That might lead many oncologists to describe his story as a success.\u003c/p>\n\u003cp>Uvanni sees no reason to celebrate. He wanted more than short-term survival for his brother.\u003c/p>\n\u003cp>“I thought we were going to have a treatment where we’d at least have a good block of quality time,” Uvanni said.\u003c/p>\n\u003cp>But treatments meant to control the cancer only made him sick. Some caused flu-like symptoms, with fever, chills and shakes. Others left him nauseated, unable to eat or move his bowels. Others caused dangerous infections that sent him to the emergency room.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I hope that if something like that happens to me,” Uvanni said, “I would be strong enough to say no to treatment.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients","authors":["byline_stateofhealth_323065"],"categories":["stateofhealth_2407","stateofhealth_13"],"tags":["stateofhealth_3095","stateofhealth_16","stateofhealth_2892","stateofhealth_2808","stateofhealth_73","stateofhealth_3093","stateofhealth_2519","stateofhealth_3094"],"featImg":"stateofhealth_323067","label":"stateofhealth"},"futureofyou_317468":{"type":"posts","id":"futureofyou_317468","meta":{"index":"posts_1591205157","site":"futureofyou","id":"317468","score":null,"sort":[1484070365000]},"guestAuthors":[],"slug":"biden-says-he-will-start-his-own-cancer-initiative","title":"Biden Says He Will Start His Own Cancer Initiative","publishDate":1484070365,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Vice President Joe Biden is outlining how he intends to pursue his \"cancer moonshot\" agenda after he leaves office next week.\u003c/p>\n\u003cp>[contextly_sidebar id=\"fXg9Yi3NNbgCtbEglpi4NJfWUuSjRQHo\"]The vice president, speaking at the J.P. Morgan Healthcare Conference in San Francisco, Monday, said cancer is a bipartisan issue, and he offered to help the next administration carry on his mission to end the deadly disease. But he said he will also create an organization called the Biden Cancer Initiative; the primary focus will be collaboration between scientists so that research will be widely shared across specialties.\u003c/p>\n\u003cp>“Virologists, geneticists, chemical and biological engineers -- they weren’t all working in unison, but today we’ve reached an inflection point ... and the promise is enormous,\" Biden said.\u003c/p>\n\u003cp>Biden said the initiative will also concentrate on improving data standards to help researchers, work with community care organizations to improve access, and push pharmaceutical companies, insurance providers and biotech companies to make sure patients can afford treatments.\u003c/p>\n\u003cp>The subject hits home for the vice president, whose son, former Delaware Attorney General Beau Biden, died of brain cancer in May 2015.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":"The Biden Cancer Initiative's primary focus will be collaboration between scientists so that research will be shared widely across specialties, the vice president said.","status":"publish","parent":0,"modified":1484083437,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":7,"wordCount":196},"headData":{"title":"Biden Says He Will Start His Own Cancer Initiative | KQED","description":"The Biden Cancer Initiative's primary focus will be collaboration between scientists so that research will be shared widely across specialties, the vice president said.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Biden Says He Will Start His Own Cancer Initiative","datePublished":"2017-01-10T17:46:05.000Z","dateModified":"2017-01-10T21:23:57.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"317468 http://ww2.kqed.org/futureofyou/?p=317468","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/01/10/biden-says-he-will-start-his-own-cancer-initiative/","disqusTitle":"Biden Says He Will Start His Own Cancer Initiative","source":"KQED Future of You","nprByline":"Associated Press and KQED","path":"/futureofyou/317468/biden-says-he-will-start-his-own-cancer-initiative","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Vice President Joe Biden is outlining how he intends to pursue his \"cancer moonshot\" agenda after he leaves office next week.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The vice president, speaking at the J.P. Morgan Healthcare Conference in San Francisco, Monday, said cancer is a bipartisan issue, and he offered to help the next administration carry on his mission to end the deadly disease. But he said he will also create an organization called the Biden Cancer Initiative; the primary focus will be collaboration between scientists so that research will be widely shared across specialties.\u003c/p>\n\u003cp>“Virologists, geneticists, chemical and biological engineers -- they weren’t all working in unison, but today we’ve reached an inflection point ... and the promise is enormous,\" Biden said.\u003c/p>\n\u003cp>Biden said the initiative will also concentrate on improving data standards to help researchers, work with community care organizations to improve access, and push pharmaceutical companies, insurance providers and biotech companies to make sure patients can afford treatments.\u003c/p>\n\u003cp>The subject hits home for the vice president, whose son, former Delaware Attorney General Beau Biden, died of brain cancer in May 2015.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/317468/biden-says-he-will-start-his-own-cancer-initiative","authors":["byline_futureofyou_317468"],"categories":["futureofyou_452","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_713","futureofyou_712","futureofyou_80"],"featImg":"futureofyou_106921","label":"source_futureofyou_317468"},"stateofhealth_157342":{"type":"posts","id":"stateofhealth_157342","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"157342","score":null,"sort":[1457328203000]},"guestAuthors":[],"slug":"fighting-cancer-by-putting-tumor-cells-on-a-diet","title":"Fighting Cancer By Putting Tumor Cells On A Diet","publishDate":1457328203,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Cancer dogma holds that most malignancies are caused by DNA mutations inside the nuclei of cells, mutations that ultimately lead to runaway cellular proliferation. Given the countless genetic blips that have been associated with various cancers, the illness has actually come to be seen as a complex of diseases for which personalized treatments might offer the best chances of success.\u003c/p>\n\u003cp>But prevailing oncology orthodoxy has its detractors, and some cancer biologists feel that while mutations are nearly ubiquitous in cancer, they may not always be the driving force for disease. Cancer, they suggest, might actually be as much a disorder of altered energy production as it is genetic damage.\u003c/p>\n\u003cp>This idea traces back to the work of German physician Otto Warburg who, in the 1920s, reported that rather than generating energy using the oxygen-based process of respiration as healthy cells do, cancer cells prefer the anaerobic, or oxygen-free, process of fermentation. Not all \u003ca href=\"http://www.scientificamerican.com/article/how-fermentation-gives-us-beer-wine-cheese-and-cancer/\" target=\"_blank\">products of fermentation\u003c/a> are as welcome as beer, wine and cheese.\u003c/p>\n\u003cp>Boston College biology professor \u003ca href=\"http://www.bc.edu/schools/cas/biology/facadmin/seyfried.html\">Dr. Thomas Seyfried\u003c/a> is a leading proponent of the metabolic theory of cancer. He proselytizes Warburg's findings and in 2012 published an academic book called \u003cem>Cancer as a Metabolic Disease\u003c/em> that lays out the evidence behind his beliefs (Currently the book's Facebook page has over 6,000 followers and a lively exchange of self-help tips).\u003c/p>\n\u003cp>Seyfried argues that decades of research, including his own, support the idea that aberrant metabolism can somehow induce malignancy. Further, he believes that research supports at the idea that limiting the fuels available for fermentation — that is, the sugar glucose and the amino acid glutamine — is an overlooked approach to aid treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He specifically implicates mitochondria, our energy-producing organelles, in spurring on malignancy.\u003c/p>\n\u003cp>This belief is in part based on work from the '70s and '80s showing that if the cytoplasm (the buoyant cellular goo that contains the mitochondria) is transferred from a normal cells to a tumorigenic cell (one with the potential to develop into a cancer) the tendency toward cancer is suppressed. Conversely, animal research has shown that transferring the nucleus of a malignant cell into the cytoplasm of a normal cell inhibits the tumor potential of that initially malignant cell, implying, according to Seyfried, that whatever is causing the cancer lies in the cytoplasm, not the nucleus.\u003c/p>\n\u003cp>More recent \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/15647368\" target=\"_blank\">research\u003c/a> shows that the introduction of mutations in mitochondrial DNA (former single-celled organisms that our cells eventually engulfed, mitochondria have their own genetic material) reduces the tumor protection purportedly provided by normal mitochondria.\u003c/p>\n\u003cp>\"If you look at the data, you could say that there is clear evidence that cancer is a genetic disease since we can inherit mutations associated with increased cancer risk,\" says Seyfried, \"but many of these mutations disturb cellular respiration. And many non-inherited causes of cancer like radiation impair mitochondrial function.\"\u003c/p>\n\u003cp>Seyfried's colleague Dominic D'Agostino, a biology professor at the University of South Florida also subscribes to the idea that the primary driver of cancer is mitochondrial dysfunction, which can be induced by any number of carcinogens — genetic predilections, radiation, chemical exposures and diet among them.\u003c/p>\n\u003cp>Not only do many mutations and pathways associated with cancer impair mitochondrial function and cell metabolism, he says, but injured mitochondria also produce volatile compounds called \"reactive oxygen species\" that can damage DNA. \"This can explain why most cancers have mutations,\" he speculates, \"in many cases they're secondary to mitochondrial damage.\"\u003c/p>\n\u003cp>Dr. E. Aubrey Thompson, a cancer biologist at the Mayo Clinic who in his own words is \"strongly on the mutation side,\" acknowledges that cancer cells re-orchestrate their metabolic activities and that interfering with cancer metabolism is a potentially fruitful area of research. \"There are hundreds of labs already working on this right now,\" he says. Yet, he adds genially, \"there is no evidence of malignancy developing in the absence of mutations. Anyone who thinks otherwise is obligated to design an experiment to disprove this concept ... that's how science works.\"\u003c/p>\n\u003cp>It turns out there is \u003cem>some\u003c/em> evidence that this might happen, but it's limited. Seyfried pointed me to a 2015 paper by Dr. Stuart Baker of the National Cancer Institute that reviews four recent studies reporting numerous tumors in which zero mutations were found. Seyfried acknowledges that mutations might have been found with more thorough screening and better DNA sequencing technology.\u003c/p>\n\u003cp>Memorial Sloan-Kettering Cancer Center President and CEO Dr. Craig Thompson (not to be confused with Mayo's Thompson) hedges on the metabolic theory of cancer. \"While the arguments raised [by Seyfried and others] have been considered by the growing field of cancer metabolism, most investigators have moved on to consider other explanations for the observations,\" he said in an interview. Still, he has \u003ca href=\"https://www.mskcc.org/blog/license-build-new-theory-cancer-puts-metabolism-center\" target=\"_blank\">recently written\u003c/a> in support of some aspects of the theory with therapeutic implications.\u003c/p>\n\u003cp>In a way, the various competing cancer theories aren't completely at odds. \"Despite all the talk of controversy in the field, the concepts that [Seyfried] and his colleagues are advancing are not really that novel,\" says Mayo's Thompson , \"I think everybody who works in cancer biology today appreciates the fact that there are many different processes involved in a conversion of a normal cell to a tumor cell.\"\u003c/p>\n\u003cp>He believes a coalescence of pernicious influences is required for a cancer to develop. \"One of these processes is probably altered metabolic activity,\" he says. \"But cancers also must acquire mutations, change the way they interact with neighboring cells and learn to evade the immune system. Every single one of these processes is probably essential to cancer development.\"\u003c/p>\n\u003cp>Matthew Vander Heiden, a biologist at MIT and oncologist at the Dana Farber Cancer Institute, also says many factors are necessary to induce cancer, including what could be considered the other major theory on the origin of malignancies, that they result from the impairment of signaling pathways that control cell division. \"My guess is it's probably metabolic, and it's probably genetic and it's probably cell signaling. I'm not sure you can separate these out since they all appear to be so interrelated,\" he explains.\u003c/p>\n\u003cp>Regardless of the initial cancer trigger, the ultimate end of the biomedical bickering is to help patients. And as Vander Heiden points out, not only are researchers and pharmaceutical companies already developing drugs that target metabolic pathways, such drugs have been around for some time. \"I think targeting metabolic pathways in cancer is a great idea. We already have five or six mainstay chemotherapies that yes, attack cell division machinery, but also target metabolism \" explains Vander Heiden, \"They're just not billed that way.\"Seyfried is skeptical that medicines alone will cure cancer. Instead he and many of his colleagues — including Dr. Eugene Fine from the Albert Einstein College of Medicine and University of Pittsburgh neurosurgeon Dr. Joseph Maroon — are focusing on the potential of dietary approaches to contain the disease.\u003c/p>\n\u003cp>There's particular interest in the ketogenic diet, similar to the low-carb Atkins diet that is low in sugar and high in fat. It's intended to starve cancer cells of the glucose they use for fermentation.\u003c/p>\n\u003cp>\"The drugs we have now are so toxic and there's no reason people should have to be poisoned to be healthy. There are a number of studies, including those we've published, showing a direct relationship between the ketogenic diet and slowed tumor growth,\" says Seyfried, also citing the work of Dr. Valter Longo, of the University of Southern California's Davis School of Gerontology. That work shows that low-calorie diets are linked with slowed tumor growth and improved response to chemotherapy. \"Why spend all this money going after all these different pathways involved in cancer when you can simply go after the key fuels?\" Seyfried asks.\u003c/p>\n\u003cp>The idea of fighting cancer by changing what patients eat has obvious appeal, but it also raises worries. \"I get a little scared when people start talking about diet for cancer since you can quickly get into pseudoscience here,\" Mayo's Thompson counters. He points out that data supporting the ketogenic diet in cancer are limited — and further that rigorous dietary studies are incredibly hard to pull off. \"The drug companies aren't going to fund these types of trials,\" he says. \"They can't make money marketing a diet.\"\u003c/p>\n\u003cp>Vander Heiden is also wary of many dietary claims, in part because of biased expectations. \"It seems that people have often decided what diet they think is best before they do a study,\" he says. \"There's a difference between setting out to prove something is a good therapy and asking what therapy is best.\"\u003c/p>\n\u003cp>His own work has shown that certain dietary interventions can be more effective than drugs at treating cancer in mice, but he says panacean claims about the ketogenic diet specifically are a bit premature. \"I think it's a really interesting hypothesis that should continue to be tested, but to claim that cancer is all metabolic or all genetic is probably incorrect,\" he says. \"Usually in science when you have something as complex as cancer, ascribing it to one particular cause is often going too far.\"\u003c/p>\n\u003cp>Even Seyfried acknowledges, despite his zeal for treating cancer by tinkering with calories, that in all likelihood diet and nutrient-based cancer treatments will serve as adjuncts to existing therapies. But what would be wrong with that? \"We're slowing the tumor down and making it extremely vulnerable to lower, less-toxic doses of available drugs,\" he says, \"When people are locked into an ideology created by a dogma they tend not to focus on rational alternatives.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\" target=\"_blank\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired\u003cem>, \u003c/em>Scientific American\u003cem> and on The Atlantic.com. He graduated from University of Virginia School of Medicine in 2005. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Fighting+Cancer+By+Putting+Tumor+Cells+On+A+Diet&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"While genetic mutations are nearly ubiquitous in cancer, they may not always be the driving force for disease, some researchers say. ","status":"publish","parent":0,"modified":1457328203,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1675},"headData":{"title":"Fighting Cancer By Putting Tumor Cells On A Diet | KQED","description":"While genetic mutations are nearly ubiquitous in cancer, they may not always be the driving force for disease, some researchers say. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Fighting Cancer By Putting Tumor Cells On A Diet","datePublished":"2016-03-07T05:23:23.000Z","dateModified":"2016-03-07T05:23:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"157342 http://ww2.kqed.org/stateofhealth/?p=157342","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/03/06/fighting-cancer-by-putting-tumor-cells-on-a-diet/","disqusTitle":"Fighting Cancer By Putting Tumor Cells On A Diet","nprByline":"Bret Stetka, NPR","nprImageAgency":"Matailong Du/NPR","nprStoryId":"468285545","nprApiLink":"http://api.npr.org/query?id=468285545&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/03/05/468285545/fighting-cancer-by-putting-tumor-cells-on-a-diet?ft=nprml&f=468285545","nprRetrievedStory":"1","nprPubDate":"Sat, 05 Mar 2016 17:37:00 -0500","nprStoryDate":"Sat, 05 Mar 2016 04:31:00 -0500","nprLastModifiedDate":"Sat, 05 Mar 2016 17:37:24 -0500","path":"/stateofhealth/157342/fighting-cancer-by-putting-tumor-cells-on-a-diet","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cancer dogma holds that most malignancies are caused by DNA mutations inside the nuclei of cells, mutations that ultimately lead to runaway cellular proliferation. Given the countless genetic blips that have been associated with various cancers, the illness has actually come to be seen as a complex of diseases for which personalized treatments might offer the best chances of success.\u003c/p>\n\u003cp>But prevailing oncology orthodoxy has its detractors, and some cancer biologists feel that while mutations are nearly ubiquitous in cancer, they may not always be the driving force for disease. Cancer, they suggest, might actually be as much a disorder of altered energy production as it is genetic damage.\u003c/p>\n\u003cp>This idea traces back to the work of German physician Otto Warburg who, in the 1920s, reported that rather than generating energy using the oxygen-based process of respiration as healthy cells do, cancer cells prefer the anaerobic, or oxygen-free, process of fermentation. Not all \u003ca href=\"http://www.scientificamerican.com/article/how-fermentation-gives-us-beer-wine-cheese-and-cancer/\" target=\"_blank\">products of fermentation\u003c/a> are as welcome as beer, wine and cheese.\u003c/p>\n\u003cp>Boston College biology professor \u003ca href=\"http://www.bc.edu/schools/cas/biology/facadmin/seyfried.html\">Dr. Thomas Seyfried\u003c/a> is a leading proponent of the metabolic theory of cancer. He proselytizes Warburg's findings and in 2012 published an academic book called \u003cem>Cancer as a Metabolic Disease\u003c/em> that lays out the evidence behind his beliefs (Currently the book's Facebook page has over 6,000 followers and a lively exchange of self-help tips).\u003c/p>\n\u003cp>Seyfried argues that decades of research, including his own, support the idea that aberrant metabolism can somehow induce malignancy. Further, he believes that research supports at the idea that limiting the fuels available for fermentation — that is, the sugar glucose and the amino acid glutamine — is an overlooked approach to aid treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He specifically implicates mitochondria, our energy-producing organelles, in spurring on malignancy.\u003c/p>\n\u003cp>This belief is in part based on work from the '70s and '80s showing that if the cytoplasm (the buoyant cellular goo that contains the mitochondria) is transferred from a normal cells to a tumorigenic cell (one with the potential to develop into a cancer) the tendency toward cancer is suppressed. Conversely, animal research has shown that transferring the nucleus of a malignant cell into the cytoplasm of a normal cell inhibits the tumor potential of that initially malignant cell, implying, according to Seyfried, that whatever is causing the cancer lies in the cytoplasm, not the nucleus.\u003c/p>\n\u003cp>More recent \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/15647368\" target=\"_blank\">research\u003c/a> shows that the introduction of mutations in mitochondrial DNA (former single-celled organisms that our cells eventually engulfed, mitochondria have their own genetic material) reduces the tumor protection purportedly provided by normal mitochondria.\u003c/p>\n\u003cp>\"If you look at the data, you could say that there is clear evidence that cancer is a genetic disease since we can inherit mutations associated with increased cancer risk,\" says Seyfried, \"but many of these mutations disturb cellular respiration. And many non-inherited causes of cancer like radiation impair mitochondrial function.\"\u003c/p>\n\u003cp>Seyfried's colleague Dominic D'Agostino, a biology professor at the University of South Florida also subscribes to the idea that the primary driver of cancer is mitochondrial dysfunction, which can be induced by any number of carcinogens — genetic predilections, radiation, chemical exposures and diet among them.\u003c/p>\n\u003cp>Not only do many mutations and pathways associated with cancer impair mitochondrial function and cell metabolism, he says, but injured mitochondria also produce volatile compounds called \"reactive oxygen species\" that can damage DNA. \"This can explain why most cancers have mutations,\" he speculates, \"in many cases they're secondary to mitochondrial damage.\"\u003c/p>\n\u003cp>Dr. E. Aubrey Thompson, a cancer biologist at the Mayo Clinic who in his own words is \"strongly on the mutation side,\" acknowledges that cancer cells re-orchestrate their metabolic activities and that interfering with cancer metabolism is a potentially fruitful area of research. \"There are hundreds of labs already working on this right now,\" he says. Yet, he adds genially, \"there is no evidence of malignancy developing in the absence of mutations. Anyone who thinks otherwise is obligated to design an experiment to disprove this concept ... that's how science works.\"\u003c/p>\n\u003cp>It turns out there is \u003cem>some\u003c/em> evidence that this might happen, but it's limited. Seyfried pointed me to a 2015 paper by Dr. Stuart Baker of the National Cancer Institute that reviews four recent studies reporting numerous tumors in which zero mutations were found. Seyfried acknowledges that mutations might have been found with more thorough screening and better DNA sequencing technology.\u003c/p>\n\u003cp>Memorial Sloan-Kettering Cancer Center President and CEO Dr. Craig Thompson (not to be confused with Mayo's Thompson) hedges on the metabolic theory of cancer. \"While the arguments raised [by Seyfried and others] have been considered by the growing field of cancer metabolism, most investigators have moved on to consider other explanations for the observations,\" he said in an interview. Still, he has \u003ca href=\"https://www.mskcc.org/blog/license-build-new-theory-cancer-puts-metabolism-center\" target=\"_blank\">recently written\u003c/a> in support of some aspects of the theory with therapeutic implications.\u003c/p>\n\u003cp>In a way, the various competing cancer theories aren't completely at odds. \"Despite all the talk of controversy in the field, the concepts that [Seyfried] and his colleagues are advancing are not really that novel,\" says Mayo's Thompson , \"I think everybody who works in cancer biology today appreciates the fact that there are many different processes involved in a conversion of a normal cell to a tumor cell.\"\u003c/p>\n\u003cp>He believes a coalescence of pernicious influences is required for a cancer to develop. \"One of these processes is probably altered metabolic activity,\" he says. \"But cancers also must acquire mutations, change the way they interact with neighboring cells and learn to evade the immune system. Every single one of these processes is probably essential to cancer development.\"\u003c/p>\n\u003cp>Matthew Vander Heiden, a biologist at MIT and oncologist at the Dana Farber Cancer Institute, also says many factors are necessary to induce cancer, including what could be considered the other major theory on the origin of malignancies, that they result from the impairment of signaling pathways that control cell division. \"My guess is it's probably metabolic, and it's probably genetic and it's probably cell signaling. I'm not sure you can separate these out since they all appear to be so interrelated,\" he explains.\u003c/p>\n\u003cp>Regardless of the initial cancer trigger, the ultimate end of the biomedical bickering is to help patients. And as Vander Heiden points out, not only are researchers and pharmaceutical companies already developing drugs that target metabolic pathways, such drugs have been around for some time. \"I think targeting metabolic pathways in cancer is a great idea. We already have five or six mainstay chemotherapies that yes, attack cell division machinery, but also target metabolism \" explains Vander Heiden, \"They're just not billed that way.\"Seyfried is skeptical that medicines alone will cure cancer. Instead he and many of his colleagues — including Dr. Eugene Fine from the Albert Einstein College of Medicine and University of Pittsburgh neurosurgeon Dr. Joseph Maroon — are focusing on the potential of dietary approaches to contain the disease.\u003c/p>\n\u003cp>There's particular interest in the ketogenic diet, similar to the low-carb Atkins diet that is low in sugar and high in fat. It's intended to starve cancer cells of the glucose they use for fermentation.\u003c/p>\n\u003cp>\"The drugs we have now are so toxic and there's no reason people should have to be poisoned to be healthy. There are a number of studies, including those we've published, showing a direct relationship between the ketogenic diet and slowed tumor growth,\" says Seyfried, also citing the work of Dr. Valter Longo, of the University of Southern California's Davis School of Gerontology. That work shows that low-calorie diets are linked with slowed tumor growth and improved response to chemotherapy. \"Why spend all this money going after all these different pathways involved in cancer when you can simply go after the key fuels?\" Seyfried asks.\u003c/p>\n\u003cp>The idea of fighting cancer by changing what patients eat has obvious appeal, but it also raises worries. \"I get a little scared when people start talking about diet for cancer since you can quickly get into pseudoscience here,\" Mayo's Thompson counters. He points out that data supporting the ketogenic diet in cancer are limited — and further that rigorous dietary studies are incredibly hard to pull off. \"The drug companies aren't going to fund these types of trials,\" he says. \"They can't make money marketing a diet.\"\u003c/p>\n\u003cp>Vander Heiden is also wary of many dietary claims, in part because of biased expectations. \"It seems that people have often decided what diet they think is best before they do a study,\" he says. \"There's a difference between setting out to prove something is a good therapy and asking what therapy is best.\"\u003c/p>\n\u003cp>His own work has shown that certain dietary interventions can be more effective than drugs at treating cancer in mice, but he says panacean claims about the ketogenic diet specifically are a bit premature. \"I think it's a really interesting hypothesis that should continue to be tested, but to claim that cancer is all metabolic or all genetic is probably incorrect,\" he says. \"Usually in science when you have something as complex as cancer, ascribing it to one particular cause is often going too far.\"\u003c/p>\n\u003cp>Even Seyfried acknowledges, despite his zeal for treating cancer by tinkering with calories, that in all likelihood diet and nutrient-based cancer treatments will serve as adjuncts to existing therapies. But what would be wrong with that? \"We're slowing the tumor down and making it extremely vulnerable to lower, less-toxic doses of available drugs,\" he says, \"When people are locked into an ideology created by a dogma they tend not to focus on rational alternatives.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\" target=\"_blank\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired\u003cem>, \u003c/em>Scientific American\u003cem> and on The Atlantic.com. He graduated from University of Virginia School of Medicine in 2005. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Fighting+Cancer+By+Putting+Tumor+Cells+On+A+Diet&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/157342/fighting-cancer-by-putting-tumor-cells-on-a-diet","authors":["byline_stateofhealth_157342"],"categories":["stateofhealth_12","stateofhealth_13"],"tags":["stateofhealth_16","stateofhealth_298"],"featImg":"stateofhealth_157343","label":"stateofhealth"},"stateofhealth_125791":{"type":"posts","id":"stateofhealth_125791","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"125791","score":null,"sort":[1450466686000]},"guestAuthors":[],"slug":"americas-third-wave-of-asbestos-disease-upends-lives","title":"America's 'Third Wave' Of Asbestos Disease Upends Lives","publishDate":1450466686,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Until the morning of Sept. 25, 2014, life was treating Kris Penny well. His flooring company had just secured its first big contract.\u003c/p>\n\u003cp>But that morning, Penny, of Clermont, Fla., was feeling lethargic. He pulled into a McDonald's for a cup of orange juice. Seconds after he drank it, he doubled over in pain. \"It felt like someone stabbed me in the stomach with a machete,\" he said. A co-worker drove him to the emergency room.\u003c/p>\n\u003cp>When he awoke in the hospital, his wife, Lori McNamara, was beside him, crying. \"I go, 'What's the matter? I'm still here,' \" Penny said. The surgeon who'd opened up his abdomen had found it full of cancer — type to be determined. The doctor \"pretty much told me to get my affairs in order, right there on the spot.\"\u003c/p>\n\u003cp>The pathology results came in four days later. Penny, 39, learned that he had \u003ca href=\"http://www.curemeso.org/site/c.duIWJfNQKiL8G/b.8578883/k.931C/Types_of_Mesothelioma__Peritoneal_Mesothelioma.htm\" target=\"_blank\">peritoneal mesothelioma\u003c/a> — a rare cancer of the lining of the abdomen almost always tied to asbestos exposure. He concluded, after consulting with a lawyer, that he'd inhaled microscopic asbestos fibers about a decade earlier while installing fiber-optic cable underground. He sued telecommunications giant AT&T.\u003c/p>\n\u003cfigure id=\"attachment_125793\" class=\"wp-caption aligncenter\" style=\"max-width: 989px\">\u003cimg class=\"size-full wp-image-125793\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990.jpg\" alt=\"Kris Penny in April (left), and in October.\" width=\"989\" height=\"440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990.jpg 989w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-400x178.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-800x356.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-768x342.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-960x427.jpg 960w\" sizes=\"(max-width: 989px) 100vw, 989px\">\u003cfigcaption class=\"wp-caption-text\">Kris Penny in April (left), and in October. \u003ccite>(Courtesy of Maryam Jameel/Center for Public Integrity; Courtesy of Kris Penny)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The cable was housed in pipe made of \u003ca href=\"http://www.concreteconstruction.net/industrial-projects/asbestos-and-old-buildings.aspx\" target=\"_blank\">asbestos cement\u003c/a>. When workers maneuvered the cable into or out of the pipe, they generated dust. Penny says he didn't know the dust contained asbestos, a claim AT&T disputes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Physicians, scientists and union officials had people like him in mind when they convened in New York in 1990 to discuss what they called the looming \"third wave\" of asbestos disease.\u003c/p>\n\u003cp>The fire-resistant mineral first had killed asbestos miners, millers and manufacturing workers. Then it had taken out insulators, shipbuilders and others who worked with asbestos products. Eventually, conference attendees agreed, it would be roused from its dormant state in pipes, ceiling tiles and automobile brakes and kill again.\u003c/p>\n\u003cp>Environmental consultant Barry Castleman went to the New York conference. The takeaway, he said, was that \"in-place asbestos was going to pose a continuing danger to millions of workers and to the general public.\"\u003c/p>\n\u003cp>The Environmental Protection Agency \u003ca href=\"http://www.epa.gov/asbestos/us-federal-bans-asbestos\" target=\"_blank\">has banned some, but not all\u003c/a>, asbestos products in the United States; 400 metric tons of the mineral were consumed in 2014, according to the \u003ca href=\"http://minerals.usgs.gov/minerals/pubs/commodity/asbestos/mcs-2015-asbes.pdf\" target=\"_blank\">U.S. Geological Survey\u003c/a>. \"The consumption's gone down by over a thousandfold\" since the 1970s, said Castleman, who testifies almost exclusively for plaintiffs in asbestos-disease cases and was retained by Penny's lawyer. \"The problem is the asbestos is still there.\"\u003c/p>\n\u003cfigure id=\"attachment_125794\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-125794 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-400x264.jpg\" alt=\"Environmental consultant Barry Castleman says embedded asbestos poses a lingering health hazard.\" width=\"400\" height=\"264\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-400x264.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-800x527.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-768x506.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-1440x949.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-1180x778.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-960x633.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Environmental consultant Barry Castleman says embedded asbestos poses a lingering health hazard. \u003ccite>(Courtesy of Maryam Jameel/The Center for Public Integrity)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even brief, light exposures to asbestos can breed mesothelioma, diagnosed in about 2,700 people each year in the United States. Most get it in the lining of the lung, or pleura.\u003c/p>\n\u003cp>What's worse is when workers are covered in dust during asbestos-removal jobs — and possibly condemned to mesothelioma, lung cancer or the lung disease asbestosis years later — because their bosses cut corners on protections to save money.\u003c/p>\n\u003cp>Craig Benedict went after such people as an assistant U.S. attorney for the Northern District of New York, working in tandem with criminal investigators from the EPA. He handled more than 100 prosecutions of so-called rip-and-run asbestos-abatement contractors over 15 years and put people in prison — perhaps most notably a father and son named Raul and Alex Salvagno. After being convicted by a jury, they were \u003ca href=\"http://www.justice.gov/archive/opa/pr/2004/December/04_enrd_803.htm\" target=\"_blank\">sentenced\u003c/a> to 19 1/2 years and 25 years, respectively, and ordered to pay $23 million in restitution to workers for overseeing dangerously slipshod work at hundreds of locations over a 10-year period. The father-and-son team secretly owned a laboratory that falsified up to 75,000 asbestos sample results to convince clients the jobs had been done safely.\u003c/p>\n\u003cp>Benedict, who retired last year, saw victims of all stripes: homeless people, children, immigrants and inmates. \"We found asbestos in a box of lollipops a bank handed out to customers,\" he said. In another case, two teenage brothers were told to tear open bags of asbestos from an abatement project and \"put them in a dumpster with the regular trash. They would end up being coated head to foot with asbestos debris.\" Illegal work was done at New York's Asbestos Control Bureau and a state police barracks. It was done in a conference room used by state legislators and a supply room frequented by workers at a hospice.\u003c/p>\n\u003cp>Benedict said he was \"never surprised\" and \"never jaded\" by the things he witnessed. In the most egregious cases, he said, it was as if the employers \"took their workers outside, lined them up against the wall and shot them with high-powered weapons. They knew — just as certainly as someone who actually did that — that their actions over time had a very high likelihood of resulting in death or serious bodily injury.\"\u003c/p>\n\u003cp>\u003cstrong>'I Just Didn't Worry About It'\u003c/strong>\u003c/p>\n\u003cp>Kris Penny was born in Wiesbaden, Germany, and grew up mostly on Air Force bases; both his father and stepfather were in that branch of the service. He held a series of trucking, sales and factory jobs in Ohio, Georgia and Tennessee after graduating from high school. He moved to Orlando in 2002, worked briefly for one cable-pulling firm and then moved to another, Danella Construction.\u003c/p>\n\u003cp>At Danella in 2003 and 2004, Penny squeezed into BellSouth manholes from Orlando to West Palm Beach. He and his co-workers would pull fiber-optic cable into asbestos-cement conduit runs, often after removing old copper-wire cable. Bursts of compressed air were used to propel string that dragged the cable between manholes. The practice kicked up dust, which at times got \"pretty thick,\" Penny said. \"If it became too much, we would jump out of the manhole.\"\u003c/p>\n\u003cp>In his lawsuit, Penny alleges that BellSouth, now part of AT&T, never told him or other Danella workers that the conduit contained asbestos, even as it cautioned its own employees not to use compressed air or break the pipe without wetting it down. Such warnings were being delivered \"by the mid-'90s at the latest, years before Kris ever got into a manhole,\" said his lawyer, \u003ca href=\"http://www.rucklawfirm.com/leadership.php\" target=\"_blank\">Jonathan Ruckdeschel\u003c/a>.\u003c/p>\n\u003cp>\"BellSouth claims that they stopped installing new asbestos conduit in the early '80s, so any pipe he was working with had to have been in the ground for at least 20 years by the time he got there,\" Ruckdeschel said. \"And yet there's nothing inside the manhole to tell the worker, 'Don't do the things that are going to cause you to get exposed. Be careful — this is asbestos-cement pipe. Invisible amounts of asbestos dust can cause you to die.' \"\u003c/p>\n\u003cp>In a deposition in October, former BellSouth supervisor Jeffrey Rolfsen testified that the company relied on Danella to enforce safety rules, though BellSouth had the authority to stop the work if it was uneasy with the contractor's practices. \"I just didn't worry about it,\" Rolfsen said. \"They knew what they were doing better than I knew.\"\u003c/p>\n\u003cp>In a written statement to the Center for Public Integrity, AT&T said, \"We hire sophisticated contractors that are experienced in dealing with asbestos, and we require them to comply with [Occupational Safety and Health Administration] regulations.\" The company said in a court filing that Penny \"knew and understood the risks and hazards of asbestos and voluntarily exposed himself to these risks\" and that his \"injuries, if any, were caused by his own negligent conduct, or by the negligent conduct of others.\"\u003c/p>\n\u003cp>Danella officials did not respond to repeated requests for comment from the Center for Public Integrity.\u003c/p>\n\u003cp>Jesse Davis, a safety coordinator for the Communication Workers of America union, says telecommunications workers nationwide are at risk of exposures similar to Penny's. \"We're finding more and more where asbestos-containing conduit exists,\" Davis said. \"Every manhole they go in, they should be asking about the presence of asbestos.\" He highlighted two incidents involving CWA members.\u003c/p>\n\u003cp>In 2011, 31 Verizon cable workers were on a job in Fairfax, Va., when a passerby told them the type of conduit they were handling contained asbestos. The Virginia Occupational Safety and Health Program later cited Verizon for three serious violations of its asbestos standard, all of which the company contested. Two of the citations were dropped as part of a settlement; Verizon agreed to improve worker training. In a statement, it said it did \"not believe there was any actual employee exposure to asbestos-containing materials\" in Fairfax.\u003c/p>\n\u003cp>In 2014, a member of a Verizon crew in Lynchburg, Va., mindful of CWA warnings, asked a union representative to test conduit he and 19 others had been working on. The pipe's asbestos content turned out to be 35 percent. The state issued six citations, which Verizon said it has contested. It declined to comment further.\u003c/p>\n\u003cp>\u003cstrong>Grim Prognosis\u003c/strong>\u003c/p>\n\u003cp>Ruckdeschel says it's unusual for him to represent someone as young as Penny. Most of his clients are in their 60s, 70s or 80s and were exposed to asbestos decades ago. Penny is at the low end of the latency period for mesothelioma, thought by experts to be at least 10 years.\u003c/p>\n\u003cp>Penny understands that his prognosis is bleak; most people with his disease survive only a year or two. Hoping to extend his life, he went to Baltimore in August for surgery at the University of Maryland Medical Center. There Dr. H. Richard Alexander opened his abdomen, removed as much of the cancer as possible and hit Penny with a stiff dose of heated chemotherapy.\u003c/p>\n\u003cp>McNamara, Penny's wife, was distraught during the 8 1/2-hour procedure. Her husband's illness, she said at the hospital, \"just changed our life completely. People get up and they go to work, and they come home and they have dinner. And they do all these things, and our life is just not like that.\" She worries most about their 6-year-old daughter, Cloey, who's close to her father and asks if he's going to die. Penny had choked up while talking about Cloey — \"my best friend in the whole world\" — the night before the procedure.\u003c/p>\n\u003cp>Penny came through the surgery reasonably well — \"a strong guy, as fit as they come,\" Alexander reassured McNamara afterward — but has faltered since. He had two more operations in Baltimore, one to repair a rupture and the other so an infection could be flushed from his belly.\u003c/p>\n\u003cfigure id=\"attachment_125795\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-125795\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/krislorihospital-x_enl-7cf0597ff6f8350b2b21dc3ccc8308633953435c-e1450466507155.jpg\" alt=\"Kris Penny, his wife, Lori McNamara, and his father-in-law, Frank McNamara, at the University of Maryland Medical Center before Penny's surgery in August.\" width=\"1920\" height=\"1279\">\u003cfigcaption class=\"wp-caption-text\">Kris Penny, his wife, Lori McNamara, and his father-in-law, Frank McNamara, at the University of Maryland Medical Center before Penny's surgery in August. \u003ccite>(Courtesy of Maryam Jameel/The Center for Public Integrity)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He went home to Florida and did not improve. There were more procedures and hospital stays. His weight dropped from 200 pounds to about 130. In a videotaped deposition on Oct. 27 — taken as the discovery phase of his lawsuit was winding down — he looks exhausted and skeletal. He points out his feeding tube and colostomy bag in a photograph. He speaks of being so bereft of energy that he has to \"think about every step\" he takes and \"time everything I do.\"\u003c/p>\n\u003cp>There will be more like him, Ruckdeschel predicts, relatively young people who get sick from even limited contact with asbestos. \"And we have to just wait as the years and the decades go by.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This piece comes from the\u003c/em> \u003ca href=\"http://www.publicintegrity.org/\" target=\"_blank\">Center for Public Integrity\u003c/a>, \u003cem>a nonpartisan, nonprofit investigative news organization.\u003c/em> \u003cem>To follow CPI's investigations into toxic chemicals and workplace diseases, go\u003c/em> \u003ca href=\"http://www.publicintegrity.org/environment/unequal-risk\" target=\"_blank\">here\u003c/a>. \u003cem>Or follow the organization\u003c/em> \u003cem>on Twitter:\u003c/em> \u003ca href=\"https://twitter.com/publici\" target=\"_blank\">@Publici\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 The Center for Public Integrity. To see more, visit \u003ca>The Center for Public Integrity\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=America%27s+%27Third+Wave%27+Of+Asbestos+Disease+Upends+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"Everything seemed to be going smoothly for Kris Penny, who pulled fiber-optic cables for a living. Then he got a cancer called mesothelioma that's almost always tied to asbestos exposure.","status":"publish","parent":0,"modified":1450475888,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":2009},"headData":{"title":"America's 'Third Wave' Of Asbestos Disease Upends Lives | KQED","description":"Everything seemed to be going smoothly for Kris Penny, who pulled fiber-optic cables for a living. Then he got a cancer called mesothelioma that's almost always tied to asbestos exposure.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"America's 'Third Wave' Of Asbestos Disease Upends Lives","datePublished":"2015-12-18T19:24:46.000Z","dateModified":"2015-12-18T21:58:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"125791 http://ww2.kqed.org/stateofhealth/?p=125791","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/18/americas-third-wave-of-asbestos-disease-upends-lives/","disqusTitle":"America's 'Third Wave' Of Asbestos Disease Upends Lives","source":"NPR","sourceUrl":"http://www.npr.org/sections/health-shots/2015/12/17/459866871/americas-third-wave-of-asbestos-disease-upends-lives","nprByline":"Jim Morris and Maryam Jameel","nprImageAgency":"Courtesy of Kris Penny","nprStoryId":"459866871","nprApiLink":"http://api.npr.org/query?id=459866871&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/12/17/459866871/americas-third-wave-of-asbestos-disease-upends-lives?ft=nprml&f=459866871","nprRetrievedStory":"1","nprPubDate":"Thu, 17 Dec 2015 17:11:00 -0500","nprStoryDate":"Thu, 17 Dec 2015 05:00:00 -0500","nprLastModifiedDate":"Thu, 17 Dec 2015 17:11:58 -0500","path":"/stateofhealth/125791/americas-third-wave-of-asbestos-disease-upends-lives","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Until the morning of Sept. 25, 2014, life was treating Kris Penny well. His flooring company had just secured its first big contract.\u003c/p>\n\u003cp>But that morning, Penny, of Clermont, Fla., was feeling lethargic. He pulled into a McDonald's for a cup of orange juice. Seconds after he drank it, he doubled over in pain. \"It felt like someone stabbed me in the stomach with a machete,\" he said. A co-worker drove him to the emergency room.\u003c/p>\n\u003cp>When he awoke in the hospital, his wife, Lori McNamara, was beside him, crying. \"I go, 'What's the matter? I'm still here,' \" Penny said. The surgeon who'd opened up his abdomen had found it full of cancer — type to be determined. The doctor \"pretty much told me to get my affairs in order, right there on the spot.\"\u003c/p>\n\u003cp>The pathology results came in four days later. Penny, 39, learned that he had \u003ca href=\"http://www.curemeso.org/site/c.duIWJfNQKiL8G/b.8578883/k.931C/Types_of_Mesothelioma__Peritoneal_Mesothelioma.htm\" target=\"_blank\">peritoneal mesothelioma\u003c/a> — a rare cancer of the lining of the abdomen almost always tied to asbestos exposure. He concluded, after consulting with a lawyer, that he'd inhaled microscopic asbestos fibers about a decade earlier while installing fiber-optic cable underground. He sued telecommunications giant AT&T.\u003c/p>\n\u003cfigure id=\"attachment_125793\" class=\"wp-caption aligncenter\" style=\"max-width: 989px\">\u003cimg class=\"size-full wp-image-125793\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990.jpg\" alt=\"Kris Penny in April (left), and in October.\" width=\"989\" height=\"440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990.jpg 989w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-400x178.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-800x356.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-768x342.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/kris-penny_enl-e89a6086136da63cfe1c1eb93f12967b16e61990-960x427.jpg 960w\" sizes=\"(max-width: 989px) 100vw, 989px\">\u003cfigcaption class=\"wp-caption-text\">Kris Penny in April (left), and in October. \u003ccite>(Courtesy of Maryam Jameel/Center for Public Integrity; Courtesy of Kris Penny)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The cable was housed in pipe made of \u003ca href=\"http://www.concreteconstruction.net/industrial-projects/asbestos-and-old-buildings.aspx\" target=\"_blank\">asbestos cement\u003c/a>. When workers maneuvered the cable into or out of the pipe, they generated dust. Penny says he didn't know the dust contained asbestos, a claim AT&T disputes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Physicians, scientists and union officials had people like him in mind when they convened in New York in 1990 to discuss what they called the looming \"third wave\" of asbestos disease.\u003c/p>\n\u003cp>The fire-resistant mineral first had killed asbestos miners, millers and manufacturing workers. Then it had taken out insulators, shipbuilders and others who worked with asbestos products. Eventually, conference attendees agreed, it would be roused from its dormant state in pipes, ceiling tiles and automobile brakes and kill again.\u003c/p>\n\u003cp>Environmental consultant Barry Castleman went to the New York conference. The takeaway, he said, was that \"in-place asbestos was going to pose a continuing danger to millions of workers and to the general public.\"\u003c/p>\n\u003cp>The Environmental Protection Agency \u003ca href=\"http://www.epa.gov/asbestos/us-federal-bans-asbestos\" target=\"_blank\">has banned some, but not all\u003c/a>, asbestos products in the United States; 400 metric tons of the mineral were consumed in 2014, according to the \u003ca href=\"http://minerals.usgs.gov/minerals/pubs/commodity/asbestos/mcs-2015-asbes.pdf\" target=\"_blank\">U.S. Geological Survey\u003c/a>. \"The consumption's gone down by over a thousandfold\" since the 1970s, said Castleman, who testifies almost exclusively for plaintiffs in asbestos-disease cases and was retained by Penny's lawyer. \"The problem is the asbestos is still there.\"\u003c/p>\n\u003cfigure id=\"attachment_125794\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-125794 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-400x264.jpg\" alt=\"Environmental consultant Barry Castleman says embedded asbestos poses a lingering health hazard.\" width=\"400\" height=\"264\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-400x264.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-800x527.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-768x506.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-1440x949.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-1180x778.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/barrycastleman-x_enl-52f062080d274c66a93683080d2cb544ca541e98-960x633.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Environmental consultant Barry Castleman says embedded asbestos poses a lingering health hazard. \u003ccite>(Courtesy of Maryam Jameel/The Center for Public Integrity)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even brief, light exposures to asbestos can breed mesothelioma, diagnosed in about 2,700 people each year in the United States. Most get it in the lining of the lung, or pleura.\u003c/p>\n\u003cp>What's worse is when workers are covered in dust during asbestos-removal jobs — and possibly condemned to mesothelioma, lung cancer or the lung disease asbestosis years later — because their bosses cut corners on protections to save money.\u003c/p>\n\u003cp>Craig Benedict went after such people as an assistant U.S. attorney for the Northern District of New York, working in tandem with criminal investigators from the EPA. He handled more than 100 prosecutions of so-called rip-and-run asbestos-abatement contractors over 15 years and put people in prison — perhaps most notably a father and son named Raul and Alex Salvagno. After being convicted by a jury, they were \u003ca href=\"http://www.justice.gov/archive/opa/pr/2004/December/04_enrd_803.htm\" target=\"_blank\">sentenced\u003c/a> to 19 1/2 years and 25 years, respectively, and ordered to pay $23 million in restitution to workers for overseeing dangerously slipshod work at hundreds of locations over a 10-year period. The father-and-son team secretly owned a laboratory that falsified up to 75,000 asbestos sample results to convince clients the jobs had been done safely.\u003c/p>\n\u003cp>Benedict, who retired last year, saw victims of all stripes: homeless people, children, immigrants and inmates. \"We found asbestos in a box of lollipops a bank handed out to customers,\" he said. In another case, two teenage brothers were told to tear open bags of asbestos from an abatement project and \"put them in a dumpster with the regular trash. They would end up being coated head to foot with asbestos debris.\" Illegal work was done at New York's Asbestos Control Bureau and a state police barracks. It was done in a conference room used by state legislators and a supply room frequented by workers at a hospice.\u003c/p>\n\u003cp>Benedict said he was \"never surprised\" and \"never jaded\" by the things he witnessed. In the most egregious cases, he said, it was as if the employers \"took their workers outside, lined them up against the wall and shot them with high-powered weapons. They knew — just as certainly as someone who actually did that — that their actions over time had a very high likelihood of resulting in death or serious bodily injury.\"\u003c/p>\n\u003cp>\u003cstrong>'I Just Didn't Worry About It'\u003c/strong>\u003c/p>\n\u003cp>Kris Penny was born in Wiesbaden, Germany, and grew up mostly on Air Force bases; both his father and stepfather were in that branch of the service. He held a series of trucking, sales and factory jobs in Ohio, Georgia and Tennessee after graduating from high school. He moved to Orlando in 2002, worked briefly for one cable-pulling firm and then moved to another, Danella Construction.\u003c/p>\n\u003cp>At Danella in 2003 and 2004, Penny squeezed into BellSouth manholes from Orlando to West Palm Beach. He and his co-workers would pull fiber-optic cable into asbestos-cement conduit runs, often after removing old copper-wire cable. Bursts of compressed air were used to propel string that dragged the cable between manholes. The practice kicked up dust, which at times got \"pretty thick,\" Penny said. \"If it became too much, we would jump out of the manhole.\"\u003c/p>\n\u003cp>In his lawsuit, Penny alleges that BellSouth, now part of AT&T, never told him or other Danella workers that the conduit contained asbestos, even as it cautioned its own employees not to use compressed air or break the pipe without wetting it down. Such warnings were being delivered \"by the mid-'90s at the latest, years before Kris ever got into a manhole,\" said his lawyer, \u003ca href=\"http://www.rucklawfirm.com/leadership.php\" target=\"_blank\">Jonathan Ruckdeschel\u003c/a>.\u003c/p>\n\u003cp>\"BellSouth claims that they stopped installing new asbestos conduit in the early '80s, so any pipe he was working with had to have been in the ground for at least 20 years by the time he got there,\" Ruckdeschel said. \"And yet there's nothing inside the manhole to tell the worker, 'Don't do the things that are going to cause you to get exposed. Be careful — this is asbestos-cement pipe. Invisible amounts of asbestos dust can cause you to die.' \"\u003c/p>\n\u003cp>In a deposition in October, former BellSouth supervisor Jeffrey Rolfsen testified that the company relied on Danella to enforce safety rules, though BellSouth had the authority to stop the work if it was uneasy with the contractor's practices. \"I just didn't worry about it,\" Rolfsen said. \"They knew what they were doing better than I knew.\"\u003c/p>\n\u003cp>In a written statement to the Center for Public Integrity, AT&T said, \"We hire sophisticated contractors that are experienced in dealing with asbestos, and we require them to comply with [Occupational Safety and Health Administration] regulations.\" The company said in a court filing that Penny \"knew and understood the risks and hazards of asbestos and voluntarily exposed himself to these risks\" and that his \"injuries, if any, were caused by his own negligent conduct, or by the negligent conduct of others.\"\u003c/p>\n\u003cp>Danella officials did not respond to repeated requests for comment from the Center for Public Integrity.\u003c/p>\n\u003cp>Jesse Davis, a safety coordinator for the Communication Workers of America union, says telecommunications workers nationwide are at risk of exposures similar to Penny's. \"We're finding more and more where asbestos-containing conduit exists,\" Davis said. \"Every manhole they go in, they should be asking about the presence of asbestos.\" He highlighted two incidents involving CWA members.\u003c/p>\n\u003cp>In 2011, 31 Verizon cable workers were on a job in Fairfax, Va., when a passerby told them the type of conduit they were handling contained asbestos. The Virginia Occupational Safety and Health Program later cited Verizon for three serious violations of its asbestos standard, all of which the company contested. Two of the citations were dropped as part of a settlement; Verizon agreed to improve worker training. In a statement, it said it did \"not believe there was any actual employee exposure to asbestos-containing materials\" in Fairfax.\u003c/p>\n\u003cp>In 2014, a member of a Verizon crew in Lynchburg, Va., mindful of CWA warnings, asked a union representative to test conduit he and 19 others had been working on. The pipe's asbestos content turned out to be 35 percent. The state issued six citations, which Verizon said it has contested. It declined to comment further.\u003c/p>\n\u003cp>\u003cstrong>Grim Prognosis\u003c/strong>\u003c/p>\n\u003cp>Ruckdeschel says it's unusual for him to represent someone as young as Penny. Most of his clients are in their 60s, 70s or 80s and were exposed to asbestos decades ago. Penny is at the low end of the latency period for mesothelioma, thought by experts to be at least 10 years.\u003c/p>\n\u003cp>Penny understands that his prognosis is bleak; most people with his disease survive only a year or two. Hoping to extend his life, he went to Baltimore in August for surgery at the University of Maryland Medical Center. There Dr. H. Richard Alexander opened his abdomen, removed as much of the cancer as possible and hit Penny with a stiff dose of heated chemotherapy.\u003c/p>\n\u003cp>McNamara, Penny's wife, was distraught during the 8 1/2-hour procedure. Her husband's illness, she said at the hospital, \"just changed our life completely. People get up and they go to work, and they come home and they have dinner. And they do all these things, and our life is just not like that.\" She worries most about their 6-year-old daughter, Cloey, who's close to her father and asks if he's going to die. Penny had choked up while talking about Cloey — \"my best friend in the whole world\" — the night before the procedure.\u003c/p>\n\u003cp>Penny came through the surgery reasonably well — \"a strong guy, as fit as they come,\" Alexander reassured McNamara afterward — but has faltered since. He had two more operations in Baltimore, one to repair a rupture and the other so an infection could be flushed from his belly.\u003c/p>\n\u003cfigure id=\"attachment_125795\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-125795\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/krislorihospital-x_enl-7cf0597ff6f8350b2b21dc3ccc8308633953435c-e1450466507155.jpg\" alt=\"Kris Penny, his wife, Lori McNamara, and his father-in-law, Frank McNamara, at the University of Maryland Medical Center before Penny's surgery in August.\" width=\"1920\" height=\"1279\">\u003cfigcaption class=\"wp-caption-text\">Kris Penny, his wife, Lori McNamara, and his father-in-law, Frank McNamara, at the University of Maryland Medical Center before Penny's surgery in August. \u003ccite>(Courtesy of Maryam Jameel/The Center for Public Integrity)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He went home to Florida and did not improve. There were more procedures and hospital stays. His weight dropped from 200 pounds to about 130. In a videotaped deposition on Oct. 27 — taken as the discovery phase of his lawsuit was winding down — he looks exhausted and skeletal. He points out his feeding tube and colostomy bag in a photograph. He speaks of being so bereft of energy that he has to \"think about every step\" he takes and \"time everything I do.\"\u003c/p>\n\u003cp>There will be more like him, Ruckdeschel predicts, relatively young people who get sick from even limited contact with asbestos. \"And we have to just wait as the years and the decades go by.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This piece comes from the\u003c/em> \u003ca href=\"http://www.publicintegrity.org/\" target=\"_blank\">Center for Public Integrity\u003c/a>, \u003cem>a nonpartisan, nonprofit investigative news organization.\u003c/em> \u003cem>To follow CPI's investigations into toxic chemicals and workplace diseases, go\u003c/em> \u003ca href=\"http://www.publicintegrity.org/environment/unequal-risk\" target=\"_blank\">here\u003c/a>. \u003cem>Or follow the organization\u003c/em> \u003cem>on Twitter:\u003c/em> \u003ca href=\"https://twitter.com/publici\" target=\"_blank\">@Publici\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 The Center for Public Integrity. To see more, visit \u003ca>The Center for Public Integrity\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=America%27s+%27Third+Wave%27+Of+Asbestos+Disease+Upends+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/125791/americas-third-wave-of-asbestos-disease-upends-lives","authors":["byline_stateofhealth_125791"],"categories":["stateofhealth_11","stateofhealth_13"],"tags":["stateofhealth_16"],"featImg":"stateofhealth_125798","label":"source_stateofhealth_125791"},"stateofhealth_120343":{"type":"posts","id":"stateofhealth_120343","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"120343","score":null,"sort":[1449596696000]},"guestAuthors":[],"slug":"why-cancer-is-gone-discourse-doesnt-help-cancer-patients","title":"Why Cancer Is 'Gone' Discourse Doesn't Help Cancer Patients","publishDate":1449596696,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Many media began to report \u003ca href=\"http://www.npr.org/2015/12/06/458699540/jimmy-carter-announces-that-his-cancer-is-gone\" target=\"_blank\">on Sunday\u003c/a> that former president Jimmy Carter had informed his church in Plains, Georgia, that his cancer is now gone.\u003c/p>\n\u003cp>Immediately, I felt joy and dismay in equal parts.\u003c/p>\n\u003cp>The joy is easy to explain. Carter is undergoing radiation and immune-based drug treatment for metastatic melanoma at Emory University's Winship Cancer Institute. He announced back in August that in addition to a tumor in his liver, malignancies had been detected in his brain.\u003c/p>\n\u003cp>The news that Carter's most recent MRI scan shows that he has no detectable cancer is splendid. As the Washington Post \u003ca href=\"https://www.washingtonpost.com/news/post-nation/wp/2015/12/06/jimmy-carter-told-his-sunday-school-class-that-he-has-no-signs-of-cancer/\" target=\"_blank\">reports\u003c/a>, pembrolizumab or Keytruda, the expensive drug Carter is receiving, does in some melanoma patients lead to sustained positive responses.\u003c/p>\n\u003cp>Why, then, the dismay? It's that celebratory responses built around Carter's cancer being \"gone\" are in real danger of swamping an accurate understanding of cancer biology and of what many patients experience as they cope with cancer or cancer recovery.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Carter himself does not use the word \"gone\" in the short video filmed in his church that accompanies the Post article.\u003c/p>\n\u003cp>My primary point here is the idea that Carter's cancer is \"gone\" is out there now, even in \u003ca href=\"http://www.bbc.com/news/world-us-canada-35022128\" target=\"_blank\">international headlines\u003c/a>.\u003c/p>\n\u003cp>Based on my reading and my personal experience, I can't imagine that any oncologist would suggest that cancer of a patient under active treatment is gone or has disappeared. I did reach out to Emory directly but they were not able to comment. In Sunday's Atlanta Journal Constitution \u003ca href=\"http://www.ajc.com/news/news/carter-cancer-is-gone/npdFQ/\" target=\"_blank\">announcement of the news\u003c/a>, a physician clarified the situation:\u003c/p>\n\u003cblockquote>\u003cp>'It doesn't mean that there is no cancer in his body; it means that there is no indication that they can find cancer for the present,' said Dr. Len Lichtenfeld, deputy chief medical officer for the Atlanta-based American Cancer Society, who stressed he was speaking about cancer in general.\u003c/p>\n\u003cp>While the scans of Carter's brain and liver show no signs of the disease, cancerous cells could still be in his bloodstream, said Lichtenfeld. Still, he said, the news is encouraging for Carter.\u003c/p>\u003c/blockquote>\n\u003cp>In the same piece, Carter's grandson James Carter is quoted:\u003c/p>\n\u003cblockquote>\u003cp>'There's no cancer in his body at this point,' said James Carter. 'He's not going to stop doing the treatment, but at this point, there's no cancer. It's incredible news.'\u003c/p>\n\u003cp>'See?' he added. 'I knew he wasn't really human.'\u003c/p>\u003c/blockquote>\n\u003cp>James Carter gets the cancer language almost right — \"there's no \u003cem>detectable \u003c/em>cancer in his body at this point\" would have been better — but then goes on to imply that Carter fought off the melanoma because he's superhuman. As understandable as this testimonial is, offered from a loving grandson, it's exactly the kind of language that's harmful to cancer patients.\u003c/p>\n\u003cp>Those of us who become cancer survivors don't live on because we fought bravely; those of us who die from cancer don't perish because we didn't fight bravely enough. Lisa Bonchek Adams, who \u003ca href=\"http://www.salon.com/2015/03/10/breast_cancer_blogger_lisa_adams_didnt_lose_a_battle/\" target=\"_blank\">died in March\u003c/a> from metastatic breast cancer, \u003ca href=\"http://lisabadams.com/2012/07/13/when-i-die/\" target=\"_blank\">expressed\u003c/a> this beautifully in her poem \"When I Die.\"\u003c/p>\n\u003cp>What happens to cancer patients depends on a complex choreography among the type and stage of our cancers, our general state of health, and the resources available to and affordable by us for treatment.\u003c/p>\n\u003cp>In May 2013, I was diagnosed with an aggressive gynecological cancer called papillary serous carcinoma that accounts for only 5 percent of all \u003ca href=\"http://www2.mdanderson.org/depts/oncolog/articles/10/4-5-aprmay/4-5-10-compass.html\" target=\"_blank\">endometrial cancers\u003c/a>. For the next eight months, I tumbled from one unexpected experience to the next: a radical hysterectomy orchestrated by a brilliant surgeon-robot team; minor surgery to implant a port in my chest to make delivery of chemotherapy drugs easier; three rounds of chemo both before and after 28 sessions of radiation (three of which were delivered internally).\u003c/p>\n\u003cp>Discovered at Stage 1, that cancer has shown no sign of recurrence nearly two years after my treatment's finish. I'm still scanned, imaged and invasively examined at regular intervals, to be sure that the chemo and radiation blasted away every last malignant cell. So far, so good. Despite some apparently permanent debilitating side effects, ranging from chemo-induced neuropathy in both feet to a form of radiation enteritis and altered blood cell counts, I'm incredibly lucky. Each reader of this post probably knows, or perhaps \u003cem>is\u003c/em>, a cancer patient who would trade places with me in a heartbeat.\u003c/p>\n\u003cp>There's every chance that Jimmy Carter will die of very old age and not of metastatic melanoma. We may all hope for this outcome and, at the same time, insist on responsible cancer discourse. We can and should do both.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara J. King, an anthropology professor at the College of William and Mary, often writes about human evolution, primate behavior and the cognition and emotion of animals. \u003c/em>Barbara's most recent book on animals is titled \u003ca href=\"http://www.npr.org/books/titles/176686699/how-animals-grieve\" target=\"_blank\">How Animals Grieve\u003c/a>.\u003cem> You can keep up with what she is thinking on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/bjkingape\" target=\"_blank\">@bjkingape\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Cancer+Is+%27Gone%27+Discourse+Doesn%27t+Help+Cancer+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"Media have reported that the cancer Jimmy Carter has been fighting is 'gone.' While it's wonderful that he has no detectable cancer in his body, the language used is important, says Barbara J. King.","status":"publish","parent":0,"modified":1449617213,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":845},"headData":{"title":"Why Cancer Is 'Gone' Discourse Doesn't Help Cancer Patients | KQED","description":"Media have reported that the cancer Jimmy Carter has been fighting is 'gone.' While it's wonderful that he has no detectable cancer in his body, the language used is important, says Barbara J. King.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why Cancer Is 'Gone' Discourse Doesn't Help Cancer Patients","datePublished":"2015-12-08T17:44:56.000Z","dateModified":"2015-12-08T23:26:53.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"120343 http://ww2.kqed.org/stateofhealth/?p=120343","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/08/why-cancer-is-gone-discourse-doesnt-help-cancer-patients/","disqusTitle":"Why Cancer Is 'Gone' Discourse Doesn't Help Cancer Patients","source":"NPR","sourceUrl":"http://www.npr.org/sections/13.7/2015/12/07/458824962/why-cancer-is-gone-discourse-doesn-t-help-cancer-patients","nprImageCredit":"Matt Rourke","nprByline":"Barbara J. King","nprImageAgency":"AP","nprStoryId":"458824962","nprApiLink":"http://api.npr.org/query?id=458824962&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/13.7/2015/12/07/458824962/why-cancer-is-gone-discourse-doesn-t-help-cancer-patients?ft=nprml&f=458824962","nprRetrievedStory":"1","nprPubDate":"Mon, 07 Dec 2015 16:51:00 -0500","nprStoryDate":"Mon, 07 Dec 2015 16:50:00 -0500","nprLastModifiedDate":"Mon, 07 Dec 2015 16:51:32 -0500","path":"/stateofhealth/120343/why-cancer-is-gone-discourse-doesnt-help-cancer-patients","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Many media began to report \u003ca href=\"http://www.npr.org/2015/12/06/458699540/jimmy-carter-announces-that-his-cancer-is-gone\" target=\"_blank\">on Sunday\u003c/a> that former president Jimmy Carter had informed his church in Plains, Georgia, that his cancer is now gone.\u003c/p>\n\u003cp>Immediately, I felt joy and dismay in equal parts.\u003c/p>\n\u003cp>The joy is easy to explain. Carter is undergoing radiation and immune-based drug treatment for metastatic melanoma at Emory University's Winship Cancer Institute. He announced back in August that in addition to a tumor in his liver, malignancies had been detected in his brain.\u003c/p>\n\u003cp>The news that Carter's most recent MRI scan shows that he has no detectable cancer is splendid. As the Washington Post \u003ca href=\"https://www.washingtonpost.com/news/post-nation/wp/2015/12/06/jimmy-carter-told-his-sunday-school-class-that-he-has-no-signs-of-cancer/\" target=\"_blank\">reports\u003c/a>, pembrolizumab or Keytruda, the expensive drug Carter is receiving, does in some melanoma patients lead to sustained positive responses.\u003c/p>\n\u003cp>Why, then, the dismay? It's that celebratory responses built around Carter's cancer being \"gone\" are in real danger of swamping an accurate understanding of cancer biology and of what many patients experience as they cope with cancer or cancer recovery.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Carter himself does not use the word \"gone\" in the short video filmed in his church that accompanies the Post article.\u003c/p>\n\u003cp>My primary point here is the idea that Carter's cancer is \"gone\" is out there now, even in \u003ca href=\"http://www.bbc.com/news/world-us-canada-35022128\" target=\"_blank\">international headlines\u003c/a>.\u003c/p>\n\u003cp>Based on my reading and my personal experience, I can't imagine that any oncologist would suggest that cancer of a patient under active treatment is gone or has disappeared. I did reach out to Emory directly but they were not able to comment. In Sunday's Atlanta Journal Constitution \u003ca href=\"http://www.ajc.com/news/news/carter-cancer-is-gone/npdFQ/\" target=\"_blank\">announcement of the news\u003c/a>, a physician clarified the situation:\u003c/p>\n\u003cblockquote>\u003cp>'It doesn't mean that there is no cancer in his body; it means that there is no indication that they can find cancer for the present,' said Dr. Len Lichtenfeld, deputy chief medical officer for the Atlanta-based American Cancer Society, who stressed he was speaking about cancer in general.\u003c/p>\n\u003cp>While the scans of Carter's brain and liver show no signs of the disease, cancerous cells could still be in his bloodstream, said Lichtenfeld. Still, he said, the news is encouraging for Carter.\u003c/p>\u003c/blockquote>\n\u003cp>In the same piece, Carter's grandson James Carter is quoted:\u003c/p>\n\u003cblockquote>\u003cp>'There's no cancer in his body at this point,' said James Carter. 'He's not going to stop doing the treatment, but at this point, there's no cancer. It's incredible news.'\u003c/p>\n\u003cp>'See?' he added. 'I knew he wasn't really human.'\u003c/p>\u003c/blockquote>\n\u003cp>James Carter gets the cancer language almost right — \"there's no \u003cem>detectable \u003c/em>cancer in his body at this point\" would have been better — but then goes on to imply that Carter fought off the melanoma because he's superhuman. As understandable as this testimonial is, offered from a loving grandson, it's exactly the kind of language that's harmful to cancer patients.\u003c/p>\n\u003cp>Those of us who become cancer survivors don't live on because we fought bravely; those of us who die from cancer don't perish because we didn't fight bravely enough. Lisa Bonchek Adams, who \u003ca href=\"http://www.salon.com/2015/03/10/breast_cancer_blogger_lisa_adams_didnt_lose_a_battle/\" target=\"_blank\">died in March\u003c/a> from metastatic breast cancer, \u003ca href=\"http://lisabadams.com/2012/07/13/when-i-die/\" target=\"_blank\">expressed\u003c/a> this beautifully in her poem \"When I Die.\"\u003c/p>\n\u003cp>What happens to cancer patients depends on a complex choreography among the type and stage of our cancers, our general state of health, and the resources available to and affordable by us for treatment.\u003c/p>\n\u003cp>In May 2013, I was diagnosed with an aggressive gynecological cancer called papillary serous carcinoma that accounts for only 5 percent of all \u003ca href=\"http://www2.mdanderson.org/depts/oncolog/articles/10/4-5-aprmay/4-5-10-compass.html\" target=\"_blank\">endometrial cancers\u003c/a>. For the next eight months, I tumbled from one unexpected experience to the next: a radical hysterectomy orchestrated by a brilliant surgeon-robot team; minor surgery to implant a port in my chest to make delivery of chemotherapy drugs easier; three rounds of chemo both before and after 28 sessions of radiation (three of which were delivered internally).\u003c/p>\n\u003cp>Discovered at Stage 1, that cancer has shown no sign of recurrence nearly two years after my treatment's finish. I'm still scanned, imaged and invasively examined at regular intervals, to be sure that the chemo and radiation blasted away every last malignant cell. So far, so good. Despite some apparently permanent debilitating side effects, ranging from chemo-induced neuropathy in both feet to a form of radiation enteritis and altered blood cell counts, I'm incredibly lucky. Each reader of this post probably knows, or perhaps \u003cem>is\u003c/em>, a cancer patient who would trade places with me in a heartbeat.\u003c/p>\n\u003cp>There's every chance that Jimmy Carter will die of very old age and not of metastatic melanoma. We may all hope for this outcome and, at the same time, insist on responsible cancer discourse. We can and should do both.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara J. King, an anthropology professor at the College of William and Mary, often writes about human evolution, primate behavior and the cognition and emotion of animals. \u003c/em>Barbara's most recent book on animals is titled \u003ca href=\"http://www.npr.org/books/titles/176686699/how-animals-grieve\" target=\"_blank\">How Animals Grieve\u003c/a>.\u003cem> You can keep up with what she is thinking on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/bjkingape\" target=\"_blank\">@bjkingape\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Cancer+Is+%27Gone%27+Discourse+Doesn%27t+Help+Cancer+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/120343/why-cancer-is-gone-discourse-doesnt-help-cancer-patients","authors":["byline_stateofhealth_120343"],"categories":["stateofhealth_12","stateofhealth_13"],"tags":["stateofhealth_16"],"featImg":"stateofhealth_120344","label":"source_stateofhealth_120343"},"stateofhealth_104264":{"type":"posts","id":"stateofhealth_104264","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"104264","score":null,"sort":[1446838350000]},"guestAuthors":[],"slug":"cancer-patients-on-medi-cal-do-worse-than-those-with-other-insurance","title":"Cancer Patients on Medi-Cal Do Worse Than Those with Other Insurance","publishDate":1446838350,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Cancer patients with Medi-Cal are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a \u003ca href=\"https://www.ucdmc.ucdavis.edu/iphi/resources/1117737_CancerHI_100615.pdf\" target=\"_blank\">study\u003c/a> by UC Davis researchers. Medi-Cal is California's version of Medicaid, health insurance for people who are low income.\u003c/p>\n\u003caside class=\"pullquote alignright\">“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks.\"\u003cbr>\n\u003ccite>Christina Clarke, Cancer Prevention Institute of California\u003c/cite>\u003c/aside>\n\u003cp>While other \u003ca href=\"http://consumer.healthday.com/cancer-information-5/breast-cancer-news-94/medicaid-patients-get-worse-cancer-care-studies-contend-688451.html\" target=\"_blank\">studies\u003c/a> have linked Medicaid insurance status to worse cancer outcomes, the UC Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.\u003c/p>\n\u003cp>Understanding how well Medi-Cal serves cancer patients is crucial, experts say, because as much as 10 percent of Medi-Cal expenditures go to cancer care. And under the Affordable Care Act, the program has grown to cover more than 12 million Californians – nearly a third of the state’s population.\u003c/p>\n\u003cp>“What’s striking is how similar the findings were for Medi-Cal members and the uninsured,” said Dr. Kenneth Kizer, director of the UC Davis’ Institute for Population Health Improvement, which conducted the study. “If we weren’t spending billions of Medi-Cal dollars on cancer care perhaps that would not be surprising, but you’d think that the outcomes might be better when you’re spending that much money.”\u003c/p>\n\u003cp>The UC Davis researchers used \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\">California Cancer Registry\u003c/a> data to study the experiences of approximately 700,000 Californians diagnosed with breast, colon, rectal, lung, and prostate cancer between 2004 and 2012. They tracked how early these patients were diagnosed, their quality of treatment and their five-year relative survival rates according to their type of insurance. The types were Medi-Cal, Medicare, dual Medi-Cal/Medicare (for lowest-income seniors), private insurance, Department of Defense (DOD) insurance and Department of Veterans Affairs (VA) insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Among the findings:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal patients were diagnosed with advanced (stage IV) prostate cancer more than three times as often as patients with private insurance or DOD coverage.\u003c/li>\n\u003cli>Medi-Cal patients with breast, colon or rectal cancer were more likely to be diagnosed at an advanced stage and to have worse five-year survival rates than people with other types of insurance.\u003c/li>\n\u003cli>Low-income seniors covered by Medicare and Medi-Cal, known as “dual-eligible patients,” were the least likely to receive recommended treatment for breast and colon cancer.\u003c/li>\n\u003cli>VA patients waited the longest to be treated for breast, colon, rectal, lung and prostate cancers, but their outcomes compared favorably to patients with other types of health insurance and they were generally more likely to receive recommended treatment.\u003c/li>\n\u003c/ul>\n\u003cp>What researchers still don’t know, Kizer said, is the reason for these disparities. It’s possible that Medi-Cal patients drop on and off the rolls, missing preventive screenings that could help detect cancers earlier. \u003ca href=\"http://khn.org/news/state-auditor-slams-californias-oversight-of-medi-cal-plans-used-by-9-million/\" target=\"_blank\">Audits\u003c/a> and studies also have shown that some of the state’s Medi-Cal patients have difficulty getting access to doctors and specialists.\u003c/p>\n\u003cp>Researchers also can’t explain why Medi-Cal patients are less likely than patients with other kinds of insurance to receive recommended treatment after they are diagnosed. And they also don’t know whether cancer patients fare better or worse in Medi-Cal managed care programs, which now cover most of the Medi-Cal population.\u003c/p>\n\u003cp>“It’s not acceptable to have these variations” based on insurance coverage, particularly regarding breast and colon cancers for which preventive screenings are well-established and effective, said Christina Clarke, a research scientist at the Cancer Prevention Institute of California and a consulting associate professor at the Stanford University School of Medicine. She was not involved in the study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks. That’s the tragic thing here,” Clarke said. “There’s a body count and we’d like to figure out a better way to insure that all Californians are getting the recommended screening for these deadly cancers and treatment according to guidelines. We have a lot of work to do.”\u003c/p>\n\n","blocks":[],"excerpt":"They are less likely to get recommended treatment and have lower survival rates. Researchers don't know why.","status":"publish","parent":0,"modified":1446838350,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":12,"wordCount":737},"headData":{"title":"Cancer Patients on Medi-Cal Do Worse Than Those with Other Insurance | KQED","description":"They are less likely to get recommended treatment and have lower survival rates. Researchers don't know why.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Cancer Patients on Medi-Cal Do Worse Than Those with Other Insurance","datePublished":"2015-11-06T19:32:30.000Z","dateModified":"2015-11-06T19:32:30.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"104264 http://ww2.kqed.org/stateofhealth/?p=104264","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/11/06/cancer-patients-on-medi-cal-do-worse-than-those-with-other-insurance/","disqusTitle":"Cancer Patients on Medi-Cal Do Worse Than Those with Other Insurance","source":"Kaiser Health News","nprByline":"Barbara Feder Ostrov","path":"/stateofhealth/104264/cancer-patients-on-medi-cal-do-worse-than-those-with-other-insurance","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cancer patients with Medi-Cal are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a \u003ca href=\"https://www.ucdmc.ucdavis.edu/iphi/resources/1117737_CancerHI_100615.pdf\" target=\"_blank\">study\u003c/a> by UC Davis researchers. Medi-Cal is California's version of Medicaid, health insurance for people who are low income.\u003c/p>\n\u003caside class=\"pullquote alignright\">“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks.\"\u003cbr>\n\u003ccite>Christina Clarke, Cancer Prevention Institute of California\u003c/cite>\u003c/aside>\n\u003cp>While other \u003ca href=\"http://consumer.healthday.com/cancer-information-5/breast-cancer-news-94/medicaid-patients-get-worse-cancer-care-studies-contend-688451.html\" target=\"_blank\">studies\u003c/a> have linked Medicaid insurance status to worse cancer outcomes, the UC Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.\u003c/p>\n\u003cp>Understanding how well Medi-Cal serves cancer patients is crucial, experts say, because as much as 10 percent of Medi-Cal expenditures go to cancer care. And under the Affordable Care Act, the program has grown to cover more than 12 million Californians – nearly a third of the state’s population.\u003c/p>\n\u003cp>“What’s striking is how similar the findings were for Medi-Cal members and the uninsured,” said Dr. Kenneth Kizer, director of the UC Davis’ Institute for Population Health Improvement, which conducted the study. “If we weren’t spending billions of Medi-Cal dollars on cancer care perhaps that would not be surprising, but you’d think that the outcomes might be better when you’re spending that much money.”\u003c/p>\n\u003cp>The UC Davis researchers used \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\">California Cancer Registry\u003c/a> data to study the experiences of approximately 700,000 Californians diagnosed with breast, colon, rectal, lung, and prostate cancer between 2004 and 2012. They tracked how early these patients were diagnosed, their quality of treatment and their five-year relative survival rates according to their type of insurance. The types were Medi-Cal, Medicare, dual Medi-Cal/Medicare (for lowest-income seniors), private insurance, Department of Defense (DOD) insurance and Department of Veterans Affairs (VA) insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Among the findings:\u003c/p>\n\u003cul>\n\u003cli>Medi-Cal patients were diagnosed with advanced (stage IV) prostate cancer more than three times as often as patients with private insurance or DOD coverage.\u003c/li>\n\u003cli>Medi-Cal patients with breast, colon or rectal cancer were more likely to be diagnosed at an advanced stage and to have worse five-year survival rates than people with other types of insurance.\u003c/li>\n\u003cli>Low-income seniors covered by Medicare and Medi-Cal, known as “dual-eligible patients,” were the least likely to receive recommended treatment for breast and colon cancer.\u003c/li>\n\u003cli>VA patients waited the longest to be treated for breast, colon, rectal, lung and prostate cancers, but their outcomes compared favorably to patients with other types of health insurance and they were generally more likely to receive recommended treatment.\u003c/li>\n\u003c/ul>\n\u003cp>What researchers still don’t know, Kizer said, is the reason for these disparities. It’s possible that Medi-Cal patients drop on and off the rolls, missing preventive screenings that could help detect cancers earlier. \u003ca href=\"http://khn.org/news/state-auditor-slams-californias-oversight-of-medi-cal-plans-used-by-9-million/\" target=\"_blank\">Audits\u003c/a> and studies also have shown that some of the state’s Medi-Cal patients have difficulty getting access to doctors and specialists.\u003c/p>\n\u003cp>Researchers also can’t explain why Medi-Cal patients are less likely than patients with other kinds of insurance to receive recommended treatment after they are diagnosed. And they also don’t know whether cancer patients fare better or worse in Medi-Cal managed care programs, which now cover most of the Medi-Cal population.\u003c/p>\n\u003cp>“It’s not acceptable to have these variations” based on insurance coverage, particularly regarding breast and colon cancers for which preventive screenings are well-established and effective, said Christina Clarke, a research scientist at the Cancer Prevention Institute of California and a consulting associate professor at the Stanford University School of Medicine. She was not involved in the study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks. That’s the tragic thing here,” Clarke said. “There’s a body count and we’d like to figure out a better way to insure that all Californians are getting the recommended screening for these deadly cancers and treatment according to guidelines. We have a lot of work to do.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/104264/cancer-patients-on-medi-cal-do-worse-than-those-with-other-insurance","authors":["byline_stateofhealth_104264"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_16","stateofhealth_99","stateofhealth_2519"],"featImg":"stateofhealth_104286","label":"source_stateofhealth_104264"},"stateofhealth_98373":{"type":"posts","id":"stateofhealth_98373","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"98373","score":null,"sort":[1445883623000]},"guestAuthors":[],"slug":"bad-day-for-bacon-processed-meats-cause-cancer-who-says","title":"Bad Day For Bacon: Processed Meats Cause Cancer, WHO Says","publishDate":1445883623,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>The World Health Organization has deemed that processed meats — such as bacon, sausages and hot dogs — cause cancer.\u003c/p>\n\u003cp>In addition, the WHO says red meats including beef, pork, veal and lamb are \"probably carcinogenic\" to people.\u003c/p>\n\u003caside class=\"pullquote alignright\">World Health Organization conclusion puts processed meats in same category as tobacco smoking and asbestos ...\u003c/aside>\n\u003cp>A group of 22 scientists reviewed the evidence linking red meat and processed meat consumption to cancer, and concluded that eating processed meats regularly increases the risk of colorectal cancer. Their evidence review is explained in an \u003ca href=\"http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2815%2900444-1/fulltext\" target=\"_blank\">article\u003c/a> published in \u003cem>The Lancet.\u003c/em>\u003c/p>\n\u003cp>The conclusion puts processed meats in the same \u003ca href=\"http://monographs.iarc.fr/ENG/Classification/ClassificationsAlphaOrder.pdf\" target=\"_blank\">category of cancer risk\u003c/a> as tobacco smoking and asbestos. This does not mean that they are equally dangerous, says the \u003ca href=\"http://www.iarc.fr/\" target=\"_blank\">International Agency for Research on Cancer\u003c/a> — the agency within the WHO that sets the classifications. And it's important to note that even things such as aloe vera are on the list of possible carcinogens.\u003c/p>\n\u003cp>In a Q & A released by the IARC, the agency says that \"eating meat has known health benefits,\" but it also points out that the cancer risk increases with the amount of meat consumed. As we've \u003ca href=\"http://www.npr.org/sections/thesalt/2012/03/12/148457233/death-by-bacon-study-finds-eating-meat-is-risky\" target=\"_blank\">reported\u003c/a>, studies show that the heaviest meat eaters tend to have the highest risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The IARC says high-temperature cooking methods (such as cooking meat in direct contact with a flame) produce more carcinogenic compounds. However, the group says there were not enough data \"to reach a conclusion about whether the way meat is cooked affects the risk of cancer.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.cancer.org/research/acsresearchers/susan-gapstur-phd-mph\">Susan Gapstur\u003c/a> of the American Cancer Society says the society recommends \"consuming a healthy diet with an emphasis on plant foods and limiting consumption of processed meat and red meat,\" she told us in a written statement.\u003c/p>\n\u003caside class=\"pullquote alignright\">... WHO also says red meats including beef, pork, veal and lamb are “probably carcinogenic” to people.\u003c/aside>\n\u003cp>The recommendation, Gapstur tells The Salt, is based on research. For instance, a systematic literature review on colorectal cancer published in 2011 by the World Cancer Research Fund found a statistically significant, 16 percent increased risk of colorectal cancer associated with each 3.5 ounces of red and processed meat consumed per day. As the ACS points out, this is an amount of meat roughly equivalent in size to a deck of cards. And according to the experts convened by IARC to make its new evaluation, eating just half that amount of processed meats daily – about 1.8 ounces per day — will increase the risk of colorectal cancer — by about 18 percent.\u003c/p>\n\u003cp>\u003cem>The Lancet\u003c/em> paper points out that red meat also contains \"high biological-value proteins and important micronutrients such as B vitamins, iron and zinc.\" And the North American Meat Institute says lots of research points to the benefits of red meat consumption.\u003c/p>\n\u003cp>\"Scientific evidence shows cancer is a complex disease not caused by single foods and that a balanced diet and healthy lifestyle choices are essential to good health,\" writes Barry Carpenter, president of the North American Meat Institute, in a \u003ca href=\"https://www.meatinstitute.org/index.php?ht=display/ReleaseDetails/i/116609\" target=\"_blank\">statement\u003c/a> on the new WHO classification.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Carpenter says it's important to put this new classification in context. \"IARC's panel was given the basic task of looking at hazards that meat could pose at some level, under circumstance, but was not asked to consider any off-setting benefits, like the nutrition that meat delivers or the implications of drastically reducing or removing meat from the diet altogether,\" the statement concludes.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Bad+Day+For+Bacon%3A+Processed+Meats+Cause+Cancer%2C+WHO+Says+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"The World Health Organization's decision puts bacon, hot dogs and sausages in the same category of cancer risk as tobacco smoking. And beef, pork, veal and lamb are \"probably carcinogenic,\" WHO says.","status":"publish","parent":0,"modified":1445883803,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":592},"headData":{"title":"Bad Day For Bacon: Processed Meats Cause Cancer, WHO Says | KQED","description":"The World Health Organization's decision puts bacon, hot dogs and sausages in the same category of cancer risk as tobacco smoking. And beef, pork, veal and lamb are "probably carcinogenic," WHO says.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Bad Day For Bacon: Processed Meats Cause Cancer, WHO Says","datePublished":"2015-10-26T18:20:23.000Z","dateModified":"2015-10-26T18:23:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"98373 http://ww2.kqed.org/stateofhealth/?p=98373","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/26/bad-day-for-bacon-processed-meats-cause-cancer-who-says/","disqusTitle":"Bad Day For Bacon: Processed Meats Cause Cancer, WHO Says","source":"NPR","sourceUrl":"http://www.npr.org/sections/thesalt/2015/10/26/451211964/bad-day-for-bacon-processed-red-meats-cause-cancer-says-who","nprByline":"Allison Aubrey","nprStoryId":"451211964","nprApiLink":"http://api.npr.org/query?id=451211964&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/thesalt/2015/10/26/451211964/bad-day-for-bacon-processed-red-meats-cause-cancer-says-who?ft=nprml&f=451211964","nprRetrievedStory":"1","nprPubDate":"Mon, 26 Oct 2015 13:53:00 -0400","nprStoryDate":"Mon, 26 Oct 2015 10:31:00 -0400","nprLastModifiedDate":"Mon, 26 Oct 2015 13:53:51 -0400","path":"/stateofhealth/98373/bad-day-for-bacon-processed-meats-cause-cancer-who-says","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The World Health Organization has deemed that processed meats — such as bacon, sausages and hot dogs — cause cancer.\u003c/p>\n\u003cp>In addition, the WHO says red meats including beef, pork, veal and lamb are \"probably carcinogenic\" to people.\u003c/p>\n\u003caside class=\"pullquote alignright\">World Health Organization conclusion puts processed meats in same category as tobacco smoking and asbestos ...\u003c/aside>\n\u003cp>A group of 22 scientists reviewed the evidence linking red meat and processed meat consumption to cancer, and concluded that eating processed meats regularly increases the risk of colorectal cancer. Their evidence review is explained in an \u003ca href=\"http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2815%2900444-1/fulltext\" target=\"_blank\">article\u003c/a> published in \u003cem>The Lancet.\u003c/em>\u003c/p>\n\u003cp>The conclusion puts processed meats in the same \u003ca href=\"http://monographs.iarc.fr/ENG/Classification/ClassificationsAlphaOrder.pdf\" target=\"_blank\">category of cancer risk\u003c/a> as tobacco smoking and asbestos. This does not mean that they are equally dangerous, says the \u003ca href=\"http://www.iarc.fr/\" target=\"_blank\">International Agency for Research on Cancer\u003c/a> — the agency within the WHO that sets the classifications. And it's important to note that even things such as aloe vera are on the list of possible carcinogens.\u003c/p>\n\u003cp>In a Q & A released by the IARC, the agency says that \"eating meat has known health benefits,\" but it also points out that the cancer risk increases with the amount of meat consumed. As we've \u003ca href=\"http://www.npr.org/sections/thesalt/2012/03/12/148457233/death-by-bacon-study-finds-eating-meat-is-risky\" target=\"_blank\">reported\u003c/a>, studies show that the heaviest meat eaters tend to have the highest risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The IARC says high-temperature cooking methods (such as cooking meat in direct contact with a flame) produce more carcinogenic compounds. However, the group says there were not enough data \"to reach a conclusion about whether the way meat is cooked affects the risk of cancer.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.cancer.org/research/acsresearchers/susan-gapstur-phd-mph\">Susan Gapstur\u003c/a> of the American Cancer Society says the society recommends \"consuming a healthy diet with an emphasis on plant foods and limiting consumption of processed meat and red meat,\" she told us in a written statement.\u003c/p>\n\u003caside class=\"pullquote alignright\">... WHO also says red meats including beef, pork, veal and lamb are “probably carcinogenic” to people.\u003c/aside>\n\u003cp>The recommendation, Gapstur tells The Salt, is based on research. For instance, a systematic literature review on colorectal cancer published in 2011 by the World Cancer Research Fund found a statistically significant, 16 percent increased risk of colorectal cancer associated with each 3.5 ounces of red and processed meat consumed per day. As the ACS points out, this is an amount of meat roughly equivalent in size to a deck of cards. And according to the experts convened by IARC to make its new evaluation, eating just half that amount of processed meats daily – about 1.8 ounces per day — will increase the risk of colorectal cancer — by about 18 percent.\u003c/p>\n\u003cp>\u003cem>The Lancet\u003c/em> paper points out that red meat also contains \"high biological-value proteins and important micronutrients such as B vitamins, iron and zinc.\" And the North American Meat Institute says lots of research points to the benefits of red meat consumption.\u003c/p>\n\u003cp>\"Scientific evidence shows cancer is a complex disease not caused by single foods and that a balanced diet and healthy lifestyle choices are essential to good health,\" writes Barry Carpenter, president of the North American Meat Institute, in a \u003ca href=\"https://www.meatinstitute.org/index.php?ht=display/ReleaseDetails/i/116609\" target=\"_blank\">statement\u003c/a> on the new WHO classification.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Carpenter says it's important to put this new classification in context. \"IARC's panel was given the basic task of looking at hazards that meat could pose at some level, under circumstance, but was not asked to consider any off-setting benefits, like the nutrition that meat delivers or the implications of drastically reducing or removing meat from the diet altogether,\" the statement concludes.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Bad+Day+For+Bacon%3A+Processed+Meats+Cause+Cancer%2C+WHO+Says+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/98373/bad-day-for-bacon-processed-meats-cause-cancer-who-says","authors":["byline_stateofhealth_98373"],"categories":["stateofhealth_12"],"tags":["stateofhealth_16","stateofhealth_2519","stateofhealth_461"],"featImg":"stateofhealth_98398","label":"source_stateofhealth_98373"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us","airtime":"SUN 2pm-3pm, MON 12am-1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png","officialWebsiteLink":"https://www.wnycstudios.org/shows/otm","meta":{"site":"news","source":"wnyc"},"link":"/radio/program/on-the-media","subscribe":{"apple":"https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2","tuneIn":"https://tunein.com/radio/On-the-Media-p69/","rss":"http://feeds.wnyc.org/onthemedia"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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