McKay Jenkins asks, “Did everyday chemicals cause my tumor?”

Oh, no!

It’s the toxins!

It’s the chemicals!

Evil, evil, evil, evil! Even worse, unnatural, unnatural, unnatural!

Such is the message we receive from many sources. The media bombards us with it constantly. Environmental groups do too. The message is so pervasive that most people take it for granted that various toxins are “poisoning” them and causing cancer. Now don’t get me wrong. I am not saying that there is not a potential risk from various chemicals that might cause cancer. Indeed, less than a year ago I wrote a lengthy post about the President’s Cancer Panel Report from 2010 in which, I hope, I covered many of the nuances of the issues better than, quite frankly, many parts of the President’s Cancer Panel Report did. You can either read my post or accept my boiled down version right here: It’s complicated. We’re looking at potential risks that can be difficult to detect above background cancer rates, particularly for common cancers. Epidemiology, depending on the question, can be a relatively crude tool, and our knowledge of the carcinogenic potential of various chemicals is incomplete or even lacking altogether. Because the issue of what chemicals do and do not cause cancer and, for the ones that do, what exposure is necessary for them to do so, how much do they elevate the risk of cancer, and which cancers produce an elevated risk, it’s almost never possible to make definitive pronouncements about “everyday chemicals.” Rather, it’s almost always degrees of risk coupled with degrees of uncertainty, all shades of gray.

Unfortunately for readers and fortunately for the author, if this excerpt on is any indication, What’s Gotten Into Us? Staying Healthy in a Toxic World appears to have no such trouble with the complexities of scientific questions and epidemiology or the nuance required to address questions of cancer causation. The title of the excerpt in itself is intentionally inflammatory, asking Did everyday chemicals cause my tumor? The answer, we are led to believe, is most definitely Yes!” The real answer, as you will see, is almost certainly, “No.” At the very least, it’s highly unlikely.

Jenkins tells his tale thusly:

My only complaint, I told my doctor, was a faint tightness in my hip that I had felt off and on for two years — and odd, sharp twinges between my left thigh, knee and shin that occasionally accompanied it. My internist looked me over and agreed that my pains were probably related to exercise, and he suggested I see an orthopedist at a nearby sports medicine clinic. The orthopedist, in turn, suggested I get an MRI to help him see a bit more clearly what was going on with my soft tissue.

I was standing in my living room when the phone rang just a few hours later. When I picked up the phone and heard the orthopedist’s voice, I knew even before he spoke that something was amiss. “Hello, Mr. Jenkins,” he said, then paused. “You have a suspicious mass in your abdomen,” he said. “It’s growing inside your left hip. Here is the number for an oncologist. You need to call him right away.”

Yes, what we have here is, as regular readers can probably recognize immediately, a testimonial. Like most testimonials, it doesn’t tell us much that is generalizable. Jenkins goes on to describe how the oncologist said that he thought the mass might be a soft tissue sarcoma, which would probably be up near the top of any decent physician’s differential diagnosis. Still, I do have to wonder when Jenkins’ story took place, because the way the tumor was treated is rather old school. These days, the main imperative after finding such a mass would be to get a tissue diagnosis before treatment, the reason being that neoadjuvant chemotherapy and/or radiation therapy might be indicated to shrink the mass and make it more easily resectable. This would be particularly true for a tumor located, as Jenkins describes it, in such close proximity to the femoral nerve, which, if cut, would cause weakness of the quadriceps muscle and difficulty walking, much less running. Yet this appears not to have been done. Why, I don’t know; even in the “old days,” biopsies were routine. They were generally surgical biopsies rather than needle biopsies and incisional biopsies rather than excisional biopsies, but they were done.

Whatever the reason, Jenkins underwent surgery to remove the mass, which is not exactly inappropriate but it is curious enough that I had to wonder why no attempt at tissue diagnosis was undertaken. The reasons to have a tissue diagnosis ahead of definitive surgery are many, including the knowledge that, if the tumor is benign then it can be removed by a “shelling out,” sparing surrounding tissue, while if it’s malignant a much wider resection needs to be carried out. Whatever the reasons, Jenkins was approached by researchers who wanted to ask him questions:

A few weeks later, I was being prepared for surgery at the hospital when two researchers approached me with questions. The first ones were pretty standard: What ethnic group best describes you? Um, white. How far did you make it in school? I have a Ph.D., I said. How many packs of cigarettes have you smoked per day, on average? None, I said. Ever. Then the questions changed, from ones I had been asked by doctors dozens of times before to ones I had never been asked in my life.

How much exposure had I had to toxic chemicals and other contaminants? In my life? I asked. This seemed like an odd question. What kind of chemicals do you mean? The researcher began reading from a list, which turned out to be long. Some things I had heard of, many others I had not. Metal filings? Asbestos dust? Cutting oils? I didn’t think so. What’s a cutting oil? How about gasoline exhaust? Asphalt? Foam insulation? Natural gas fumes?

Where was this going?

The words kept coming. Vinyl chloride? I wasn’t sure. What was that? How about plastics? Are you kidding? Everything is made of plastic. Dry-cleaning agents? Detergents or fumes from plastic meat wrap? Benzene or other solvents? Formaldehyde? Varnishes? Adhesives? Lacquers? Glues? Acrylic or oil paints? Inks or dyes? Tanning solutions? Cotton textiles? Fiberglass? Bug killers or pesticides? Weed killers or herbicides? Heat-transfer fluids? Hydraulic lubricants? Electricfluids? Flame retardants?

I have to be honest here; the design of this research project baffles me. If I were a researcher looking for a link between chemical exposures and cancer, I would concentrate my effort only on patients who–oh, you know–had actually been definitively diagnosed with cancer. One of my inclusion criteria would be that the patient must have a biopsy-proven cancer, and one of my exclusion criteria would be any patient whose diagnosis was in doubt. True, from the anecdote, it appears that Jenkins had been presumed to have soft tissue sarcoma, but I see no sign that there was a tissue diagnosis. So why were the investigators asking Jenkins these questions?

I have no idea. Maybe the book explains it better. Maybe not. I don’t think I’ll be buying it to find out. In the meantime, the excerpt from the book blunders on. His purpose is made crystal clear in the prose that follows:

It’s worth thinking about what a relatively short time we’ve been swimming in synthetic chemicals. The Synthetic Century, let us say, has been full of grand achievements and equally grand consequences, many of them unintended. In 1918, a scientist named Fritz Haber won the Nobel Prize for figuring out how to make synthetic nitrogen, a key component of soil, and thus “improving the standards of agriculture and the well-being of mankind.” But during World War I, his technology also helped Germany make bombs from synthetic nitrate and, later, poison chlorine and phosgene gas. In World War II, Hitler used another one of Haber’s compounds, Zyklon B, in Nazi concentration camps. After the wars, synthetic fertilizers paved the way for the explosion of industrial-scale agribusiness, which has, in turn, created great wealth but also unprecedented levels of pollution, monoculture and processed foods.

Oh, noez! It’s teh chemical toxins! The same things used to make poison gas, one of which Hitler used in his nearly successful attempt to exterminate European Jewry! Talk about poisoning the well! I mean, seriously. Wasn’t it enough just to mention that chemicals have caused problems in the past, but do Jenkins have to bring Hitler into it? This borders on argumentum ad Nazi-ium, at least to me. Of course, from the description of the book on its page, demonizing chemicals appears to be exactly what Jenkins is about:

Do you know what chemicals are in your shampoo? How about your cosmetics? Do you know what’s in the plastic water bottles you drink from, or the weed killer in your garage, or your children’s pajamas? If you’re like most of us, the answer is probably no. But you also probably figured that most of these products were safe, and that someone–the manufacturers, the government–was looking out for you. The truth might surprise you.

After experiencing a health scare of his own, journalist McKay Jenkins set out to discover the truth about toxic chemicals, our alarming levels of exposure, and our government’s utter failure to regulate them effectively. The result of his two-year journey, What’s Gotten into Us?, is a deep, remarkable, and empowering investigation into the threats–biological and environmental–that chemicals now present in our daily lives. It reveals how dangerous, and how common, toxins are in the most ordinary things

I’ve actually butted heads with some of my fellow skeptics in being a bit more open to the idea that chemicals can be greater risk factors than suspected for various health problems. Indeed, a couple of years ago, when ACSH invited me to be on its board of advisors, I turned it down because I perceive ACSH as going too far in the other direction (not to mention the problem of its behaving largely like an industry shill) to the point that it takes the germ of a reasonable idea (that there’s too much fear mongering about “chemicals”) and takes a despicable turn with it by implicitly likening concerns about chemical pollutants and other chemicals that might cause health problems to mental illness by labeling them “chemophobia.” Indeed, Dr. Elizabeth Whelan, the president of ACSH, has even referred to “chemophobia” as an “emotional, psychiatric problem,” which is not very skeptical at all. It’s denialist tripe.

I’ve even gotten into it with skeptics for pointing out to them that their assumption that the breaking of chemical bonds is a necessary prerequisite for the development of cancer, that requirement being a main argument against the possibility that cell phone radiation can cause cancer. True, I view the hypothesis as being incredibly implausible based just on physics, but I have lambasted certain skeptics for their incredibly simplistic understanding of carcinogenesis because they have declared it impossible based on that misunderstanding.

That being said, I sense major fear mongering coming from Professor Jenkins. (Jenkins is the Cornelius A. Tigham Professor of English at the University of Delaware.) Let’s just put it this way. His excerpt discusses his cancer scare. Then, even though his mass turned out to be completely benign and the surgeon managed to shave it off of the femoral nerve without incident, Jenkins uses that as a jumping off point to speculate on how it must be the chemicals that are poisoning us. After claiming that only 4% of such masses as his turn out to be benign (which isn’t true; soft tissue masses are more commonly benign than malignant), he points out how many of his family and friends have developed cancer, ignoring the fact that cancer is now competing with heart disease for the number one cause of death, which means it’s very common and most of us, myself included, have relatives and friends who have had cancer and died of it. What matters is not how many family members and friends have developed cancer but rather what the incidence and prevalence of cancer are, and they are not rising catastrophically, as Jenkins seems to believe (in fact they are leveling off). Moreover, if you correct for asbestos exposure, even chemists don’t have a higher incidence and prevalence of cancer than the general population.

They say you can’t judge a book by its cover, but I do think you can judge it be its excerpt, and Jenkins’ excerpt reveals a serious lack of understanding. IF you doubt me when I say this, then just look at this passage:

You want to wash your infant’s hair. What could be more benign than baby shampoo? But look closer at the label on the bottle: the baby shampoo contains formaldehyde, which causes cancer and compromises the immune system.

This is, of course, utter nonense, as I have pointed out when anti-vaccine apologists have invoked the dread “formaldehyde gambit” and fear mongers like Jenkins have complained about sodium lauryl sulfate in shampoo. In fact, one of the commenters nailed it when he said, “Every day chemicals cause cancer” is the new “vaccines cause autism” and further pointed out that Jenkins’ “scientific method seems to be comprised strictly of navel-gazing and conjecture.” As I’ve pointed out time and time again, formaldehyde is a normal byproduct of human metabolism, and small exposures to it are indeed harmless.

Dissecting the relative effects of genes, environment, diet, and other contributors to different cancers and making such a discussion accessible for a lay reader would be a difficult feat, even for a scientist. For someone like Jenkins, who is clearly neither a scientist nor a lay person who has taken the time to educate himself in the basic science and epidemiology of cancer sufficiently to discuss the matter accurately. The fact that he would even mention formaldehyde as a danger in baby shampoo demonstrates that his understanding of basic human physiology and metabolism is woeful in the extreme. As a result, I get the distinct feeling that Jenkins’ book is going to be chock full of similar fear mongering based on ignorance.