The Maine Cancer Registry reports that Maine ranks fifth highest in the country in overall cancer mortality and that one out of every three Maine women and two out of every three Maine men will be hit by some form of cancer in their lifetime. Maine also has one of the worst environmental pollution records in the United States. As a new Maine resident, I was alarmed by these discoveries and set out to inquire into the spread of this dreaded disease, and the possible environmental correlations. My first interview was with Dr. Sandra Steingraber, biologist, cancer survivor and author of Living Downstream - A Scientist's Personal Investigation of Cancer and the Environment.

RDK: What compelled you to write Living Downstream?

Steingraber: I was interested in shining a spotlight on cancer and environmental contamination. Most of the books that were already out there I felt dealt with lifestyle or genetic issues which are also important, but I wanted to specifically look at the connection between cancer and the environment.

RDK: Is environmental health essential to human health?

Steingraber: I think there is a real exquisite connection between environmental health and human health. Let's just talk about cancer for a minute. We know for example that the kinds of cancers that are rising most rapidly in industrialized countries right now are those that we have pretty good evidence are linked to environmental contamination. For example, one of the most swiftly rising cancers are childhood cancers. I'm talking about pediatric leukemia, brain tumors amongst four year olds, ovarian cancer amongst adolescent girls, testicular cancer amongst adolescent boys. These cancers are rising really rapidly and of course children don't smoke, drink or hold stressful jobs. We therefore, can't really evoke life style explanations. Moreover these cancers are not hereditary. There are no good familial links that we know of.

Other cancers that are rising quickly in the US registry data include non-Hodgkin's lymphoma and multiple myeloma. These cancers have more than doubled or tripled in the last half century. We know early and better detection cannot explain it. We know that heredity cannot explain it, and there seems to be no real lifestyle issues that are associated with these cancers, so that is why I think we need to look at the environment for more explanation. Studies show that children who live near certain kind of chemical industries or who live near very busy roads where there is lots of car exhaust, especially when their mothers are pregnant with them have higher risks of certain kinds of cancers than children who live further away from such facilities.

In a very famous cancer cluster in Woburn Massachusetts, solvents in the drinking water were implicated in the cause of childhood leukemia. We know it was the contaminated water received by the women when they were pregnant that was the major predictor for whether or not children in that town went on to develop leukemia. I think this kind of evidence shows us that it is not even so much the amount of exposure to a cancer causing chemical that creates the disease risk, it is the timing of exposure. If people are exposed to carcinogens when they are embryos or newborns they are far more sensitive to the effects of these chemicals then they are later on in life.

That is also true for adolescents. We are beginning to recognize that not only pre-natal life but adolescent life is a time of great vulnerability to cancer causing chemicals, when the connection between health and the environment becomes even more important.

RDK: Can you explain the significance of genetics and environment to the development of cancer.

Steingraber: I think the current trend is to look for genes that cause cancer, whether they are inherited genes or genes that acquire certain mutations. What we have forgotten about is that the gene itself has been damaged by something. We need to pull back a little bit and not just look at the molecular level but look at the larger social level to see what kind of gene damaging chemicals we might be exposed to.

All cancers are genetic in so far that you cannot get cancer unless one of your genes has been mutated in some way. And actually we now have good evidence to suggest that it requires a lot more than one mutation. Our cells are actually pretty resilient and usually you need about eight to ten mutations along the DNA.

I always think of our DNA as being keys on a piano if you will. The piano being a chromosome and then the genes are different keys on the piano. Therefore if you damage certain keys then you can't play certain notes. The music that our genes and our chromosomes perform for us is the real work of the cell itself. But you need about eight to ten of these damaged keys or damaged genes before the cell actually goes haywire and the process that we know as runaway growth that is the hallmark of cancer starts happening. It may be true that some of us are more susceptible because we may have inherited one or two genes that predispose us to cancer. Meaning that we need fewer acquired mutations from the environment before we finally develop a tumor, but in every almost case we see an interaction between heredity and the environment.

In other words, somebody like myself who developed bladder cancer at the age of twenty might mean that I was born with a genetic susceptibility to get this disease, but it doesn't mean that the genes I was born with doomed me to develop cancer. It probably means that I am far more susceptible to environmental contaminants then people with a different set of genes. In which case I actually need more protection from environmental carcinogens then other people. So I think inheritance and the environment are not either or questions, they are two dancers in a very exquisite dance. They both play a role, but we have focused on only one of the dancers in the media and the popular medical research, which is the role of inheritance, and my hope is that we can look at the role of the environment as well.

RDK: You call the prevalence of cancer as a human rights abuse in your book, could you share your thoughts on this idea....

Steingraber: Sure, at the end of Living Downstream I proposed that we should start looking at cancer as a human rights issue. What I meant by that is that we have enough evidence to say with great certainty that different kinds of activities, both agricultural, in the use of pesticide, or industrial, in the use of solvents, are putting chemicals that we either know cause cancer or we suspect very strongly play a role in cancer, and yet we allow these chemicals to be released into the environment. We know that when we do this somebody is going to contract cancer because of their consequential exposures to the chemicals that are allowed out there. So the problem we have is that somebody is making a profit and somebody else is paying the price. Whenever there is a disconnect between those who are benefiting and those who are being harmed I think we have a human rights problem.

There are a lot of innocent victims who are getting cancer in order that businesses might be able to profit from the continued use of carcinogenic chemicals. I think that people with cancer need to organize and insist that we put human health as high on the social list of priorities as the ability of corporations to make a profit.

RDK: Given the power that big businesses wield, do you think that it is likely the American government will listen to those voices?

Steingraber: Well, I am the first to admit that my optimism comes right out of my experience of being a cancer survivor. When cancer survivors become political activists we are a very powerful force, because we are so used to feeling optimism in the face of despair. We refuse to take no for an answer. For me in my generation I think our duty is to find a way to bring democracy back into the process of how we regulate and manage harmful chemicals.

RDK: Yet you admit we citizens face a difficult opponent in the big corporations...

Steingraber: From what I have seen as a biologist over the years there is a louder and louder voice coming from corporate interests and their laboratories in the world of science. More and more research is being privately funded as the US government is divesting itself of public interest research. As that research becomes privatized and is done by scientists within the corporate structure the whole process of science is profoundly altered.

Science is supposed to be an objective process. When one tests a hypothesis one is not supposed to have a stake in the outcome of the answer. The information that comes out of science and the knowledge that it generates has always historically been considered for the public good. It is supposed to be published and other scientists are supposed to look at it and replicate the results. It is supposed to be peer reviewed and subject to scrutiny and available to all. However, when science is brought into the corporate world and is yoked to profit-making activities then what we see is that if certain kinds of science show something might be harmful and dangerous, then that information is suppressed rather than released because it is seen as a bad public relations problem.

Moreover other kinds of knowledge that get generated are often seen as trade secrets and proprietary information and they are not available to the rest of us scientists. We are seeing this really strongly in the whole campaign to genetically modify the food supply. It is really hard as a public interest scientist to even comment on whether this is dangerous or not because the data simply aren't available to us. It is being held very tightly within the corporate structure. I think it is a problem when corporations speak with the voice of science and the public thinks what they are hearing is objective science without realizing it is the voice of corporate interest.

I think public interest scientists need to reclaim science for the people not for corporate profit. Increasingly people outside the world of science who are paying the price because of exposure to toxic chemicals are also organizing and demanding change. I feel we are on the brink of a new civil rights movement in the US. And it is a civil rights movement that is specifically focused on environmental health.

RDK: What are the most important precautions you think we should take to safeguard our children and our own well-being?

Steingraber: I think it is a myth that we can somehow live safely within a toxic world. And one of the things I always try to do is divest people of that belief because one can spend a lot of energy trying to filter water and have air filters and create a safe bubble for one's children to live in. But the fact is that we all depend on the air we all are exposed to and whatever contaminants are in tap water. Even if we chose to drink bottled water we still have to give ourselves and our children baths. It turns out that most of our exposure to chemical carcinogens in tap water doesn't come from drinking it at all. They come from bathing and showering, because the chemicals are inhaled and they go right through the skin.

We really can't think that we can save our children and just allow the world to continue to be toxic. Mothers need to organize against toxic pollution whether it is pesticides that their children might be exposed to in school or dioxin from the garbage incinerators that they are drinking in their milk. You know how very protective mothers feel about their children and when that protectiveness is carried over into the environment it becomes a very powerful political force.

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Kennebunkport resident, Ms. Dixit-Kubiak is an independent health/environment researcher, yoga teacher, shiatsu therapist, and program coordinator for Big Medicine's Eco-Holistic Health Exchanges. Her email is metamed@nancho.net.