“Move to a leafy suburb to cut cancer risk”

A new Harvard study suggests the risk of getting cancer decreases when people live around more greenery – such as in suburbs:

People whose homes are surrounded by the most greenery are 13 per cent less likely to die of cancer. Their risk of dying from respiratory disease also drops by 34 per cent, the biggest ever study into green spaces and health has shown.

Overall mortality was 12 per cent less for people who had the most greenery within 250 metres of their homes during the eight year follow-up period.

It is thought that being surrounded by vegetation improves mental health and lowers depression. It also allows people to get out and about more, giving more opportunities for exercise and social engagement, both of which are known to be protective against disease. The lack of air pollution in green areas also plays an important role…

More than 100,000 women enrolled in the Nurses’ Health Survey were followed between 200-2008. Scientists used satellite imagery from different seasons and years to monitor how much greenery surrounded their homes.

The early suburbs of England and the United States were popular in part because of their health benefits compared to the growing dirty industrial cities. The suburbs then featured much more greenery and the idea of having a small house in the midst of nature. I’m not sure today’s suburbs can truly compare, particularly those closer to the central city. I’m reminded of James Howard Kunstler’s commentary in this TED Talk about the “nature band-aid” that is often applied in suburbs today. But, this study suggests that a greener setting – even if it is heavily modified by humans in suburban settings – can help.

More evidence for having IRBs: sociologist finds that US Army released toxic cadmium into St. Louis air in the 1950s and 1960s

A sociologist in St. Louis says she has discovered an unknown story involving the US Army releasing cadmium into the air in the 1950s.

The aerosol was sprayed from blowers installed on rooftops and mounted on vehicles. ”The Army claims that they were spraying a quote ‘harmless’ zinc cadmium sulfide,” says Dr. Lisa Martino-Taylor, Professor of Sociology, St. Louis Community College. Yet Martino-Taylor points out, cadmium was a known toxin at the time of the spraying in the mid 50?s and mid 60?s. Worse, she says the aerosol was laced with a fluorescent additive – a suspected radiological compound – produced by U.S. Radium, a company linked to the deaths of workers at a watch factory decades before.

Martino-Taylor says thousands upon thousands of St. Louis residents likely inhaled the spray. ”The powder was milled to a very, very fine particulate level.  This stuff traveled for up to 40 miles.  So really all of the city of St. Louis was ultimately inundated by  the stuff.”

Martino-Taylor says she’s obtained documents from multiple federal agencies showing the government concocted an elaborate story to keep the testing secret. “There was a reason this was kept secret.  They knew that the people of St. Louis would not tolerate it.” She says part of the deception came from false news reports planted by government agencies.  “And they told local officials and media that they were going to test clouds under which to hide the city in the event of aerial attack.” Martino-Taylor says some of the key players in the cover-up were also members of the Manhattan Atomic Bomb Project and involved in other radiological testing across the United States at the time. “This was against all military guidelines of the day, against all ethical guidelines, against all international codes such as the Nuremberg Code.”

She says the spraying occurred between 1953 and 54 and again from 1963 to 65 in areas of North St. Louis and eventually in parts of South St. Louis. Martino-Taylor launched her research after hearing independent reports of cancers among city residents living in those areas at the time.

When students ask why we have Institutional Review Boards (IRBs) and why it may seem they have researchers jump through a series of hoops, I remind them of stories like this. This experiment even took place after the establishment of the beginnings of the modern ethical guidelines for science  through the Nuremberg Code. It is not too long ago when the government and other organizations undertook silent experiments and violated two of the primary ethical principles sociologists and others hold to: do not harm participants and ensure that they are participating on a voluntary basis.

Another note: it sounds like these experiments were justified in the name of safety. The tests were conducted under the cover that the city needed to prepare for a possible bombing, presumably by Russia.

ProCure proton therapy: you are not “close to downtown Chicago”

I’ve heard plenty of radio commercials for the ProCure proton therapy facility in Warrenville, Illinois and one thing gets me every time: the ad claims the center is “close to downtown Chicago.” A few thoughts about this:

1. The actual distance from Chicago to the facility is 30 miles. While the drive is relatively simple (Eisenhower to I-88 and then about 0.6 miles off the Winfield Road exit), this is not “close.” It probably wouldn’t even qualify as nearby. In no traffic, this drive would take at least 35-40 minutes and during the day would be longer. In my world, 10 miles or less would be close to downtown Chicago.

2. I’m not sure why the facility was built in Warrenville: the land is conveniently located near an interstate, close to Central DuPage Hospital (CDH), I assume the land was cheaper than in or near Chicago, and was able to be put up in “record time.” And there was competition: Northern Illinois University wanted to build a proton therapy facility in West Chicago and CDH filed a lawsuit against NIU that was withdrawn when a regulatory board gave the go ahead to the Warrenville facility.

3. One reason they might make this claim is because not too many people have heard of Warrenville. Going to Warrenville, a small community, doesn’t sound as good as going to somewhere “close to Chicago.”

4. Another reason they may have made this claim is that they want to win market share in the Chicago region. The ProCure facility has teamed with CDH which provides care to western DuPage County and has designs on a larger healthcare footprint (with a recent merger with Delnor Hospital) but may not be familiar to all of Chicagoland. Perhaps the claim of being close to Chicago is more about winning the PR battle against Chicago hospitals such as University of Chicago, Northwestern, Rush, and Loyola.

Debating the merits of using the word “cancer”

Many would say that they know what cancer is. But medical experts suggest it is not so clear and perhaps the term “cancer” is not the best description for every situation that might usually be labelled with this term.

Though it is impossible to say whether the treatment was necessary in this case, one thing is growing increasingly clear to many researchers: The word “cancer” is out of date, and all too often it can be unnecessarily frightening…

“The definition of cancer has changed,” said Dr. Robert Aronowitz, a professor of history and sociology of medicine at the University of Pennsylvania.

Many medical investigators now speak in terms of the probability that a tumor is deadly. And they talk of a newly recognized risk of cancer screening — overdiagnosis. Screening can find what are actually harmless, if abnormal-looking, clusters of cells.

But since it is not known for sure whether they will develop into fatal cancers, doctors tend to treat them with the same methods that they use to treat clearly invasive cancers. Screening is finding “cancers” that did not need to be found. So maybe “cancer” is not always the right word for them.

This is an interesting discussion to read about after having recently completed reading The Emperor of All Maladies: A Biography of Cancer. Several points are found in both works:

1. Our knowledge of cancer is constantly evolving. We don’t know as much about it as the public might think.

2. Different cancers present different issues, leading to some of the issue with the term cancer. Cancers don’t have a common cause or necessarily act in the same way.

3. Screening is a big issue. Who should get screened? Is it cost-effective?

One other issue that I don’t see discussed in this article or in the book: is part of the problem with the word “cancer” the connotations that this has for people? In his book, Mukherjee suggests that cancer is associated with a bleak prognosis. When patients hear this term, they know they are in for a very difficult fight. Would changing the use of the term shift some of this conversation away from the immediate fear involving cancer to a more medical term that requires more explanation and obscures the severity a bit? Is this also in even just a little way about public relations?

Seeing Alzheimer’s as a social problem

The cover story in the current issue of Time is about Alzheimer’s research. The main story is set up in a typical way: the condition affects a lot of people and yet research into a cure is underfunded. What is interesting is that Time employs two statistics that suggest the cover story should really be about how people could make Alzheimer’s a social problem worthy of more attention.

The first statistic is an actual dollar amount: one expert says $500 million a year is spent on researching Alzheimer’s while $1 billion is spent on heart disease, and $5.6 billion on cancer. The second measure concerns public perception: 48% of Americans think “a great deal or some progress has been made in curing” the disease while 81% say the same about heart disease and 74% say the same about cancer. With these two statistics, Time suggests Alzheimer’s has a certain public image: it doesn’t attract the same kind of research dollars as other diseases and the public is pretty pessimistic about progress.

While the rest of the story concerns itself with the medical and scientific advances, perhaps it should be about how the public could be convinced that the disease deserves more attention. Some ways the public image could be enhanced: it needs more fund-raisers, more celebrity supporters, more support for research from public officials, and more stories that demonstrate how many people are affected by Alzheimer’s. Look at the public image of other conditions: diseases like breast cancer (where are those “edgy” Facebook campaigns for Alzheimer’s?) have effectively been cast as critical social problems that everyone should care about.

Perhaps this cover story is itself intended to help raise the profile of Alzheimer’s. While real medical progress is the true goal and it is what will ultimately benefit people, Alzheimer’s as a social problem is another important issue to be considered.

How diseases become a social problem

NPR explores how certain diseases, such as cancer, particularly breast cancer, turn from a medical condition that no one talked about to a prominent social cause. Some of the factors, according to the article, that helped cancer become a visible concern:

[T]he women’s health movement, the rise of information technology and a shift in the medical culture itself away from a purely hierarchical system in which doctors were always assumed to know best…

A lot of illness-awareness promotion, though, stems from the way AIDS patients responded to the rise of that disease…The tropes developed with AIDS — clothing accessories such as ribbons, displays of commemorative quilts, marches on Washington — have all since been adopted by groups concerned with other conditions.

How certain issues (and not others) become social problems is often a fascinating tale. What one time period and culture sees as problematic is not an issue for the same culture in a later period – Prohibition would be a great example. There is often a complicated process that takes place by which the problem is brought to the attention of the public and then people become convinced it is a cause that requires their action.