r BGH Hormones Breast Cancer and Pink Ribbons

r. BGH, Hormones, Breast Cancer, and Pink Ribbons Martin Donohoe

Recombinant Bovine Growth Hormone (r. BGH) • aka recombinant Bovine Somatotropin (r. BST), brand name Posilac© • 10 -14% of U. S. dairy cows injected with r. BGH • Used to increase milk production by cattle

r. BGH • Marketed primarily to large dairy farms (LDFs), which are supplanting small dairy farms • LDFs have – Worse environmental impact records – Higher rates of workplace injuries – Contribute to decreasing agricultural diversity

Effects of r. BGH on Humans • Serum IGF-1 levels increase 13% above baseline in individuals drinking milk from r. BGH-treated cattle • IGF-1 interacts with estrogens, and other growth promoters • Milk is the food most associated with high IGF-1 levels • IGF-1 not important in yogurt, since it is used as a food source by some of the bacteria responsible for yogurt production

Risks of r. BGH • IGF-1 is a suspected contributor to breast, prostate and GI cancers – Promotes cell division and reduces apoptosis (preprogrammed cell death) in animals – Inhibits the ability of various anti-cancer drugs to kill cultured human breast cancer cells

Risks of r. BGH • Along with pesticides, other endocrine disruptors, and obesity, IGF-1 may be partly responsible for earlier onset of puberty (9. 9 yrs in 2006, compared with 10. 9 years in 1991) – IGF-1 also associated with PCOS (polycystic ovarian syndrome) and obesity • Women who eat dairy products deliver twins at five times the rate of vegans

Risks of r. BGH • Children, who have more years of life to live and drink more milk (and more milk per body weight) than adults, are disproportionately affected • Some evidence suggests r. BGH milk being funneled to U. S. children through school lunch programs – Many school systems have gone r. BGH-free

Harmful Effects of r. BGH • FDA: r. BGH causes 16 different harmful conditions in cattle, including heat stress, hoof disorders, GI disturbances, birth disorders, ovarian and uterine problems, and mastitis – Antibiotic treatment of mastitis leads to increased antibiotic resistance in cattle and humans

r. BGH (Posilac©) • Originally developed and marketed by Monsanto • Sold to Elanco, a division of Eli Lilly, in 2008 • 2017: Elanco reportedly seeking buyer for r. BGH and Augusta, GA manufacturing facility

Monsanto • Agent Orange, PCBs, dioxins, DDT • Largest producer of genetically-modified seeds – Contamination events – Unethical experiments – Harassment of scientists

Monsanto • Pesticide Roundup used in “War on Drugs” in Colombia • Incidents of bribery, environmental contamination • Profitable • Member of corporate front groups fighting food safety legislation/organizations

Monsanto • Roger Beachy (long-time president of the Danforth Plant, Monsanto’s nonprofit arm) now chief of USDA’s National Institute of Food and Agriculture, overseeing almost $500 million in grants and research funding

Monsanto • Islam Siddiqui, VP at Crop. Life America (US branch of Crop. Life International, an agribusiness front group led by Monsanto and others) Obama’s Chief Agricultural Negotiator for the US Trade Representative’s Office

Eli Lilly • Paid record-setting settlement of $1. 42 billion to US Justice Department for illegally marketing Zyprexa to children and elderly for non-FDA approved indications • Multiple other instances of illegal and unethical marketing

Eli Lilly • Manufactures antibiotics used to treat mastitis • Produces Gemzar (used to treat breast cancer)

Elanco • Marketed diethylstilbestrol (DES) for almost 2 decades despite data showing link between DES exposure in mothers and clear cell vaginal cancers in offspring – Contraindicated for human use by FDA in 1971, used in other parts of world through late 1970 s – Banned for use in cattle in 1979

Elanco • Manufactures ractopamine (Optaflexx), a beta agonist given to livestock for last 7 -28 days of life to increase protein synthesis – OK’d by FDA, but banned in 160 nations – Can cause hyperactivity and muscle breakdown – Dangerous for human consumption

Elanco • 2009: Elanco paper, commissioned through PR company Porter-Novelli, authors paid by Elacno – Loaded with misinformation (see report and OR p. SR rebuttal on phsj website) • Authors admit falsely claiming AMA and AAP endorsements for r. BGH, misstate ACS’s neutral position

FDA Approval of r. BGH • OK’d for use by FDA in 1993; on market since 1994 • FDA official (and former Monsanto attorney) Michael Taylor oversaw process – became Monsanto VP after leaving FDA; now FDA Deputy Commissioner for Foods and Veterinary Medicine

FDA Approval of r. BGH • FDA relied on industry summary of internal tests • GAO investigation: – Found 3 FDA employees involved in decision had conflicts of interest and multiple ethics rules violations – Criticized sloppy, manipulative science, lack of data on human health effects

r. BGH Worldwide • Canada, Australia, New Zealand, Japan, and the European Union have banned r. BGH • The Codex Alimentarius, the UN’s main food safety body, has refused to certify r. BGH as safe

Opposition to r. BGH • • • APHA ANA Health Care Without Harm AMA President Ron Davis (’ 07 -’ 08) BMJ

Opposition to r. BGH • • • Humane Society Animal Protection Institute Humane Farming Association Farm Sanctuary ACS – no formal position (2009); previously supported r. BGH

r. BGH Today • All fluid milk products in Oregon now r. BGH-free • 55 of the top 100 U. S. dairies are now at least partially r. BGH-free or have announced that they will be • Starbucks’ (company-owned stores), Chipotle, 160 hospitals nationwide r. BGHfree

Hormones in Beef • Six steroid hormones routinely used in US beef production: estradiol, testosterone, progesterone, zeranol. melengestrol, trenbolone • DES (1954 -1979)

Hormones in Beef • Since 1988, use of steroids in cattle production illegal in Europe • US government states hormone residues in beef from adult cattle pose no threat to human health – Endocrine Society, APHA, others disagree

Other reproductive toxins/carcinogens • Phthalates, bis-phenol A (BPA), pesticides (persistent organic pollutants) • Body burden high (EWG) • Nursing infants at top of food chain

Hormone-Related Diseases on the Rise • • Breast and prostate cancers Thyroid disease Obesity Diabetes Endometriosis Uterine fibroids Infertility

Hormones in the Food Supply • Earlier onset of breast development and puberty in young girls • Altered sex ratio (more girls, fewer boys) • Increasing cryptorchidism – Risk factor for testicular cancer • Micropenis, hypospadias increasing

Komen Foundation • Largest breast cancer charity in US • Founded by Nancy Brinker, whose sister Susan Komen died of breast cancer in 1980 – Brinker – ambassador to Hungary under George W Bush – 2011 CEO salary = $417, 712; 2012 (CEO) = $684, 000; 2013 (Chair, Global Strategy) = $560, 896 • Known for pink ribbon campaigns, Race for the Cure

Komen Foundation • Affiliates in over 100 US cities and 50 other countries • Has collected over $1. 9 billion for breast cancer research and programs, including free mammograms and biopsies for uninsured women – Mammograms decrease risk of dying of breast cancer by 0 -20%

Komen Foundation • 83% of donations go to mission programs – 43% to education – 15% to research ($63 million in 2011, compared with $763 million [NIH], $150 million [DOD], $17 million [ACS]) – 12% to screening – 5% to treatment • 18% to fund-raising and administration

Pink Ribbon Campaigns • Positive aspects: – Community of survivors – Fund raising – Research – Advocacy – $30 million raised per year through pink ribbon campaigns • Negative aspects: Pinkwashing

Pinkwashing • Outgrowth of the transformation of corporate philanthropy in the 1980 s and 1990 s to "strategic philanthropy" and "cause-related marketing“ • No one owns the pink ribbon image or oversees its use

Pinkwashing • Pink ribbon packaging can mean donations to breast cancer research – with or without cap – with or without use of coupon – ongoing or time-limited – or simply to raise awareness of breast cancer

Pink Ribbons • Avon Breast Cancer Crusade spends up to 25% of money raised on overhead • Breast Cancer Awareness Month created by Astra Zeneca (manufacturer of tamoxifen) – AZ was a leading manufacturer of pesticides until corporate reorganization in 2000

Pinkwashing • "Consumption philanthropy" may dampen people's willingness to make direct charitable donations • Pink ribbon products can be carcinogenic, production may involve labor and even human rights violations

Egregious Examples of Pinkwashing • Cosmetics – teens use avg. 17 personal care products/d – adults 12/d • Yoplait – previously contained r. BGH (now r. BGH-free)

Egregious Examples of Pinkwashing • • • Bottled water Pink alcohol Drill bits used in (carcinogenic) fracking Kentucky Fried Chicken NFL Jingle Jugs

Cosmetics • ACS's "Look Good. . . Feel Better" program provides 30, 000 women per year with a free makeover and bag of makeup donated by the Cosmetic, Toiletry, and Fragrance Assn • Cosmetics contain a number of environmental toxins – See Environmental Working Group website for database of toxins in cosmetics

Environmental Causes of Breast Cancer • Komen Foundation and ACS largely ignore environmental contributors to breast cancer (50 -70%) – 30 -50% associated with known risk factors (family history – 10%; early menarche, late menopause, late or no childbirth, HRT alcohol, radiation exposure – 20 -40%) •

Environmental Causes of Breast Cancer • KF denies link between BPA and other endocrine disruptors and breast cancer, despite “Reducing Environmental Cancer" (a report from the President's Cancer Panel) and multiple suggestive peer-reviewed studies (and in opposition to the Precautionary Principle)

Environmental Causes of Breast Cancer • KF denies link between exposure to organochlorine pesticides and cancer – EHP, 2007: fivefold increased risk of breast cancer among women exposed to DDT as adolescents – Multiple other studies showing link • Komen Foundation accused of overstating benefits of mammography (BMJ, 2012)

Environmental Causes of Breast Cancer • ACS allocates less than 0. 1% of its annual budget to environmental and occupational causes of cancer – ACS has rejected the President’s Cancer Panel Report, which concluded that “the true environmental burden of environmentallyinduced cancers has been grossly underestimated. ” – Pays its CEO $2 million/yr – High administrative costs

Environmental Causes of Breast Cancer • ACS “Excalibur Donors” ($100, 000+/yr) include big Pharma and petrochemical, industrial waste, auto, cosmetic, and junk food companies • Komen has over 200 corporate partners which provide approximately $50 million/yr in revenue

Komen Foundation and Planned Parenthood • 2012: Komen Foundation revokes grants for breast cancer screening programs at Planned Parenthood ($700, 000 annually), then reverses decision after intense public protest – Donations drop dramatically; multiple events cancelled – 2013: Hires Judy Salerno (from IOM) as CEO • Komen Foundation’s position on embryonic stem cell research unclear

What Can You Do? • Read the fine print when you buy pink Avoid bottled water - use a refillable stainless steel bottle • Avoid milk products from r. BGH-treated cattle • Eat organic, free-range beef if you are not vegetarian • Do not microwave food in plastic containers

What Can You Do? • Avoid cooking in non-stick pans and eating foods packaged with non-stick plastic • Get recommended breast exams (possibly helpful), mammograms • Get angry at corporate malefactors for polluting the environment and food supply – e. g. , GE-NY Presbyterian agreement • Spread the word

Breast Cancer Epidemiology (Risk factors alter odds) • Odds of woman developing breast cancer: – Birth to age 49 – 1. 9 (1 in 53 women) – Age 50 to 69 – 2. 3 (1 in 44 women) – Age 60 to 69 – 3. 5 (1 in 29 women) – Age 70 and older – 6. 7 (1 in 15 women) – Birth to death – 12. 3 (1 in 8 women) • 1/800 chance of woman developing invasive breast cancer • 1/4, 566 chance of woman dying from breast cancer

ACS (2015) and USPSTF (2016) Breast Cancer Screening Guidelines Mammography Screening Parameter Starting age (y) Screening frequency Stopping age (y) ACS USPSTF 45 Annually to age 54 y, then biennially For as long as a woman is in good health and has a life expectancy of at least 10 y 40 -50 (individualize) Biennially, beginning at age 50 y 75 Total lifetime mammograms if screening continued to age 20 13 74 y (n) Lifetime risk of dying of 1. 8 -1. 9 2. 0 breast cancer (%) Lifetime risk of dying of breast cancer with no screening is 2. 7%.

Further Information • Breast Cancer Action (download “Think Before You Pink” guide): http: //bcaction. org/ • Campaign for Safe Food, Oregon Physicians for Social Responsibility: http: //www. psr. org/chapters/oregon/saf e-food/campaign-for-safe-food. html

Contact Information Public Health and Social Justice Website http: //www. publichealthandsocialjustice. org http: //www. phsj. org martindonohoe@phsj. org