Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, June 06, 2016

A Cautionary Recommendation

"I went into the bathroom, I grabbed my Johnson's Baby Powder and threw it in the wastebasket."
"I said, 'What else could it be?' [the cause of her diagnosis of ovarian cancer]."
"I knew nothing about this before. I figured baby powder is for babies, it must be safe."
Deane Berg, 59, physician assistant, Sioux Falls, South Dakota

"There is no way we're ever going to know for certain that any exposure is necessarily causal to a disease."
"The best we can do, is look at the preponderance of the evidence."

Dr. Shelley Tworoger, Brigham and Women's Hospital and Harvard University
The suits follow a jury decision in Missouri that awarded US$72 million to the family of a woman who died of ovarian cancer after using Johnson & Johnson feminine hygiene products for years that contained its talcum powder.
Matt Rourke/AP Photo file  The suits follow a jury decision in Missouri that awarded US$72 million to the family of a woman who died of ovarian cancer after using Johnson & Johnson feminine hygiene products for years that contained its talcum powder.
"The talc in our baby powder has a long history of safe and gentle use."
"After 30 years of studies by medical experts around the world, science, research and clinical evidence continues to support the safety of cosmetic talc …. We continue to believe in the safety of Johnson’s baby powder containing talc."
Johnson & Johnson

"The evidence is real clear that Johnson & Johnson has known about the dangers associated with talcum powder for over 30 years."
"Instead of giving a warning, what they did was targeted the groups most at risk for developing ovarian cancer [overweight women, black and Latino]."
Jim Onder, attorney for plaintiffs
And the evidence is there that there does exist the need for cautionary advice to women, not to use talcum powder for their intimate bodily cavities, and nor should it, in actual fact, be used for what Johnson & Johnson markets it primarily for: dusting over a baby's body or diapers. Talc, a clay mineral whose composition is an amalgam of magnesium and silicon is often mined close to where asbestos exists, and asbestos most certainly is a known carcinogen.

Some of the properties of talc are very similar to those of asbestos, a fact not unknown to the supplier who provides Johnson & Johnson with its talc and who has added warning labels about the possible consequences of its use, whereas Johnson & Johnson saw no need to. The use of talc powder on babies is strongly discouraged by pediatricians who are concerned that babies can become ill or even die after breathing in the particles. Talc's reputation is such that condom and surgical glove makers no longer dust their products with it.

Ten years ago Deane Berg, then 49, was diagnosed with ovarian cancer, a type of cancer that is often deadly, albeit relatively rare. She knew that the usual risk factors for ovarian cancer did not apply to her. She went on line to see if she could discover anything that might point her in the direction of the cause. And there she found that warning; websites that listed talc as a possible source of ovarian cancer. And she had dusted baby powder every day for 30 years between her legs.

The research is certainly there, and it dates back to 1971 when Welsh scientists discovered talc particles embedded in ovarian and cervical tumours. Among African-American women, genital use of baby powder has been linked with a 44 percent increase in the risk of invasive epithelial ovarian cancer. Johnson & Johnson insists its baby powder is safe. It is so certain that it plans to appeal two multimillion-dollar jury awards.

Thousands of women whose use of talc has led to dire health threats and in some instances, death, followed in the sake of Deane Berg, to sue Johnson & Johnson. The International Agency for Research on Cancer classified talcum powder as a possible human carcinogen when used in the female genital area ten years ago. In 1982, 215 women with ovarian cancer and 215 healthy women were compared in a study by Harvard's Dr. Daniel Cramer and colleagues.

It was concluded that women using talcum power were at twice the risk of ovarian cancer compared with non-users. Women who used talc on a regular basis on their genitals and sanitary pads saw their risk rise to over three times the relative risk. Since the mark of a successful conclusion to research is its repeatability, that research was  verified by ten subsequent studies, as opposed to a handful that found no heightened risk for women using talc.

Pooling the results of such studies involving almost twenty thousand women, researchers found talc use to be associated with a 24 percent increase in risk for ovarian cancer, an often fatal disease. Johnson & Johnson, however, holds fast to their own research and the expert advice of Dr. Larry Copeland, an Ohio State University Wexner Medical Center oncologist on contract with Johnson & Johnson.

Dr. Copeland is reliant on a government-funded study, the Women's Health Initiative. In that study over sixty-one-thousand women were asked by researchers if they had used perineal powder. Their health was followed for the next dozen years. And the study established the finding that there appeared to be no relationship between the use of the talc and cancer onset.

Scientists can always be found to refute what other researchers find, and this case is no different.

Dr. Steven A. Narod from Toronto, and an expert in cancer genetics was of the opinion that the study's cohort was insufficiently large, and the women were not tracked for a long enough period of time. Furthermore, as far as he was concerned, the findings did not render the earlier observational research invalid in its conclusion that a link existed between talc and cancer.

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