In July 2003, Nancy A. Nichols was among the millions cheering Lance Armstrong to his fifth victory in the Tour de France. Nichols had more than a rooting interest: Armstrong was the world's most celebrated cancer survivor, and she'd just started chemotherapy.
But the cyclist's hero status got Nichols thinking. Her insights about survivorship are among the more provocative aspects of her new book, Lake Effect: Two Sisters and a Town's Toxic Legacy (Island Press), in which she argues that instead of fixating on miracle cures, we should look harder at potential man-made causes of cancer.
By the time she'd started chemo, for pancreatic cancer, Nichols was already several years into researching the book, which began with a promise she made to her older sister as she lay dying of ovarian cancer. Nichols -- a veteran broadcast and print journalist whose resume includes The McNeil Lehrer Newshour -- vowed to investigate whether the malady's roots lay in the environment where they'd grown up in the 1960s and '70s.
Waukegan, Ill., had become infamous for its toxic pollution, particularly in the waters of neighboring Lake Michigan. Industry belched out toxins, including polychlorinated biphenyl (PCBs), a probable human carcinogen. Lake sludge tested in the '70s, for instance, revealed PCB levels more than one million times the contamination rate accepted as safe today. Nichols and her sister, Sue, had swum in the lake's water and eaten its fish.
In Lake Effect, Nichols, now 49, weaves her investigations of Waukegan's pollution and the causes of cancer with her own story of diagnosis and treatment. It's a thoughtful examination of the risks faced by bodies made by nature in a world fabricated by technology.
Nichols assails what she calls the "false uncertainty" that the makers and marketers of consumer products can create about what might cause cancer (such as tobacco) by manipulating how scientific studies are interpreted; Nichols quotes Robert Proctor, who called this "the social construction of ignorance."
Moreover, notes Nichols, tracing the environmental causes of disease can be a daunting challenge. When we pump chemicals into the air, soil and water, the effects might take decades to show up -- and the chemicals themselves can stay toxic even longer. Meanwhile, the people exposed to those chemicals move around, geographically severing diseases from their possible causes. And new research suggests that toxins might be harmful in doses much smaller than previously thought -- and might affect people differently when combined with the countless other synthetics we're exposes to daily, not only in "traditional" pollutants but also in everyday household products.
Indeed, as Nichols' journalistic forebear Rachel Carson noted 46 years ago, in Silent Spring, the 20th-century mania for synthetics, from pesticides to plastics, has made each of our bodies an "uncontrolled experiment" in toxicity. "There is no way to design a study. Because there's no population that is untouched," says Nichols, by phone from her home in Massachusetts. "You can't say, 'I'll take these people who have no body burden [of toxins] whatsoever, and I'll test them against people who have this body burden.'"
In addition, though genetics undoubtedly influence whether someone gets cancer, an inclination to blame inherited causes can also distract us, Nichols says. That's because genetic tendencies toward cancer might be activated by environmental triggers -- and because toxins can themselves alter a person's genetic makeup, in ways that can resonate in future generations.
In terms of finding causes, triumphant stories like Lance Armstrong's can be similarly distracting.
"I am a great admirer of Lance Armstrong, and when I was sick I found him extremely inspirational," says Nichols.
"On the other hand, I think that when people lionize the survivor -- and particularly, I happen to have survived a disease that most people die from -- then you're missing something in the equation too," adds Nichols, who's a featured speaker at the annual Women's Health & the Environment conference here Sept. 25. "It's much easier to focus on people who survive, and be excited for them, and talk about all that we've accomplished, rather than look at the fact that an awful lot of people with cancer don't survive. They die."
Armstrong's case is especially illuminating. When we note that more people survive testicular cancer these days, for instance, "it obscures the fact that the disease has sort of skyrocketed in the post-World War II era, when we started to talk about pesticides and herbicides, and have increased chemical use in manufacturing," says Nichols. Indeed, between 1975 and 2004, the incidence of testicular cancer in U.S. males ages rose by 72 percent, according to National Cancer Institute figures.
Meanwhile, awareness of the possible carcinogenic and mutagenic effects of commonplace materials and chemicals -- and not just smokestack emissions and industrial spills -- is spreading. For instance, chemicals known as "endocrine disrupters" (including PCBs, DDT and dioxin) have been shown to damage the reproductive organs and other glands of animals. And studies released just this year found serious risks to human health associated with exposure to both bisphenol A, a primary ingredient of common household plastics, and an additive to the polyvinyl chloride (PVC) used to make shower curtains. Nichols notes that researchers are also asking whether environmental toxins play a role in asthma, autism and learning disorders.
One answer to the problem, says Nichols, is tighter regulation of synthetics. "I think we could do better to be more like the European Union, to do more testing on chemicals," she says.
More fundamentally, she says, people must understand that humans are not separate from "the environment."
"We are an environment," says Nichols. "Our little bodies are our own environments. We really are only as healthy as the ecosystems that we live in."
Nancy A. Nichols speaks at Women's Health & the Environment. Thu., Sept. 25. David L. Lawrence Convention Center, Downtown. Registration is full; talks will be available via podcast on www.womenshealthpittsburgh.org