Did everyday chemicals cause my tumor?

One day, I seemed healthy. A few weeks later, I was going under the knife. Then, I made a powerful connection

Published April 17, 2011 12:01AM (EDT)

On a crisp fall afternoon a couple of years ago, I went in for a routine two-year checkup with my internist. Everything seemed to be fine: My home life was happy and nurturing. I had never smoked. I ate right, got plenty of rest, and had been a dedicated runner and cyclist my entire adult life. Save for the usual aches and pains, nothing had ever been wrong with my body, and as long as I was smart about it, I figured, I’d still be riding my Fausto Coppi racing bike well into my '80s.

My only complaint, I told my doctor, was a faint tightness in my hip that I had felt off and on for two years — and odd, sharp twinges between my left thigh, knee and shin that occasionally accompanied it. My internist looked me over and agreed that my pains were probably related to exercise, and he suggested I see an orthopedist at a nearby sports medicine clinic. The orthopedist, in turn, suggested I get an MRI to help him see a bit more clearly what was going on with my soft tissue.

I was standing in my living room when the phone rang just a few hours later. When I picked up the phone and heard the orthopedist’s voice, I knew even before he spoke that something was amiss. "Hello, Mr. Jenkins," he said, then paused. "You have a suspicious mass in your abdomen," he said. "It's growing inside your left hip. Here is the number for an oncologist. You need to call him right away."

What can you say about such moments? I remember hanging up the phone. I remember looking at my wife, Katherine, and looking at my children putting together a puzzle on the floor in the next room. My son was 4, my daughter not yet 18 months. I fell apart.

Katherine and I passed the next three weeks in a kind of silent panic. When I met with my oncologist, he sketched out what he thought was going on. Although he couldn’t be certain without further tests, the tumor was likely a soft-tissue sarcoma, an ugly cancer of the fibers connecting my hip to the muscles and nerve tissues of my left leg. The prognosis depended on how big the tumor was, where precisely it was growing, exactly how aggressive it was.

At worst, this was, well, very bad. At best, a surgeon could cut out the tumor, but might be compelled to sever my femoral nerve, the trunk line that connects the nerves in the leg to the spine. Which meant I would probably never run or ride my bike again. And then I’d have to remain vigilant to see if the cancer returned. To this day, the ride home has remained indelible.

This was really happening. But how? This was not a grinding descent into illness; it was a bolt from the blue. I did not feel sick, and never had. My mind raced. How could I possibly have cancer? A few weeks later, I was being prepared for surgery at the hospital when two researchers approached me with questions. The first ones were pretty standard: What ethnic group best describes you? Um, white. How far did you make it in school? I have a Ph.D., I said. How many packs of cigarettes have you smoked per day, on average? None, I said. Ever. Then the questions changed, from ones I had been asked by doctors dozens of times before to ones I had never been asked in my life.

How much exposure had I had to toxic chemicals and other contaminants? In my life? I asked. This seemed like an odd question. What kind of chemicals do you mean? The researcher began reading from a list, which turned out to be long. Some things I had heard of, many others I had not. Metal filings? Asbestos dust? Cutting oils? I didn’t think so. What’s a cutting oil? How about gasoline exhaust? Asphalt? Foam insulation? Natural gas fumes?

Where was this going?

The words kept coming. Vinyl chloride? I wasn't sure. What was that? How about plastics? Are you kidding? Everything is made of plastic. Dry-cleaning agents? Detergents or fumes from plastic meat wrap? Benzene or other solvents? Formaldehyde? Varnishes? Adhesives? Lacquers? Glues? Acrylic or oil paints? Inks or dyes? Tanning solutions? Cotton textiles? Fiberglass? Bug killers or pesticides? Weed killers or herbicides? Heat-transfer fluids? Hydraulic lubricants? Electricfluids? Flame retardants?

By now I had begun to feel distinctly uncomfortable. Not about my history of "industrial" exposures, which were nonexistent, but about the myriad, and mostly invisible, chemicals the researchers seemed to be curious about. What was a flame retardant, exactly, and how in the world would I know if I had been exposed to one? I had never used pesticides, but Lord knows there were plenty in my neighborhood.

A couple of hours later, a doctor led me into the operating room, and I lay down on the table. A moment later, it seemed, I awoke. My eyes felt fuzzy, and blurred by bright overhead lights. Where was I? I blinked. There, at the foot of my bed, stood Katherine and my surgeon. Both were beaming. Something must have gone well, I thought. You're a lucky man, the doctor said. The tumor was as big as an orange, but it turned out to be growing out of a nerve cell rather than a muscle cell. We sent a slice of it down to the lab; it turned out to be benign. Of a hundred cases like this, about four turn out this way. Not only that, we managed to peel the tumor off your femoral nerve. Once you recover, you can get back to running and riding your bike. You’re a very lucky man.

And so I was.

As joyful as my outcome had been, I was left feeling somehow bereft. Had this whole thing been bad luck? Where had this tumor, this navel orange, come from? It wasn’t until I’d answered the hospital questionnaire that I had ever even considered the vast arrays of chemicals I had been exposed to over the years. Was it possible that the questions constituted a trail of bread crumbs that could lead me to some answers? Suddenly, these questions began to take on a whole new sense of urgency.

In the four years that have passed since my surgery, cancer has burned its way through a swath of my family and friends. My beloved aunt Julie recently passed from a combination of breast cancer, bone marrow cancer, and Parkinson’s disease. My friend Scott, still in his 40s, just learned that he has pancreatic cancer. Like me, he has small children. So do Leah and Suzie and Susan, young women who have all recently suffered terrible bouts with breast cancer. My cousin’s husband, Phil, died of a brain tumor before his 40th birthday. He left a wife and a young daughter. And on and on and on.

What is going on here?

No one goes through a cancer scare without experiencing a kind of awakening. Here’s what mine looked like: I went from being a passive observer of other people’s suffering to feeling an intimate desire to prevent that suffering. I wanted to know if there were root causes. I wanted to try to see things just as they are, how they came to be that way, and what I could do to protect myself and my children.

It's worth thinking about what a relatively short time we’ve been swimming in synthetic chemicals. The Synthetic Century, let us say, has been full of grand achievements and equally grand consequences, many of them unintended. In 1918, a scientist named Fritz Haber won the Nobel Prize for figuring out how to make synthetic nitrogen, a key component of soil, and thus "improving the standards of agriculture and the well-being of mankind." But during World War I, his technology also helped Germany make bombs from synthetic nitrate and, later, poison chlorine and phosgene gas. In World War II, Hitler used another one of Haber’s compounds, Zyklon B, in Nazi concentration camps. After the wars, synthetic fertilizers paved the way for the explosion of industrial-scale agribusiness, which has, in turn, created great wealth but also unprecedented levels of pollution, monoculture and processed foods.

In his book "The Omnivore’s Dilemma," Michael Pollan outlines the way our industrial food chain floats on an ocean of cheap oil. This is also true of our vast array of consumer products. Although coal companies in the mid-1800s were processing coal gas for lighting and synthesizing other products like dyes, this was but a baby step compared to what happened a hundred years later. Since World War II, Big Oil and, more recently, Big Coal and Big Natural Gas, have supplied our economy not just with energy for our homes and cars but with the very building blocks of our domestic lives: not only our plastics but our fertilizers and pesticides, our furniture, our personal care products, even our clothing. Consider this: in the last 25 years, the country’s consumption of synthetic chemicals has increased 8,200 percent.

The trouble with such rapid proliferation of products made from petrochemicals, of course, has been that the production and use of synthetic chemicals has vastly outpaced our ability to monitor their effects on our health and the environment. We learned to love what chemicals could make; we just never bothered to wonder if there could be a downside. By the mid-1970s, there were some 62,000 chemicals in use; today the number is thought to be closer to 80,000. The EPA has a full set of toxicity information for just 7 percent of these chemicals, and the U.S. chemical industry, a $637-billion-a-year business, is so woefully underregulated that 99 percent of chemicals in use today have never been tested for their effects on human health. Fewer than 3 percent of these chemicals have ever been tested for carcinogenicity. Far fewer (or none) have been assessed for their effect on things like the human endocrine system or reproductive health.

The human immune system has evolved over millennia to combat naturally occurring bacterial and viral agents. It has had only a few decades to adjust to most man-made contaminants, many of which are chemically similar to substances produced naturally by our own bodies. The effects of this are far from fully understood. "We face an ocean of biologically active synthetic organic compounds," the ecologist Sandra Steingraber writes. "Some interfere with our hormones, some attach to chromosomes, some cripple the immune system, some overstimulate certain enzymes. If we could metabolize them into benign compounds and excrete them, they would be less of a worry. Instead, many accumulate. So they are doubly bad: they are similar enough to react with us, but different enough not to go away easily."

What becomes clear, if you stop to think about it, is that what’s gotten into us is not just chemicals but culture. We aren’t just saturated with chemicals, after all; we are saturated with products, and marketing, and advertising, and political lobbying. Fifty years ago, it was not uncommon to see advertisements for DDT featuring an aproned housewife in spike heels and a pith helmet aiming a spray gun at two giant cockroaches standing on her kitchen counter. The caption below reads, "Super Ammunition for the Continued Battle on the Home Front." Another ad shows a picture of a different aproned woman standing in a chorus line of dancing farm animals, who sing, "DDT is good for me!" DDT was marketed as the "atomic bomb of the insect world," but also as "benign" for human beings. And we believed it.

Our ignorance is not an accident. We are not meant to know what goes into the products we use every day. The manufacturers of most American-made products tend to keep the ingredients and formulations of their products secret, and rarely mention that individual ingredients might (or do) cause cancer, or impede fetal development, or lead to hormone imbalances. It seems that the intention in packaging is to make information harder to find, not easier -- an imitation of information, not information itself. With so little information, it’s easy to see why we have become so complacent. And why we have allowed ourselves to live, albeit uncomfortably, with assurances that these products are "safe." A single exposure to these chemicals never killed anyone, we tell ourselves. This is true. But smoking a single cigarette never killed anyone, either. The trouble with exposure to toxic chemicals, as with exposure to tobacco, is that the impact is cumulative, long-lasting and, frequently, slow to reveal itself.

So here we are.

Almost 50 years after Rachel Carson's "Silent Spring," and the tide of synthetic chemicals is only rising. We are faced, every day, with an overwhelming number of choices as consumers: Do I choose this detergent or that one? This mattress or that one? The chemical lawn-care company or the "green" one? This shouldn’t be so hard. We’re talking about washing our children’s hair. Or cleaning the sink. Or tending a garden. Why has this become so complicated? And on what information do we make our decisions?

The most important thing, as I have said, is finding the courage to see things clearly. But as I have learned, when it comes to toxic chemicals, seeing things clearly is harder than you might imagine. Every choice we make is a bargain with the devil. You go to get your suits dry-cleaned, only to learn that dry cleaners rely on perchloroethylene, or perc, a known carcinogen. Is having crisp creases worth the risk? You want to wash your infant’s hair. What could be more benign than baby shampoo? But look closer at the label on the bottle: the baby shampoo contains formaldehyde, which causes cancer and compromises the immune system. The more alienated we get from the things we use every day, the more confused we get. The more confused we get, the dumber we feel. The dumber we feel, the less confident we are in our decisions. The less confident we are, the more susceptible we become to the suggestion that everything is as it should be, that the experts (the manufacturers, the regulators) are keeping an eye on things. The more we bury our worries under such shaky ground, the more abstracted we become.

As overwhelming as some of the scientific evidence about our consumer products can seem, there can be real liberation in learning to look at things with clear and unblinking eyes. A good part of this has to do with reconnecting with our things. With understanding what things are for, and how they are made, and by whom. It’s worth relearning some of what we’ve forgotten. How to build and furnish and clean our houses. How to care for our lawns. How to feed and clothe and bathe our children. Strangely enough, you might find that some of these old ways actually feel empowering. We’ve been bombarded with advertising and marketing ploys for so many years that we have tended to make decisions out of unconscious habit rather than conscious choice. Not only is it increasingly clear that there is physical risk in such habits, there is also a genuine psychological sacrifice.

In the moment when we reach unthinkingly for a product, we suspend judgment and even, at times, common sense. When we act unconsciously, we implicitly grant authority -- and trust -- to what manufacturers have told us, that a product is "safe." But the truth is, whether the product is an apple, a T-bone steak, a can of air freshener, or a mattress makes no difference: we have no idea what has gone into creating the product, even if someone, somewhere, has assured us that the product is benign. In many, many cases, this is clearly no longer true. And as the physical and psychological distance has grown between us and the products we consume, we have traded an intimate knowledge for a vague and anxious "trust," a feeling that is inevitably accompanied by its darker corollary, fear and loss of control. This does not seem like a fair trade.

Excerpted from "What's Gotten into Us?" by McKay Jenkins Copyright © 2011 by Mckay Jenkins. Excerpted by permission of Random House, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

McKay Jenkins is the Cornelius A. Tilghman Professor of English and director of journalism at the University of Delaware. He is the author of "The Last Ridge," "The White Death" and "Bloody Falls of the Coppermine."

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