Wednesday, June 15, 2011

Weighing cancer risks, from cellphones to coffee (AP)

You're sitting in a freshly drywalled house, drinking coffee from a Styrofoam cup and talking on a cellphone. Which of these is most likely to be a cancer risk?

It might be the sitting, especially if you do that a lot.

Despite all the recent news about possible cancer risks from cellphones, coffee, styrene and formaldehyde in building materials, most of us probably face little if any danger from these things with ordinary use, health experts say. Inactivity and obesity may pose a greater cancer risk than chemicals for some people.

"We are being bombarded" with messages about the dangers posed by common things in our lives, yet most exposures "are not at a level that are going to cause cancer," said Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer.

Linda Birnbaum agrees. She is a toxicologist who heads the government agency that just declared styrene, an ingredient in fiberglass boats and Styrofoam, a likely cancer risk.

"Let me put your mind at ease right away about Styrofoam," she said. Levels of styrene that leach from food containers "are hundreds if not thousands of times lower than have occurred in the occupational setting," where the chemical in vapor form poses a possible risk to workers. "In finished products, certainly styrene is not an issue," and exposure to it from riding in a boat "is infinitesimal," she said.

Carcinogens are things that can cause cancer, but that label doesn't mean that they will or that they pose a risk to anyone exposed to them in any amount at any time.

They have been in the news because two groups that periodically convene scientists to decide whether something is a carcinogen issued new reports.

Last month, the International Agency for Research on Cancer, part of the World Health Organization, said there is a possibility cellphones raise the risk of brain tumors.

"The operative word is `possibility,'" said Lichtenfeld, who among others has pointed out the thin evidence for this and the fact that cancer rates have not risen since cellphones came out.

Last week, the National Toxicology Program, part of the National Institute of Environmental Health Sciences � both of which Birnbaum heads � issued its report.

It adds to the list of known carcinogens formaldehyde, which is in building materials and some hair-straightening products, though Birnbaum said on-the-job exposure is the main concern. The list also adds a plant substance in some "natural" arthritis remedies, aristolochic acid. Six other things were dubbed "reasonably anticipated" to be carcinogens, including styrene and another herbal medicine ingredient, riddelliine (rih-DELL-een).

Since 1971, the international cancer agency has evaluated more than 900 substances. Just over 100 have been deemed carcinogens, 59 are called probable carcinogens, and 266 others are possible ones.

In this last category of possibles � besides the electromagnetic energy from cellphones � are coffee, engine exhaust and talc-based body powder. Talc in its natural form may contain asbestos, though products sold for home use since the 1970s have been asbestos-free. Again, most risk is thought to involve occupational or unusual exposure to natural talc.

The evidence on coffee has gone back and forth for years, with no clear sign of danger and some suggestions of benefit.

However, known carcinogens include alcoholic beverages, estrogen treatments for menopause symptoms, birth control pills, certain viruses and parasites, and even some drugs used to treat cancer, such as cyclophosphamide and tamoxifen.

"Most people would probably be shocked to see the number of things they interact with every day" on these lists, Lichtenfeld said.

Here's the problem: The agencies that pass judgment on a carcinogen don't regulate it or determine what levels or routes of exposure are a concern and for whom.

"People immediately assume it's going to cause cancer at any exposure level, and that's simply not true," said A. Wallace Hayes, editor of the scientific journal Food and Chemical Toxicology, and an industry consultant.

The rule is "RITE" � Risk Is equal to Toxicity times Exposure � and "they've left out half of the equation" by not saying how much exposure is a concern, Hayes said.

"The organizations that list these substances as possibly carcinogenic have to be conservative. That means if there's any reasonable evidence, way before it's a sure thing, they have to say, `Let's be cautious.' That's their job � to raise the flag," said David Ropeik, a consultant and author of "How Risky Is It Really? Why Our Fears Don't Always Match the Facts."

It's human nature to fear risks we didn't choose, such as hazardous chemicals, more than those we did, such as lack of exercise, poor diets or smoking, he said.

"A risk that is imposed on us scares us more than a risk we take voluntarily," especially if it comes from companies we don't trust, Ropeik said.

Styrene is an example: The government says it is a component of tobacco smoke and that is the biggest way most people are exposed to it. Smoking, of course, is the most easily preventable cancer risk.

To minimize risk, people can take reasonable measures to avoid exposure to possibly harmful things, experts say.

"If you walk into a room and you can smell formaldehyde, you probably want to vent the room before you spend a lot of time in it. That's just common sense," Birnbaum said.

If you're concerned about pesticides, you can peel fruit and vegetables or choose organics, though there is some evidence that organic products may be less safe in terms of germs like E. coli and salmonella.

People worried about cellphones can hold them farther from the head, text-message instead of talk, or use a headset or earpiece as Lichtenfeld does. He was returning from a major cancer conference in Chicago last week when a fellow traveler pointed at Lichtenfeld's Bluetooth earpiece and said, "Do you know that thing can cause cancer?"

"I said, `Yes, ma'am, I'm very familiar with the data and I choose to use Bluetooth,'" said Lichtenstein, who didn't tell her he was one of the biggest cancer experts she'd ever meet.

"You can't live life in fear," he said. "You have to live life."

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Online:

Carcinogens: http://bit.ly/aJI6ht

IARC: http://monographs.iarc.fr/index.php

NIH: http://ntp.niehs.nih.gov/go/roc12

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP



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US births down for 3rd year; economy may be factor (AP)

ATLANTA � U.S. births apparently have declined for a third year in a row, probably because of the weak economy.

Births had been on the rise for years, and the number hit an all-time high of more than 4.3 million in 2007.

But the count has been dropping since then. Last year, it fell 3 percent to slightly more than 4 million births, according to preliminary figures released Wednesday by the Centers for Disease Control and Prevention.

It's possible the decline is leveling off: The falling birth rate seemed to bottom out in October, November and December. However, it's too early to say whether that marks an end to the trend, said Paul Sutton, a CDC demographer who was the report's lead author.

The report is a first glimpse at 2010 births from state health departments. It doesn't include an actual review of birth certificates or specifics about what's going on in different groups of women. The CDC plans to do more analysis later.

However, the number usually is pretty close to the final statistics, officials said.

Experts believe the downward trend is tied to the economy, which officially was in a recession from December 2007 until June 2009 and is still flagging. The theory is that women who are unemployed or have other money problems feel they can't afford to start a family or add to it.

In 2008 and 2009, the only increase in births was in women older than 40 � considered more sensitive to the ticking of their biological clocks.

A drop in immigration to the United States, blamed on the weak job market, may be another factor in last year's decline.

"Hispanics have higher birth rates," explained Dr. Roger Rochat, an Emory University researcher who has studied fertility and abortion trends

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Online:

CDC report: http://www.cdc.gov/nchs



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Experts: Weiner's behavior similar to addicts' (AP)

GARDEN CITY, N.Y. � So what's wrong with Anthony Weiner?

The New York congressman says he is seeking professional treatment "to focus on becoming a better husband and healthier person" following a sexting scandal that threatens to drive him from office.

Weiner hasn't specified what type of care he is getting, or where. If he has opted for an inpatient treatment facility, experts say there are just a handful of places where he could be, including a Mississippi clinic where Tiger Woods reportedly sought help for his litany of marital indiscretions. Or perhaps he is getting outpatient advice on sexual addiction.

Experts witnessing the demise of the rising politician's reputation, if not his career, are among those opining from afar. Some say Weiner's actions � making electronic sexual contact with strangers � mimic the characteristics of drug addicts, alcoholics or problem gamblers.

"He's exhibiting behavior of an addict. The secrecy, the risk taking, the denial," said Robert Weiss, founder of the Sexual Recovery Institute in Los Angeles.

"I am sure he understood on some level what he was doing," Weiss said. "When someone like that is not in a state of arousal, they can have a more intellectual, nuanced view of things. But that gets lost in the euphoria. And he begins not thinking clearly."

Weiss, a nationally recognized expert who has appeared on the Oprah Winfrey and Larry King programs, said Weiner probably can't explain his actions because they are on some level inexplicable even to him.

"I have a lot of empathy for him. He really doesn't understand why," Weiss said. "He can't figure out why he made these choices."

Kimberly Young, clinical director of the Center for Online Addiction in Bradford, Pa., said that in many ways, Weiner's online behavior was "very commonplace." Plenty of men and women secretly live out their fantasies on the Internet, sometimes in compulsive fashion.

The treatment for online compulsion, she said is usually twofold. Patients have to first modify their online behavior; that might mean not using the computer during certain hours, or at certain locations, or only communicating with certain types of people online. Next, they must examine what mental health issues might be causing the behavior.

"Is he depressed, is he anxious and stressed out?" she said. "First you need to deal with the behavior, then deal with the reasons why that happened ... It will probably take more than a 28-day rehab program. ... The treatment has to fit the person."

Timothy Lee, a licensed clinical social worker who runs New York Pathways, which treats sexual addiction on an outpatient basis, said Weiner's proclivity for sending photos of himself to strangers likely has escalated over time.

"He didn't wake up and just start sending pictures," Lee said. "I assume this is some type of voyeuristic exhibitionism type behavior. But it does show how delusional one must be to engage in this behavior. To think that the person on the other end is going to get off on it?"

Behavior like Weiner has confessed to, Lee said, usually starts with an innocent joke or flirtation, perhaps with an acquaintance or co-worker, but can quickly escalate.

"The greater the risk, the more excited they get. It's sort of like the high gamblers get," Lee said. "The greater the risk in getting caught, the bigger the high. I would look at his abusing his sexuality like someone else might abuse a drug," Lee said.

Weiner's weekend announcement that he is seeking treatment was short on specifics; he did not explicitly say that he has entered a rehab facility. A statement said only that he requested "a short leave of absence from the House of Representatives so that he can get evaluated and map out a course of treatment to make himself well."

Lee said if the congressman has gone for inpatient treatment, he would likely have to be in a program for 30 days or more, although some facilities offer help in less time. He said Pine Grove Behavioral Health and Addiction Services in Hattiesburg, Miss., where Woods reportedly went, has a 45-day program. The Meadows in Wickenburg, Ariz., has about a 30-day program, The Keystone in Chester, Pa., offers a 14-day program, other experts said.

Calls or e-mails to clinic officials seeking comment were not returned; most boast of offering confidentiality to patients.

As far as Weiner's prospects after treatment?

"People love a comeback story," said Lee. "From a PR perspective, going into rehab is the best thing he can do. Obviously he is also dealing with the humiliation he has brought upon his wife. It's just a sad case."

Dr. Jeffrey T. Parsons, a sex addiction expert and psychology professor at Hunter College in New York City, noted sexual addiction is officially recognized as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders. The next edition is due out in 2013 and there has been talk about including a passage on the topic, describing it clinically as a hypersexual disorder, he said.

Taking an alternate view from some his colleagues, Parsons questions whether Weiner indeed is a sex addict in need of treatment.

"I'm not so sure. He certainly has a media relations nightmare and saying he needs treatment sounds a lot better than the alternatives," Parsons said. "It's a lot harder to bash someone who says he is seeking treatment and help."

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Associated Press writer David B. Caruso contributed to this report.



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