From cancer survivor to environmental health expert

From Sandra Steingraber's bladder cancer diagnosis to raising her two children amid the threat of fracking, her life's work has focused on the links between the environment and human health.
Written by Christina Hernandez Sherwood, Contributing Writer

From Sandra Steingraber's bladder cancer diagnosis to raising her two children amid the threat of fracking, her life's work has focused on the links between the environment and human health. The author of four books, most recently Raising Elijah, Steingraber is also a distinguished scholar in residence at Ithaca College.

This month, Steingraber won a prestigious Heinz Award for her efforts. She is donating the prize money -- $100,000 -- to the fight against fracking. I spoke with Steingraber this month. Below is Part 1 of our interview.

You were diagnosed with bladder cancer at 20. How did that impact your career path?

It was profoundly affecting. I was, up to that point, traveling the high-achieving pre-med path. I realized when I woke up in the hospital with this diagnosis that I didn't want a hospital to be my workplace. Because bladder cancer, of all the human cancers, is the one most likely to recur, check-ups happen every three months. I knew I was going to be tethered to the medical system for the rest of my life. I didn't want to make it my workplace. I went back to the university not sure what my plans were. Just about that time, there was a new ecologist hired in the faculty. I began to take ecology courses and realized how much I enjoyed biological research, especially if it could be practiced outside. My plan became to be a field biologist and travel the world to beautiful pristine places. And I did. I went to the Central American Rainforest and the Nile River Valley and the Headwaters of the Mississippi.

I had another epiphany while I was working on my dissertation. My study site had been surreptitiously sprayed with Agent Orange years earlier. It messed up part of my study. The secrecy that surrounded the deployment of those herbicides in the park meant that I didn't have all the data I needed to design the study I was trying to do. Also, it meant that I could have been exposed. One of the contaminants of Agent Orange can last up to 50 years in the soil. It made me realize that there's no away. There are no unaffected places. My job as a biologist shouldn't be to keep finding more undisturbed and beautiful places in the world, but rather confront these violations of the environment and human rights. It became my life's work.

Was your career path also influenced by the possibility that your cancer could have been caused by environmental toxins?

That was there too. I can't say that it wasn't. My diagnosing physician asked me a lot of questions about my possible environmental exposures. Those were surreal questions for me. I was asked if I'd ever vulcanized tires, if I'd ever smelted aluminum. Even though I grew up in a working class community, I thought of myself as someone who [was high achieving]. I didn't smoke or drink or do drugs. I was trying to win scholarships and get straight As. I somehow thought that would protect me from environmental harm. It didn't make sense that those things should have anything to do with me.

When I read about the causes of bladder cancer, it turned out [the doctor] was asking the right questions. There is, in fact, an aluminum smelter in my town. There were two coal-burning power plants. There were dry cleaning fluids in the drinking water. I didn't actually research those things systematically until I made the decision to do public health. I'd already been a biology professor for a few years. I got this wonderful post-doctoral fellowship from Harvard that allowed me to research the connection between cancer and the environment. Then, I moved to my sister's basement and began a systematic investigation of the toxic history of my town. I learned some skills in investigative journalism, such as filing Freedom of Information Act requests. I began to connect the dots. The realization that I was just one data point in a cancer cluster was sobering and inspiring to me. My diagnosis as a cancer patient informs the work I do now, but by itself I don't think it would have been enough to push me in that direction.

The other factor I have to mention is my status as an adoptee. That also gave me a lot to think about. My mom and I were cancer patients together. My aunt died of the same kind of bladder cancer I had. I have a cousin who has colon cancer. But being adopted, I'm not related to my family members by genes. As a biologist, I began to think about this presumption that when we see cancer running in families there's a hereditary component. But families share a lot of other things in common -- air, food and water. As an adoptee, I was interested in understanding the way in which genetic predisposition and environment interact with each other. Bringing an adoptee's perspective to the question led me down a different path of inquiry.

What's the status of your cancer now? Are you in remission?

That word doesn't really apply to bladder cancer. I've mostly had a good outcome, but it can come back at anytime. The last couple check-ups showed a new spot. We don't know what it means. The urine taken to the lab looks fine, but the spot isn't going away. Now I'm back to having check-ups every few months.

It's a high wire act for me to medically be vigilant. I can't pretend everything is fine and be in denial when I have abnormal results. I have to keep doing more ultrasounds, more follow ups. I'm the mother of two small children. I can't overlook anything. On the other hand, psychologically I try not to live my life as if I'm waiting for the other shoe to drop. Psychologically, I like to act like I'm fine and medically I act like I'm not. I find the idea of the mind-body split to be useful.

In your research, what have you found about the link between chemicals and diseases that worries you the most?

The most worrisome thing of all is the pervasive silence about the connection between cancer and the environment. That silence seems to persist at every level, from government regulations to the world of science to the world of cancer advocacy. It's hard to have a conversation about the evidence, which is quite convincing and robust. That's the conclusion I came to when I wrote Living Downstream. When the film version came out, I had the chance to write a second edition of the book to update the science. The second edition is much thicker than the first. The evidence has gotten more powerful. There's a whole field now of molecular epidemiology and also epigenetics, which gives us a way to look at how environmental signals can alter gene expression and place a cell on the pathway to tumor formation. The mechanism by which different environmental chemicals can contribute to cancer has been elucidated greatly just in the last 10 years.

The conclusion that human cancer is a story about our shared environmental exposure was also a conclusion reached by the President's Cancer Panel in 2010. The panel wrote a strong report that encompassed all the evidence and took the unusual step of accompanying the report with a letter to President Obama that urged him to use the power of his office to remove carcinogens from air, food and water. Nothing was done in response to that. I don't hear a lot of talk about carcinogens in the environment from the American Cancer Society. Many of the breast cancer groups are racing for cures that are not around the corner.

Every time there's another study showing a link to cancer and something, it makes the news and it's as though it's disappeared. I think people have a hard time with the information psychologically. I don't quite get that. It seems to me that the depressing thing would be if cancer was mostly caused by our inherited genetics. There's nothing we can do about that. But there's not a lot of evidence that inherited genes play a significant role in cancer. It's just a tiny percent. It seems to me good news that the story of cancer is about being born with a good set of genes to which something bad happens along the way. Then we can intervene. If people can make these chemicals and put them into our economy, then people can change things. But we can't redesign our materials economy if no one can have a conversation about it.

Coming Thursday: Steingraber on fracking, which she describes as the greatest environmental issue of our time, and on raising children in a toxic world.

Photo: Sandra Steingraber / By Dede Hatch

This post was originally published on Smartplanet.com

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