Where are the Warnings? Talcum Powder and Ovarian Cancer
Mesh Medical Device News Desk, July 8, 2016 ~ Talcum Powder & Ovarian Cancer – Is there a link? Juries think so. Just how much information has been out there despite denials from the powder industry?
by Eva Hvingelby NP, PhD, and Dr. Greg Vigna, MD JD, Lifecare 123
Warnings Absent Despite 40 Years of Talc Controversy
One of the first studies connecting talc to ovarian cancer was published in 1971. Researchers found small particles of talc inside ovarian tumors. This piqued the interest of scientists, and more studies were published soon after. Together with these early publications is the beginning of a 40 year old paper trail documenting the cosmetic industry’s attempts to suppress the findings, and discourage researchers from looking deeper into the risk of talc based products.
For example, after two researchers from the National Institutes of Health published a study in 1979 about the potentially dangerous link between talc and ovarian cancer, a consultant to the Cosmetic, Toiletry and Perfumery Association, Francis Roe, submitted a letter to the editor of an influential medical journal in which he wrote “at a time when suspicion hangs over so many everyday chemicals…In my personal opinion such research [into talc] merits little priority.”
The NIH researchers responded that they found it disturbing the cosmetic industry would attempt to discourage further research, and even called on the industry to lead the investigation into the dangers of its own products, saying “We hoped that the cosmetic industry would lead the search for answers. Consumers have a right to expect that manufacturers will investigate potential risks.”
In 1982 Dr. Daniel Cramer published a study about the potential danger of talcum powder in the medical journal Cancer. He warned that women who regularly used talc products such as baby powder in their underwear, and on the skin around the vagina, might be 3 times more likely to develop ovarian cancer.
Dr. Cramer is an epidemiologist. He specializes in finding patterns between specific behaviors, and risk of getting diseases such as cancer; he still practices at Brigham and Women’s Hospital in Massachusetts. Dr. Cramer has repeatedly encouraged further study of talc-exposure risk.
Unfortunately, the cosmetic industry has not adequately followed the recommendations made by these expert scientists, and now it’s worrisome that there may be thousands of women who developed ovarian cancer because talc products, such as baby powder, continued to be sold without any warnings, despite decades-long concern about their safety.
Is There Really a Connection?
Research takes time. With each research study scientists attempt to better understand the problem, look at it from different perspectives, and identify cause and effect relationships.
It is pretty easy to argue against a connection between talcum powder and ovarian cancer, if the only studies used are ones in which women only used talc occasionally. This is a reason why some headlines say there isn’t enough evidence, or that the connection is controversial. However, when studies are used that hone in on longer, more frequent use, the connection between talc and cancer is easier to see.
Dr. Daniel Cramer was on the right track when he published his findings, because he focused on how women used talc. He wrote “It is especially notable that women who regularly had both dusted their perineum [vaginal area] with talc, and used it on sanitary napkins had more than a 3 fold increase in risk”.
Another thing we’ve learned since Dr. Cramer’s early study, is that using talc over many consecutive years is an important risk factor.
Those who argue against the connection between talc and cancer say one of the biggest limitations is relying on women’s ability to correctly remember how much, and how often they used talc. This is considered a weakness in the evidence. Their concern is that once diagnosed with ovarian cancer women believe they used more of the product than they actually did.
Women who follow a long term personal hygiene routine disagree, and say they know exactly how much they use because they’ve been doing it for years.
What Happens at the Cellular Level?
Ovarian tumors are often caught after they have been growing for some time. Cancer is staged from levels 0-4 with level 0 being the earliest changes to individual cells. At stage 4 the cancer has spread throughout the body. Most ovarian cancers are found at stage 3 when it has spread to nearby organs, or at stage 4.
Why some cells become cancerous isn’t always clear. When it comes to ovarian cancer there are numerous studies that link inflammation with cellular changes. Inflammation, or irritation, causes the body to secrete chemicals and hormone like substances. These substances are meant to help fight off toxins or other invaders, bit as a side effect they also damage nearby cells.
Inflammation that happens once in a while may not be a big deal, but if cells are irritated by a substance on a daily basis, it is more likely that the surrounding cells will be damaged, mutate and become cancerous.
So is this what happens with talc? Does it irritate the tissues over years of use and cause inflammation to develop?
Lack of Adequate Warning
Many agree that repeated, long term genital exposure to talc has the potential to cause irritation, and that chronic irritation is a factor in cancerous cell changes. In 2006 the International Agency for Research on cancer placed genital talc use in carcinogen group 2B as “possibly carcinogenic to humans”. There are numerous other studies that show a connection between talc and cancer, and they all call for more research to understand what happens at the cellular level of ovarian tumors.
So the question becomes, why was there no warning from the manufacturers about the regular use of baby powder, directly on the genitals? Even while scientists were discussing these findings in the 1970’s, it was possible for manufacturers of talc based products to change the ingredients, or warn consumers, instead of trying to suppress the information.
And regardless if the evidence was incomplete, wouldn’t it be in the best interest of women to let them know about the controversy so they could decide for themselves if the risk was worth it? Women were not given this chance, and that is why corporations are now being challenged in court about their role in promoting a possible cancer causing product decades after the first studies raised a red flag.