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What an oncologist wants us to know about everyday chemicals
00:26:15
Endocrine disrupting chemicals can be found in everything from your nonstick pan to your shampoo. But what are they – and how worried should you really be about them?
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- [00:03]
Elahe Izadi
The other day, I was scrolling on Instagram and this chart popped up. It showed everyday items in my house that could actually be messing with how my body functions. Things like shampoo, floss, water bottles. The chart said all these items contain things called endocrine disruptors. Endocrine disruptors are chemicals that can interfere with the complex system, system that produces and interacts with our hormones. There's research linking some of these endocrine disruptors to a bunch of health problems. They can affect the reproductive system, our kidneys, and even increase our cancer risk. And these chemicals are everywhere in our food, our hygiene products, our makeup, our pots and pans. This scared me. But rather than continuing to doom scroll, I thought, you know, let me talk to someone who actually knows the science and isn't getting all of his information from social media. That person is Dr. Mikhail Seckeris. He's an oncologist, professor, and cancer epidemiologist. And as part of his research, he tracks potential links between environmental exposures and cancer. So we called him up to ask, how freaked out should I be?
- [01:28]
Dr. Mikhail Seckeris
Let me try to lower your freakout range.
- [01:32]
Elahe Izadi
From the newsroom of the Washington Post, this is Post Reports. I'm Elahe izadi. It's Wednesday, August 6th. Today, Dr. Secharis answers all my questions about endocrine disruptors and cancer. He shares with me how he makes his own choices on what products to buy and avoid and how I can do the same. He's the chief of the hematology division and professor of medicine at the Sylvester Comprehensive Cancer center at the University of Miami. He also writes regularly for the Post. And I have to say I felt much better and smarter by the end of our conversation. So I hope you do, too. Dr. Sechres, thank you so much for joining me today. I appreciate it.
- [02:23]
Dr. Mikhail Seckeris
What a delight it is to be here. Thanks for having me.
- [02:25]
Elahe Izadi
I am very much looking forward to this conversation because on a personal note, I feel like every time I open up social media, my phone, look at the news, I keep getting bombarded with information about everyday products that are in my home that could actually be harmful for me. And the words that keep popping up are endocrine disruptors. So I would love to, with you, dig into some of the specifics of items I should be careful about and also thinking through how much I should be worrying or not worrying about this. But first, I think it's helpful to start with just big picture, the science of all this, so I can calibrate my concern appropriately.
- [03:04]
Dr. Mikhail Seckeris
I think that's a Terrific intro to this. And typical Saturday for me is waking up in beautiful South Florida, putting on my biking clothes, getting out onto my bike, going for a ride, drinking adequate amounts of water from a water bottle, getting home, reheating some food in a Tupperware container for lunch, and lounging on the couch with those very simple, straightforward behaviors. I have invoked a number of potential exposures to endocrine disrupting chemicals. And maybe a good place to start is to start with the endocrine system. The endocrine system are a bunch of glands that secrete hormones like estrogen, testosterone, cortis. And those hormones then interact with targets, what we call receptors in the body to regulate our growth, development, reproduction, metabolism, energy balance and body weight.
- [03:58]
Elahe Izadi
So is it sort of like it helps regulate functions within the body?
- [04:02]
Dr. Mikhail Seckeris
Yeah, exactly. And you almost have to cross your eyes and think backwards when you're thinking about the endocrine system and how it works. You have a hormone that will then stimulate a receptor, and often that means it's stimulating cells to grow and to produce chemicals. And then it's always involved with a feedback loop, meaning that once your body has responded to that hormone stimulation, once it produces adequate amounts of what the body's looking for it to produce, it shuts off the initial trigger to produce those chemicals. And its activity differs as we age. So you can imagine the endocrine system is really active when we're little and we're growing and you know, we make the joke in our house, aren't we 16 year old son at home, that he must have a hollow leg with how much he eats. Right. He's constantly consuming food and we don't know where it goes. Well, because he's actively growing and his endocrine system is like on max capacity. As we age, the endocrine system may not have that much activity.
- [05:03]
Elahe Izadi
Does it then follow that endocrine disruptors are things that disrupt that normal functioning of the endocrine system?
- [05:12]
Dr. Mikhail Seckeris
Yeah, exactly. So chemicals that interfere with this complex communication system are called endocrine disrupting chemicals. And they work in a variety of ways, including overstimulating receptors, blocking receptors so that normal hormones can't interact with them, and altering hormone production or availability. There are over 1000 types of these chemicals according to some estimates. So it's a tremendous number of chemicals. And some of these are formally listed by international organizations as being toxins. And they can be found everywhere from your nonstick pans, to canned foods, to your shampoo and even hair dye.
- [05:54]
Elahe Izadi
I want to dig into what some of These endocrine disrupting chemicals are the ones we most commonly encounter. I wondered if we could start with bpas. That's an acronym that I come across often. What are those?
- [06:07]
Dr. Mikhail Seckeris
So BPAs, or bisphenol A is, is a chemical used in the production of polycarbonate plastics and epoxy resins. And it's structurally similar to synthetic estrogen. So it belongs to a larger class of chemicals called bisphenols. And the primary exposure for most people is through their diet. So BPAs can leach into food or drinks from the protective internal epoxy resin coatings of canned foods and from consumer products such as polycarbonate tableware. Food storage containers. I mentioned in my little story as, as an intro that I go out biking, I drink from a water bottle. They can be in water bottles. I reheat food in a Tupperware, they can be in food storage containers. But the US FDA has said they can no longer be used in things like sippy cups and baby bottles.
- [06:58]
Elahe Izadi
Okay. There's another class of chemicals I think about in this conversation, and that is forever chemicals, which is a big umbrella. I've also heard them referred to as pfas. Can you tell me about those?
- [07:10]
Dr. Mikhail Seckeris
Yeah, pfas. So that's PER and polyfluoroalkyl substances. These are chemicals used as oil and water repellents and coatings for cookware, food packaging, even carpets and textiles. So in my little story about going biking, I mentioned lounging on the couch. Right. Well, that's a textile. They're known as forever chemicals because once PFAS are created, they persist in the environment because they don't break down like some other chemicals. They can be found in everything from dental floss to menstrual products as well. They contaminate drinking water near facilities where they're manufactured, and they've also been found on military bases and firefighting training facilities where foam containing PFAS is used. So they can really be in a lot of different areas. There's kind of a famous study that was conducted near Parkersburg, West Virginia, that found a probable link between a type of PFAS called perfluorooctanoic acid or Pfizer PFOA exposure, and a number of disease categories, including testicular cancer and kidney cancer.
- [08:16]
Elahe Izadi
Wow. I mean, just to think that these chemicals are in things from floss to menstrual products really makes you think, like, everywhere I'm looking around my home or, you know, just anything anyone uses, you're going to encounter these chemicals.
- [08:29]
Dr. Mikhail Seckeris
Well, we're Consumers. We're all consumers in the 21st century. So we have some. Some pretty amazing things that we can use that we couldn't use two centuries ago. But a lot of these come from these sort of chemicals, preservatives and plastic manufacturing. So. Sure, you're right.
- [08:44]
Elahe Izadi
Tell me about this other class of chemicals. When we're having this conversation, I probably won't be able to pronounce it. Can you? I'm going to try. Thank goodness for these other acronyms. Phthalates. Can you say that for me?
- [08:59]
Dr. Mikhail Seckeris
Well, I pronounce it phthalates, but. But you're absolutely right. It sounds like it's a word that would be used in the national spelling bee.
- [09:06]
Elahe Izadi
Yes, exactly.
- [09:07]
Dr. Mikhail Seckeris
Something that Sylvester the cat would stumble. So these are chemicals used in cosmetics and personal care products that make plastics more durable. They're also known as plasticizers. These liquids are colorless, odorless, and oily. They resist evaporation and function as solvents and stabilizers in products like perfumes, shampoos, hair sprays, hair straighteners, nail polishes, and cleansers. And probably the most common one in cosmetics is diethyl phthalate, or dep. That's used as a solvent and fixative in fragrance differences like perfumes.
- [09:43]
Elahe Izadi
Is there any particular health concern or a set of research around this class of chemicals that we should be aware of?
- [09:51]
Dr. Mikhail Seckeris
So with this one, there have been a couple of studies in sisters. So take a step back and think about epidemiologic studies. If you and I were to design the perfect study to study risk factors for developing cancers, we would randomize 100,000 people where half would be exposed to something like a phthalate and half wouldn't be exposed to a phthalate. We would follow them over 40 years, and we would see who developed cancer at a greater rate. Well, of course, a study like that is inherently inethical and impossible to do. So what we turn to is the next best thing. And the next best thing in epidemiologic studies are what are referred to as prospective cohort studies. In other words, you take tens of thousands of people, in this case, tens of thousands of sisters, and you ask them, gee whiz, a whole bunch of questions about all their behaviors. Do you smoke? If you smoke, how much do you smoke? Do you go out into the sun? Do you use sunscreen? Do you not use sunscreen? What kinds of foods did you eat in the past week? A bunch of different types of potential risk factors for a variety of types of medical conditions. And so in these studies, in this case, it was sisters were asked about their use of permanent hair dyes and then were followed over time for whether or not they developed breast cancer. And in one study that included more than 46,000 women, it found that permanent hair dye use was associated with an increased use of breast cancer, particularly among black women, while frequent use of straighteners was linked to a higher risk of both breast and ovarian cancer.
- [11:31]
Elahe Izadi
So kind of the takeaway I'm having from what you've described so far is that there are all these chemicals. They are all around our home. We interact with them every day. There is some research that indicates increased risk of cancer and other health problems with repeated exposure to some of these chemicals. But I'm also not hearing that if you are drinking every day from a plastic bottle, you're definitely gonna get sick. Is that accurate or how would you summarize the. I guess what I'm asking you, doctor, is how freaked out should I be?
- [12:05]
Dr. Mikhail Seckeris
Let me try to lower your freak out range, because my freakout range, of course, as soon as I read this stuff is to be pretty high. And then I go through the data and realize there's not as much evidence supporting the link between these chemicals and us developing cancer as there is for a lot of other behaviors that we can modify. So let's put this in context. So some of these studies, you know, I mentioned the study looking at phthalates and development of breast cancer. I mentioned a sister study of 46,000 women. Well, when you break it down to how many of those women actually were exposed to these dyes and then developed breast cancer, you're just talking about a few hundred. Right? So it boils down really quickly to a much lower number. And these are probably the best data among all of the things that we've discussed for a link between an exposure and cancer in this class of chemicals. Compare that to the recent surgeon general's warning about alcohol exposure and the development of cancer. In that warning, that included studies of tens of thousands, over 100,000 people with very detailed information about their exposure to alcohol, and found a very clear link between that alcohol exposure and a variety of cancers. In fact, alcohol exposure contributed to 5 to 6% of new cancer diagnoses in this country and to 44,000 breast cancer diagnoses per year in the United States. Now, that's based on studies of, as I mentioned, over 100,000 people. Compare that to these studies that we're talking about with endocrine disrupting chemicals, where we're talking about a few hundred people who were involved. So the level of evidence about linking these chemical exposures to cancer is really much lower in actual people. I think what would get people stirred up is that there are some laboratory studies, so studies that take place in test tubes or in, for example, lab mice that show a link between exposure to these chemicals and the development of cancer in the lab. But as we've known for decades, that doesn't always predict development of cancer in people, just as lab and test tube studies of drugs to treat cancer don't always predict that they're going to work in people.
- [14:33]
Elahe Izadi
After the break, Dr. Sechres explains which products to consider ditching and which ones aren't worth worrying about. We'll be right back.
- [14:54]
C
The Washington Post is known for pulling back the curtain on what's really going on in politics, policy and power. Now we're expanding that mission, introducing Washington Post Intelligence, a new venture to help business executives, policy innovators and thought leaders navigate the unpredictability of business and politics. I'm Martin Cady, the general manager of Washington Post intelligence. As a 20 year editor and reporter on politics and policy in Washington, I know how important it is to have the right tools to make critical decisions for your business. WP Intelligence gives you that with its new executive briefing service. Our briefings and analysis are hosted by star analysts like Josh Rogan and Jason Dean who have decades of experience on global economics, geopolitics, AI and technology. So if you're an executive policy leader, government or legislative staffer, head over to wpintelligence.com to learn more about this new premium service. Even better, one of our experts will walk you through a demo. Again, that's wpintelligence.com there's information and then there's WP intelligence.
- [15:54]
Elahe Izadi
Dr. Seckers, I think what you described about how to calibrate our concern around this is really helpful. And also I think it's just important before we dive into like the practicality of how to incorporate some of these findings into our day to day lives, to remember that the environments we're in were complicated. Our bodies are super complex. Just because you're exposing yourself to one thing doesn't necessarily mean you have caused yourself cancer. I mean, I just think it's important to like caveat all that so that I don't know when I think about these things, I don't want to get into this loop of, oh, I'm making myself sick by using this shampoo. Like, it's just really hard to know if you have Cancer, like why that happened.
- [16:36]
Dr. Mikhail Seckeris
Right, right, right, absolutely. And, you know, one of the most common questions my patients ask me is what did I do to cause my cancer? And it's this very kind of moving moment in a relationship, I think, between me and my patients. And the exact same thing I would ask because I think a lot of us are programmed to assume that we did something wrong to bring on cancer. Most cancer occurs by just dumb luck. Over the course of our living on this earth for decades and our cells dividing and reproducing and trying to make a perfect copy of themselves every single time they divide, statistically, one time out of thousands of divisions, they're going to screw up. So statistically, our chance of getting cancer is just random bad luck. It's nothing that we could have done to prevent it. But we have clear examples of exposures that we have where we can do something to intervene to lower our own personal chance of developing cancer.
- [17:41]
Elahe Izadi
I love that caveat and that sort of foundation of us diving into this. Because I don't want to get into this like, blame game thing. So let's start with the kitchen. You know, in the story you were saying, there's like the food and the water bottle. If I'm in my kitchen, I'm looking at the containers I store food in, the utensils I use, the plateware I, or what I cook with. What are some things that I can think about avoiding, maybe swapping out? Where would you recommend I start?
- [18:07]
Dr. Mikhail Seckeris
Yeah, a great question. I think there are a couple of easy interventions we can all make. So number one, and these are things I've done myself. So like I said, I don't think the epidemiologic evidence is strong enough yet to say that, for example, drinking water from a plastic water bottle is going to lead to an increased risk of cancer. We don't know that yet. But if we want to try to be careful and make some easy interventions in our life. One that I've done is to stop drinking water out of plastic water bottles. I use metal water bottles or I use glass lined water bottles when I have a drink of water. Another thing that I do, I don't know about you, but I like to bring in my own lunch to work every day and therefore, and inspiration. I'll pack an extra one for you. Thank you. I think it's a really good way to control what we eat and to avoid the easy trap of eating out or ordering food for delivery. So when I bring my food in, instead of using plastic containers for it, I now Use glass containers and just, you know, cheapo ones that I buy from Target. You don't have to get fancy ones for something like that. So I do these not because again, I want to emphasize this. The epidemiologic studies are not there yet to say that exposure to these substances definitely causes cancer. But you know, I'm playing the odds that. But 20 years from now there won't be a study that's published that says that it was a risk. And look, I modified my behavior 20 years ago.
- [19:36]
Elahe Izadi
And what about pots, pans, spatulas, Teflon? I've read or heard, oh, I should look for ceramic or stainless steel when I'm thinking about pots and pans and spatulas to avoid plastic and fine silicone. Is that what you would recommend as well?
- [19:51]
Dr. Mikhail Seckeris
Yeah. So again, there's a practical aspect to this as well, and that is to buy cookware and that states that it's PFAS free. I try to buy kitchen utensils also that are PFAS free if possible. I also try to, you know, I do my best to consume fresh food that isn't heavily packaged because. Because the packaging itself can contain PFAs or that isn't ultra processed.
- [20:15]
Elahe Izadi
Yeah. So let's go to the bathroom and just think about what are some items that maybe I should avoid or if I'm running out of something, rethinking my replacement. I'm thinking of a, you know, shampoos, conditioners, and even, you know, makeup. And we mentioned floss, menstrual products. What, what are some places I could start?
- [20:36]
Dr. Mikhail Seckeris
Yeah, again, we. You want to try to buy substances that don't have phthalates in them and sometimes they will actually state that they're phthalate free and trying to avoid things that have strong fragrances to them because fragrances, again, may have that DEP in them that I mentioned earlier. So going for more natural products, looking at labels, being a little more attentive to that. Another thing is that sometimes these endocrine disrupting chemicals will be in bottles that have a recycle code, three or seven in them, that those may include BPAs or BPA like substances. So something again to look for if you're really being rigorous about trying to avoid your exposures.
- [21:20]
Elahe Izadi
Yeah. And that's helpful to also think about the recycling label. Like that's something so easy to just look at and see what number that is. Okay. So if I'm looking at the totality of my house and I'm trying to revamp it or think about where do I start? How would I think about it? What's a way I can start that does not feel overwhelming?
- [21:43]
Dr. Mikhail Seckeris
So and again, I don't go crazy about these things. I think we can only modify our lives so much. And as you heard, a lot of these chemicals are ubiquitous. Right. They are everywhere. So it's impossible to avoid them entirely. But I think my biggest take home message for this in all honesty is there are a heck of a lot of other behaviors we can give attention to that have really been shown to reduce our cancer risk unequivocally. Yeah, don't smoke. And if you do smoke, try to stop smoking is responsible for 86% of lung cancer diagnoses, 50% of cancers of the esophagus and bladder, among many other cancer types. Over a 45 year period in the US from 1975 to 2020, smoking cessation programs have been estimated to reduce lung cancer Deaths by almost 3.4 million people. And the good news is that if you do smoke and then you stop smoking, the risk of lung cancer drops by half with 10 to 15 years of smoking cessation and actually falls to almost non smoker levels for those who quit by age 40. So. Right. That's a huge, huge inroad you can make to lowering cancer risk. Another approach, keep alcohol intake to a minimum. And I've written about this in the post about how you know what I do enjoy a beer or two when I'm outside in the sweltering sun and out at a baseball game. Right. But I limit my intake to no more than one to two drinks per week. You want to try to keep that alcohol intake to less than one drink per day wearing sunscreen. I am fair skinned. I freckle easily. Ultraviolet radiation from the sun is responsible for about 6% of cancer cases in men and about 4% of cancer cases in women.
- [23:31]
Elahe Izadi
So sorry with the sunscreen, it's interesting because I think that's also something that comes up for people like oh, some of these sunscreens have lots of chemicals. It's better, I don't even wear it. But is it better to wear a sunscreen or not to wear it? If it's a chemical?
- [23:44]
Dr. Mikhail Seckeris
Yeah. So it's a terrific way that you asked that question. And without getting too controversial, it's like the debate about should you take a COVID vaccine or not. Let me tell you, the health consequences of getting Covid are tremendous. And we're only just at the tip of the iceberg of looking at long term effects of people Who've been exposed to Covid and who've had florid Covid. Compare that to the very, very low risks of getting a COVID vaccine, and there's no doubt about what the approach should be. You take the COVID vaccine to prevent the very real and very mighty risks associated with having Covid. The same is true with sunscreen. Very low risks that we know of of the chemicals contained in sunscreen, Very high, tangible risks of cancer with being exposed to the sun.
- [24:30]
Elahe Izadi
And then the other risk that I think I keep being bombarded with these days is red meat. So just going back to what you were talking about, There are other things that really should be at the top of your list when you're thinking of reducing cancer risk.
- [24:44]
Dr. Mikhail Seckeris
Yeah, yeah, yeah. So it turns out that research has found an association between colorectal cancer and consumption of red meat and processed meat, especially with low dietary fiber and calcium, to the point where processed meat has actually been listed as a toxin by international agencies. Right. Just like some of the chemicals we just discussed. So I am an omnivore. I eat meats, I eat vegetables. But, you know, I remember an interview with Julia Child once where somebody said, gee, in this health conscious world we live in, how can you still cook the way you do? And she looked at the person and said, I don't eat the whole meal. I just eat a little bit. So, you know, her point, though, has always stuck with me. Everything in moderation. So do I enjoy a burger during the summer? Absolutely. How often do I have a burger during the summer? Maybe once a month. No more frequently than that.
- [25:31]
Elahe Izadi
What about once a week? Can I have one once a week? I'm Persian. I like kabab.
- [25:38]
Dr. Mikhail Seckeris
So, yeah, if you love burgers. Listen, everything is about relative risk. We can't be risk free the way we grow up, Right? But we have to choose our risks, choose our pleasures, and choose our tolerance of risk for developing cancer or heart disease.
- [25:53]
Elahe Izadi
Well, I have to tell you, Dr. Secharis, I feel a lot better. I feel more equipped to navigate the world. I feel, like, empower that I understand a little bit more about what I'm interacting with and how to calibrate my concern appropriately. So thank you so much for taking the time to join me.
- [26:10]
Dr. Mikhail Seckeris
I appreciate it. Oh, my God, what a joy it was to be on here. Thank you for having me.
- [26:18]
Elahe Izadi
Dr. Mikel Sikkeris is the chief of the hematology division and professor of medicine at the Sylvester Comprehensive Cancer Center, University of Miami. If you love the show, help other people discover it. You can do this by leaving a rating and comment on Spotify or a rating and review on Apple Podcasts. That's it for Post Reports. Thanks for listening. Today's show was produced by Thomas Lu, with help from Rennie Srinofsky, who also mixed this episode. It was edited by Ariel Plotnick. Thanks to Emily Kotick. I'm Elahe Izadi. We'll be back tomorrow with more stories from the Washington Post.
- [27:17]
C
The Washington Post is known for pulling back the curtain on what's really going on in politics, policy and power. Now we're expanding that mission, introducing Washington Post Intelligence, a new venture to help business executives, policy innovators and thought leaders navigate the unpredictability of business and politics. I'm Martin Katie, the general manager of Washington Post intelligence. As a 20 year editor and reporter on politics and policy in Washington, I know how important it is to have the right tools to make critical decisions for your business. WP Intelligence gives you that with its new Executive Briefing service. Our briefings and analysis are hosted by star analysts like Josh Rogan and Jason Dean, who have decades of experience on global economics, geopolitics, AI and technology. So if you're an executive, policy leader, government or legislative staffer, head over to wpintelligence.com to learn more about this new premium service. Even better, one of our experts will walk you through a demo. Again, that's wpintelligence.com there's information and then there's WP intelligence.