Tuesday, July 19, 2011
Why Did I Get Thyroid Cancer?
On this, the day of my follow-up with my specialist (Endo #4), I will find out the status of the thyroid cancer in my body. At the end of April this year, I completed the Radioactive Iodine Ablation (RAI) aka radiation, I have had two whole body scans and two blood tests since then and now will find out the results. I am feeling pretty hopeful. Months ago, Endo #4 said that chances are pretty likely that I will not require a second therapeutic dose of radiation since I am in a low risk group. I have gauged my condition based on his statement, my own readings on thyroid cancer treatment, and the increased sense of energy I feel.
Being an inquisitive soul however I still have questions and concerns about why I have thyroid cancer in the first place.
What is going on here? The incidence of Thyroid Cancer is rising at a rate of 6% annually in the province of Ontario except in the years 1998-2002 when it more than doubled to a rate of 14.5% per year, amongst females. (I borrowed this quote from the Thyroid Cancer Canada facebook page). I've really got ask what is going on. I have met two women. One knows three friends going through thyroid cancer. Another said she knows five people who've had thyroid cancer. I know two other teachers, both of them women under the age of 35 years old, like myself, who work for the same school board. To learn more about these growing rates in Ontario, read the article Thyroid Cancer Incidence Increasing in Ontario.
Thyroid cancer is also labeled as the "good cancer". Who comes up with these bull*&^ labels? According to the Brian Lobel, quoted in the book Everything Changes, "The idea that there are 'good cancers to have' is a disgusting thought." What a piece of propaganda! After reading Thyroid cancer a growing threat for women, you can see that thyroid cancer is no picnic or vacation. You don't say to people that they have the "best diabetes" or the "best heart disease" or the "best stroke". Cancer is cancer. Besides the fact that the radiation from RAI carries a small risk of getting other cancers, thyroid is not completely isolated.
So I decided to do my best and list some existing theories that I have come across about the origins of thyroid cancer. This is not a conclusive or finite list. Given that research is constant and new reports and articles are published, I will continue to update this list. If you come across any articles on thyroid cancer causes, please send them my way.
Environmental radiation exposure theory
The most commonly linked cause of thyroid cancer is radiation exposure. How did we learn this? From environmental catastrophes such as the Chernobyl accident. According to wikipedia:
The Chernobyl disaster (locally, Chornobyl Catastrophe) was a nuclear accident that occurred on 26 April 1986 at the Chernobyl Nuclear Power Plant in Ukraine (officially Ukrainian SSR), which was under the direct jurisdiction of the central Moscow's authorities. An explosion and fire released large quantities of radioactive contamination into the atmosphere, which spread over much of Western USSR and Europe. It is considered the worst nuclear power plant accident in history, and is one of only two classified as a level 7 event on the International Nuclear Event Scale (the other being the Fukushima Daiichi nuclear disaster).
Given that the Ukrainian (and surrounding people) were not warned about this incident and told to move away in time, this increased their radiation exposure. Through the ingestion of milk (produced by cows who ate radioactive grass) and leafy vegetables contaminated with high doses of radioactive Iodine (I-131, the same isotope used to treat thyroid cancer), children were affected quite early on. Some of these children were exposed while still in the womb.
The environmental impacts of Chernobyl are still felt today. In addition, the Japanese earthquake and the radiation levels emitted from the nuclear reactors have been the focus of news stories for weeks.
Do I live any nuclear power plants? Well, there is the Nuclear Power Plant in Pickering, a smaller city located immediately east of Toronto. I have not been to the Power Plant but I learned from a woman at a vegetarian conference, the one who knew five people with thyroid cancer, that the incidents of thyroid cancer are higher in the Greater Toronto Area (GTA) than other parts of Ontario. Hmmm... I did grow up here all of my life. I wonder if she's right.
Have I had early radiation exposure? Well I did have many x-rays as a child. I do not know if I was given a thyroid guard to wear during that time to protect me from the radiation. However, I found at a conference that the level of radiation from modern x-rays is a lot less than what was administered in the 1950s and 1960s. Those "old skool" doses were very high and are considered the cause of some thyroid cancer diagnoses.
For more information on the thyroid cancer and Chernobyl, read the article:
Chernobyl's Legacy: Twenty-five years after the nuclear disaster, the clean-up grinds on and health studies are faltering. Are there lessons for Japan?
For more information about the radiation risks from the Japanese earthquake, read the article:
Tainted water raises risk of thyroid cancer
Other than environmental radiation exposure, genetic origins are often sourced as the reason for thyroid cancer. However among all of the people I have talked to, including myself, I have not met one who had thyroid cancer in their family. Given that I have a history of hypothyroidism and goiter in my family does predispose me to thyroid-related issues yet I am the first of my relatives that I know has thyroid cancer. According to Richard Beliveau, Ph.D., and Denis Gingras, Ph.D. in Foods that Fight Cancer, genetics only account for 15% of cancer diagnoses. So yes indeed, genetics play a role for some of us.
Early Detection Theory
On the other hand, part of the reason that thyroid cancer rates are on the rise is that detecting thyroid cancer has improved immensely over the decades so the thyroid cancer of our ancestors may have gone unfounded. In a recent Time magazine article called The Screening Dilemma, there is something to be said about early detection. On the last page of the article, I quote:
In a 1985 study, researchers examined the bodies of 101 people who had died of causes other than thyroid cancer and found that a third of them contained cancerous thyroid cells. Because of the sampling method, the researchers knew that they were certainly missing some cases, meaning the percentage was even higher, and yet none of those people were killed by the disease.
This research study indicates that over 30% of people may have thyroid cancer cells in their bodies but it is often not the cause of death. According to David Servan-Schreiber, MD, PhD in the Anti-Cancer, all of us have cancer cells in our body but not all of us will develop cancer.
Perhaps what the Time article suggests is that for most of us, thyroid cancer is in this undetectable stage which does not develop.
Bovine hormone link
I do not know much about this theory but first read about it in Skinny Bitch. Authors Rory Freedman and Kim Barnouin, cite Prosilac, a commercialized form of bovine growth hormone used to increase cow's milk production, as linked to thyroid cancer. Given that this is an American book, this may account for some American thyroid cancer patients. What about us, Canucks? Apparently, bovine growth hormones are not permitted among Canadian cows.
A few articles have indicated a link between weight and thyroid cancer. In fact, like most relationships, it's complicated. It's kind of a "chicken and egg" scenario. Does being overweight cause thyroid cancer? Consequently, does thyroid cancer cause being overweight? I can attest for the fact that "going hypo" (for us Thyrogen-deficient and 'old skool' thyroid cancer patients) may cause weigh gain. (Holla! I have never been overweight but always a "thick" and "big boned" kind of girl.) When you "go hypo", you put your body in a state of extreme hypothyroidism for several weeks. Side effects of this hypothyroidism are bloating, depression, fatigue, hair loss, and, you guessed it folks, weight gain. In addition, some thyroid cancer patients have experienced hypothyroidism a lot earlier especially if it began before their cancer diagnosis. For more on this topic read, the following articles:
Does Extreme Obesity Affect Thyroid Hormone Metabolism?
Is obesity directly involved in causing thyroid cancer?
I just came across this one which erroneously indicates a link between mammograms (scan to test for breast cancer in breasts) and thyroid cancer. I have never had a mammogram (yet) but if you wish to learn more about this theory, read ACR & SBI: Mammo not dangerous to thyroid .
The Ethnic Theory
The theory that Asian people tend to be at a higher risk for thyroid cancer was totally new to me, especially if you are Filipino or Chinese. I first learned about this theory at "Thyroid Cancer: Navigating Support and Education Resources for Patients" presented by Dr. Catherine M. Kelly, MD, FRCPC a Clinical Educator and an Associate Professor of Medicine at the University of Toronto. She is the Division Director of Endocrinology at Women’s College Hospital. Then again, I learned about this theory some more from Kairol Rosenthal, author of Everything Changes, response to my article Money Talks I. So far, I know one person who is Asian and has thyroid cancer. Member of Parliament, Olivia Chow, who I have had the pleasure of meeting on a number of occasions, is Chinese-born. Also, a friend of mine who is Hong Kong Chinese offered to introduce me to a friend of hers who is a thyroid cancer survivor. Lastly, Thyroid Cancer Canada has offered a Patient Forum in Chinese this year. A Chinese language forum would be based on a growing need to provide information and services to this community in their spoken language.
From "The Needs of Canadian Thyroid Cancer Survivors: Building Knowledge and Understanding Through Social Learning",
a report by Patricia Sharkey, I quote:
By publicly sharing her experiences with thyroid cancer, Olivia has been a boundary spanner between Thry’vors and the Canadian-Chinese community, a community where thyroid cancer has a higher incidence. After Olivia’s news release, Thry’vors on-line membership jumped by 15%, many of these new members are from the Canadian-Chinese community.
Amongst all of the thyroid cancer survivors I met and the conferences I have attended, I have not seen a large number of Asians in attendance. However, does the ethnic theory suggest a genetic, dietary, or environmental cause? Hmmm.....
Is it quite possible that diet causes thyroid cancer? I recently read the China Study which indicates the Western diet (low fibre, high animal protein, high animal fat) as a major contributor to cancer growths and recurrences in addition to the other diseases. As I read the chapter about autoimmune diseases, which include Type I Diabetes, Multiple Sclerosis, and lupus, I wondered about thyroid issues. Hypothyroidism and hyperthyroidism (Graves' disease) are both autoimmune disease because they result from a malfunction of the thyroid gland. The thyroid gland is either underactive (hypo) or overactive (hyper) which results from parts of this organ's function being destroyed. Autoimmune means that the immune system begins to attack the healthy tissues of the body causing them not to function properly. According to T. Colin Campbell, PhD and Thomas M. Campbell III, the immune system can become confused when it cannot distinguish between its own healthy tissue and foreign tissues that are sourced from meat. So, in lay man's terms, if I ate beef that had some piece of cow thyroid tissue in it and my immune system recognized that as a foreign invader, it would start to attack and destroy the foreign meat. What Campbell argues is that the immune system loses its ability to distinguish the foreign thyroid tissue from my own thyroid tissue, hence attacks it as well. Okay, okay, that's good for hypothyroidism and hyperthyroidism. What about thyroid cancer? Campbell's theory suggests that animal proteins and fats (from meat) promote cancer growths and recurrences. You've got to read the book to learn more.
So if what Campbell is saying is that a Western diet which is higher in animal fats and animal proteins increases the incidence of cancer, why are Asians getting thyroid cancer at a higher rate? Campbell claims that most of the participants in his China Study ate typically less animal fats and proteins and high plant-fibre. This is complicated. The details of the Asian study, according to Kairol Rosenthal, come out of Washington state. So these Asians would include recent immigrants as well as first-, second-, and third-generation individuals. According to the research, when immigrants leave their country of origin, they often adopt a more Western diet and hence increase their chances of cancer diagnoses. Is this the case for the ethnic connection of being Asian? Hmmm....
For more information about the dietary causes of thyroid cancer, read:
FDA Urged to Prohibit Carcinogenic "Caramel Coloring"
Environmental Chemical Exposure Theory
Okay so I'm reading Kairol Rosenthal's Everything Changes and I come across another theory which I forgot to mention. How could I forget? Starting on 108, she interviews Richard Acker, an environmental lawyer, who at the time of interview was 36 years old, a father of one, and a patient of stage IV colon cancer. He mentioned the fact that we are exposed to environmental toxins on such a regular basis. He also indicates that there are one to two hundred synthetic chemicals in the average person's bloodstream. These are in our clothing, materials, foods, cars, plastics, containers, etc. Who knows the biological and physiological impacts of having so many chemicals in combination with each other inside of our bodies? Acker states that "each chemical" individually "poses a minimum risk", so if you have 150-200 things swimming around in your system, who knows the greater risk they can pose when they get together?
Two resources come to mind on this topic.
First, a book on my reading list is called There's Lead in Your Lipstick: Toxins in our everyday body care and how to avoid them by Gill Deacon.
Plus, there's a little local organization in Toronto called the Women's Healthy Environment Network (WHEN) which focuses on environmental links to health.
Occupational Stress Theory
When I got diagnosed for my cancer, I wondered if it was caused by the stresses associated with my work. I have been a teacher (elementary, middle, and high school) for the last seven years. Being a teacher can be a high stress position. I know, I know. Many people do not see it that way because they think teachers get two months of summer vacation plus two weeks of March Break and Winter Break as well as statutory holidays. This is true and a great reward but teachers do have a tough job. There are all the other tasks that one does not see. Yes, the school day is roughly 6 to 6 1/2 hours long but (a big but here), you are in front of an average of 16-34 students during that time. (These are the sizes of the classes I have taught.) You are not in front of a desk or a computer during this time where you can hide, you're "on". If you are working with younger children, you are more intensively involved with their care. High schoolers are more laid back. I have taught in a variety of schools. I have experienced violent students, hostile parents, slander, harassment, physical assault, you name it. Teaching is not what it used to be. I experienced all this and then you add on the other challenges which include report cards, plans, meetings with staff and parents, extracurricular activities, new initiatives by the province and school board which equals more work, overtime, etc... etc... Don't get me wrong but there are many aspects of teaching to love as well. (Through my twenties, I also busied myself with my Master's degree and founding and running a nationally touring film festival for three years.) So when I was first diagnosed, I felt guilty and thought I caused my cancer somehow by leading a busy lifestyle and stress. (I learned since then that there are other cancer patients who felt this way.) During my recovery period over the last several months, I met 3 other female teachers under the age of 35 (like myself) who work and live in the same city and have been diagnosed with cancer. Two of them have thyroid cancer (like me), one has lymphoma. I have also met retired teachers with cancer. I wondered if the occupational stress related to teaching caused the cancer but then this logic does not add up. Teaching is a female dominated profession and there are lots of teachers out there. (Like nurses and I have met a few nurses with cancer.) Teachers are great about educating themselves, researching, and accessing resources which explains why I met these women through the support groups and activities in which I participate. I do know that some occupations, such as mining and welding, have some health hazards which may lead to some forms of cancer because of the exposure to carcinogenic chemicals. However I do not believe this is my case. Cancer does not discriminate by occupation.
Past Lives/Karma Theory
On August 1, I began to read a book called Lotus in the Fire: The Healing Power of Zen by Jim Bedard. The book describes the his healing journey from acute myeloid leukemia or AML. As a practicing Buddhist, Bedard believes in the concepts of karma and "past lives". Karma meaning that things do not occur by chance but by causation. Before diagnosis, the author who led an otherwise very healthy life as a former martial arts instructor, athlete, and vegetarian found himself sick and weak undergoing intensive care as well as severe side effects from his chemotherapy. Essentially he believes the cause of his cancer is deeds caused in "past lives" by those who came before him. Suffering and death are inevitable in life so Bedard interpreted his cancer as an opportunity to experience his karma and hence a blessing. I am still reading the book nor am I all that familiar with Buddhist philosophy so I am not sure if I am quoting this all correctly. However, I will add some more to this theory as I continue.
There are a whole school of theorists who believe that cancer is a manifestation of stressful live events and/or mental states. It is similar to the Past Lives/Karma Theory. I have read a few books by these theorists and reviewed them. See my book reviews of the Anti-Cancer David Servan-Schreiber, MD, PhD , You Can Heal Your Life by Louise L. Hay, LOVE, MEDICINE & MIRACLES: Lessons Learned About Self-Healing from a Surgeon's Experience with Exceptional Patients by Bernie S. Siegel, M.D., and Anatomy of the Spirit: The Seven Stages of Power and Healing by Carolyn Myss, Ph.D. This is quite a popular school of thought as I learned and perhaps one of the most popular proponents of this theory is Louise L. Hay who claimed that she cured her cervical cancer through positive thinking, affirmations, and forgiveness. Hay has built an entire industry on these theories including books, CDs, DVDs, and workshops. In the beginning of my diagnosis, I found these types of theories quite encouraging and useful on figuring out how to treat thyroid cancer. According to Hay, cancer is caused by deep resentments that stem from childhood and eat away at the body. Thyroid ailments are caused by humiliation and lack of self-expression. In Everything Changes: The Insider's Guide to Cancer in Your 20s and 30s by Kairol Rosenthal, the author who is a thyroid cancer survivor claims that she has never had a problem with self-expression and does not agree with Hay's theory. Similarly, Dr. Myss also links thyroid ailments to emotional issues. Myss associates the thyroid with the fifth chakra— the will and the sacrament is Confession. This has to do with having faith, giving up one’s fear, and surrendering to God’s will. She suggests that the greatest act of will in which we can invest our spirits is to choose to live according to certain rules including making no judgments and having no expectations. Hmmmm.... food for thought.
This one was sent to me by fellow Thy'Ca survivor Lindsay. She says that in Europe fluoride is used to suppress hyperthyroidism. In Canada, fluoride is present in our drinking water and many brands of toothpaste. There is an article about a link between thyroid issues and fluoride. Here is the link:
Fluoride & the Thyroid