Sandra Steingraber weaves her personal story of developing bladder
cancer as a young adult with a scientific review of the state of environmental
causes linked with cancer in Living
Downstream: An Ecologist’s Personal Investigation of Cancer and the Environment.
The result is a touching story that engages audiences and reminds them of the
devastating personal effects that cancer has on individuals, families, and
communities as well as a review of the current state of knowledge and a charge
that communities should demand limitation of exposures to contaminants even in
the face of incomplete evidence that certain contaminants cause cancer.
“How much evidence do we need before we act?” This question
was posed to a group of academic and governmental agency scientists about a
year ago during a workshop I was taking on amphibian and reptile diseases. The
speaker was a young scientist studying amphibian immune response to the deadly
chytrid fungus. She was focused on the mechanism of how the pathogen leads to
disease in amphibians, but she made a point that the focus on the mechanisms is
not essential to put into place strategies for conservation of populations in the
wild. It seems that since that time this question has come up again and again,
especially during this seminar. How much evidence do we need that amphibian are
declining from disease before we act? How much evidence do we need to know
where to place protected marine sanctuaries? How much evidence do we need about
climate change before we enact policies? How much evidence do we need about
environmental causes of cancer before we limit our exposures? The answer to
this question seems to becoming a bit clearer. Well, at least we know what we
don’t need. We know we do not need
perfect data to move forward with action.
Steingraber convincingly makes the case that we know that
our mothers, sisters, husbands, fathers, and children are suffering increased
incidence of cancers that could be caused by environmental exposures of classes
of contaminants that mimic hormones of the human body. And though the data are
not perfect, there is enough evidence to suggest that limiting our production
and release of these compounds may reduce cancer incidences. Steingraber
artfully makes this argument by summarizing a massive amount of literature on
documented causes of cancers. She deftly describes why it is so difficult
statistically and experimentally to prove this point beyond doubt while at the
same time pulling on the readers emotions as she relates her own experiences of
living with cancer. While I am convinced that she is making an important point
that the public needs to hear and in a way that would connect with many readers,
I am anxious to see if she proposes how we become a community that demands the
precautionary principle over the financial gains of industry.