Dr. Ralph Moss is usually very focused on cancer treatments, so that's an important move. He is read widely.
HERE AT THE MOSS REPORTS
This week I begin a three-part series concerning the safety of devices such as cell phones that emit radiofrequency energy fields. Do these energy fields cause or predispose to the development of cancer? Controversy still swirls around the issue. While some researchers have concluded that the risk is minimal, others are less sanguine. A weak but statistically significant link has been established between residential exposure to energy emissions from nearby power lines and the development of a small percentage of childhood leukemias, for example (Greenland 2000; Ahlbom 2000). Researchers have repeatedly demonstrated that radiofrequency electromagnetic fields are capable of disrupting physiological processes at the cellular level, leading, among other things, to the accumulation of free radicals within the cell, and have proposed that such disturbances may in turn create conditions in which malignant change can more easily take place.
Yet agencies such as the American Cancer Society continue to issue blanket reassurances that cell phones, microwave ovens, power lines and other radiofrequency energy-emitting devices are safe, and do not contribute to the incidence of cancer.
What are we to make of these contradictory pronouncements? This is not the only sphere in which the research suggests cause for concern while the agencies charged with protecting the public’s safety insist that there is nothing to worry about. While research is still in progress the debate should remain open, yet all too often the attitude of these agencies can suggest at best a willful complacency, and at worst a stubborn and paternalistic refusal to acknowledge even the need for a continued dialog on the subject.
DO RADIOFREQUENCY ENERGY FIELDS CAUSE CANCER? PART ONE
Do devices such as cell or mobile phones, that emit radiofrequency electromagnetic fields (RFEMF), cause cancer? According to the American Cancer Society (ACS), this is just another widespread "cancer myth" that is befuddling the minds of the American public. A recent ACS "cancer literacy" poll found that 30 percent of the general public agrees with the proposition that electronic devices, like cell phones, can cause cancer in people who use them.
Ted Gansler, MD, MBA, Director of Medical Content, American Cancer Society, blames the persistence of this belief on litigious lawyers and the sensationalist media. "Alarming front-page coverage," he says, is primarily to blame. The reality, says Dr. Gansler, is that although "a few studies have suggested a link with certain rare types of brain tumors the consensus among well-designed population studies is that there is no consistent association between cell phone use and brain cancer" (Gansler 2005).
"What has been proven," Dr. Gansler adds, "is that using a cell phone while driving increases the risk of having a car accident. So, keeping your hands free and your eyes on the road is a more significant issue for people who use cell phones" (Gansler 2005b) - as if one potential danger canceled out the other!
Furthermore, according to Dr. Gansler, "considerable research has also found no clear association between any other electronic consumer products and cancer."
Dr. Gansler points out that while ionizing radiation such as gamma rays and X-rays can increase cancer risk by causing changes to DNA in cells of the body, low frequency, non-ionizing radiation [such as that emitted by cell phones, ed.] does not cause these DNA changes.
This statement, as far as it goes, is true. However, direct damage to the DNA is not the only way in which harm could be done. Dr. Gansler ignores the possibility that exposure to radiofrequency energy might bring about damage indirectly, through subtle physiological effects on cellular functions. It has been established, for example, that radiofrequency electromagnetic fields can induce a wide variety of physiological changes in cell membranes, signaling pathways, cell growth cycle regulation, and other metabolic processes within the cell.
It has also been suggested that radiofrequency electromagnetic fields may cause what are called 'epigenetic’ changes. Epigenetic changes are minute alterations in gene expression, which are brought about by environmental influences. Such alterations in the settings of individual genes can have far-reaching results – as, for example, when a protective gene is deactivated, or a dormant gene switched on. Epigenetic changes, in other words, even though they do not involve direct damage to the DNA, can cause radical alterations in gene expression and cellular functions that can last a lifetime, and that may result in a significantly increased risk of an individual developing cancer and other diseases.
Effects on Melatonin
Furthermore, radiofrequency electromagnetic field exposure may possibly exert a disruptive effect on the body’s hormonal systems, with wide-ranging consequences. As researchers at the Fred Hutchinson Cancer Research Center in Seattle have shown, RFEMF is capable of suppressing pineal gland production of the hormone, melatonin. Melatonin may exert a protective effect against cancer, and depressed melatonin levels may in turn predispose towards the development of cancer (Davis 2001).
Other subtle changes in metabolic norms may also be induced by radiofrequency emissions. This summer, Turkish scientists at Suleyman Demirel University published a paper showing that exposure to 900 MHz electrical fields (the kind typically emitted by cellular telephones) suppresses production of TSH (thyroid stimulating hormone) and thyroid hormones in rats (Koyu 2005).
They have also shown that long term RFEMF exposure can lead to chronically increased levels of free radicals, which, coupled with a concomitant decrease in key antioxidant systems in the brain, can lead to a heightened risk of brain cancer. Interestingly, these researchers found that the increased risk of brain cancer could be substantially offset by administration of the dietary supplement, gingko biloba (Ilhan 2004).
A weak but consistent association between exposure to RFEMF and the development of childhood leukemia has been demonstrated. In 1999, the US National Institute of Environmental Health Sciences (NIEHS) concluded that although the evidence was not strong, there were still reasons for caution. The NIEHS rationale, according to its own website, was that "no individual epidemiological study provided convincing evidence linking magnetic field exposure with childhood leukemia, but the overall pattern of results for some methods of measuring exposure suggested a weak association between increasing exposure to EMF and increasing risk of childhood leukemia. The small number of cases in these studies made it impossible to firmly demonstrate this association. However, the fact that similar results had been observed in studies of different populations using a variety of study designs supported this observation."
Clearly therefore, even though the association between RFEMF and disease is still very much under investigation, there are definite grounds for concern.
Last week we spoke about the possible link between radiofrequency electromagnetic fields (RFEMF), such as are emitted by cell/mobile phones, and cancer. We continue the discussion this week.
Dr. Ted Gansler, with the full authority of the American Cancer Society (ACS) behind him, confidently assures us that people who worry that there may be an association between cell phone use and cancer are victims of an urban myth. Why, then, does Dr. Gansler feel the need to provide a website address for the Food and Drug Administration Center for Devices and Radiological Health (CDRH), which "offers advice to people concerned about their risk." He continues: "Experts from the CDRH explain practical ways to minimize exposure to radio frequency radiation while using a cell phone. Also, there’s the option of using digital rather than analog telephones."
I find this rather strange. If cell phones and other electronic devices are as innocuous as Dr. Gansler asserts then why does he encourage people to learn how to minimize their risk? Dr. Gansler and his ACS colleagues appear to be unaware that the FDA’s stated position is that "[i]t is generally agreed that further research is needed to determine what effects actually occur [from RFEMF exposure, ed.] and whether they are dangerous to people" (FDA 2002).
What the Science Shows
There are hundreds of published articles on the subject of radiofrequency electromagnetic fields and the possible association with diseases including cancer. Scientists in this field primarily must rely on laboratory and epidemiological data (i.e., population-based studies), but these often reach ambiguous or contradictory conclusions. For instance, a recent review by scientists at the Medical College of Wisconsin, Madison, was generally dismissive of a causal link between RFEMF and cancer, calling evidence for such a link "weak."
However, while the authors felt that a straightforward cause and effect link remained unproven, the article concluded: "...the existing epidemiology is limited and the possibility of epigenetic effects has not been thoroughly evaluated, so that additional research in those areas will be required for a more thorough assessment of the possibility of a causal connection between cancer and the RF energy from mobile telecommunications" (Moulder 2005).
The key word in my opinion is "limited." The bottom line is this: almost all reputable researchers in this area concede that it is really not yet definitively known whether or not radiofrequency electromagnetic fields do increase the risk of cancer. Some people take this as confirmation of their view that such devices are safe. But one would think that while the issue is still very much under investigation it would be wisest for the ACS not to brand concern about RFEMF prematurely as just another "cancer myth." It seems to me to be arrogant to declare the debate closed while the near unanimous opinion in the scientific world is that the issue is still far from settled.
Some Studies Find a Link
Many scientists dismiss the possibility that RFEMFs can cause cancer. But a minority disagrees. Briefly, here are just three of the current and recent studies that have indicated a link between radiofrequency electromagnetic fields and malignancy.
In the eyes of some researchers, in fact, "there is a growing amount of evidence about the harmful effects of EMFs [electromagnetic fields, ed.] on the human body, the most dangerous of which is the possible carcinogenic effect." So wrote Israeli scientists in reviewing the overall field in the spring of 2005 (Beniashvili 2005).
Drs. Leeka I. Kheifets and C. Chantal Matkin, of the Electric Power Research Institute (EPRI) in Palo Alto, California agree with many others that "most of the epidemiologic data do not provide strong support for an association between EMF and breast cancer." However they also state that because of the limited statistical power and the possibility of bias in much of the existing data, "it is not possible to rule out a relationship between EMF and breast cancer" (Kheifets 1999).
Significantly, EPRI is generally a pro-industry group, which includes almost 1,000 energy producers as members. As of 2001, 27 of its 30-member Board of Directors represented utility companies. Some people turn up their noses at such overtly partisan institutions. But my feeling is that pro-industry researchers would on the whole be less likely than more independent scientists to warn of the potential risks of EMF exposure, so the fact that these researchers acknowledge the possibility of a breast cancer/EMF link is very significant.
Again, I want to emphasize that most research in this field concludes that electromagnetic field exposure, at least that emanating from power lines, is harmless. Yet even among this body of literature there are a few disturbing trends in some of the data. For example, in a meta-analysis performed at the University of Cologne, Germany, Prof. Thomas C. Erren found a 12 percent increased risk of cancer in women and a 37 percent increase in men that seemed attributable to EMF exposure. Yet, like most scientists in the field, he adds a note of caution, noting "probable misclassification of exposure and the possible misclassification of the disease itself."(Erren 2001)
Scandinavian researchers have identified an increased risk for acoustic neuroma (i.e., a benign tumor of the eighth cranial nerve) in cell phone users, and a slightly increased risk of malignant brain tumors such as astrocytoma and meningioma on the same side of the brain as the cell phone was habitually held. However, the authors of this latter study have acknowledged some methodological concerns, and further investigations are planned in order to determine whether such an association can be definitively established with statistical significance (Hardell 2004 and 2005).
Most recently, the aforementioned Dr. Djemal Beniashvili and other scientists at the Edith Wolfson Medical Center, Holon, Israel postulated a link between exposure to power frequency fields and breast cancer in elderly women. They made an extensive study of medical records extending over a period of 26 years, involving the analysis of over 200,000 biopsy and surgery samples. They then compared the breast cancer rates in elderly women from an earlier period (1978-1990) to a more recent period (1991-2003), which has been characterized by a much more extensive use of personal computers (more than 3 hours a day), mobile/cell telephones, television sets, air conditioners and other household electrical appliances.
Among the elderly women who developed breast cancer in the first time frame, 19.5 percent were regularly exposed to power frequency fields. But in the more modern period 51.1 percent were so exposed, mainly through the use of personal computers. The authors conclude: "There was a statistically significant influence of EMF [electromagnetic fields, ed.] on the formation of all observed epithelial mammary tumors in Group II." This represented a more than two-fold increase, which was considered highly significant (Beniashvili 2005).
Of course, many other environmental factors have changed since the period 1978-1990, but increased environmental exposure to power frequency fields is among the more conspicuous changes to have taken place. And while there is a body of evidence that contradicts the findings of Dr. Beniashvili and his colleagues, again, there are many aspects of this question that remain to be clarified. The issue is far from conclusively settled.
It is therefore highly inappropriate for the ACS to deride the misgivings of the public on the question of radiofrequency electromagnetic fields and their possible association with cancer. I have seen the credentials and motivation of those who raise doubts about the safety of RFEMF questioned. However, the researchers who have raised doubts about the safety of RFEMFs are neither avaricious lawyers nor sensation-seeking journalists, but serious scientists, trying to do an important job in a rational, dispassionate way. For example, the senior author of this Israeli paper, Dr. Itzhak Zusman, is himself the author of 139 PubMed-listed articles, 80 of which relate to cancer. S. Ozen, who coauthored the paper on EMFs and thyroid function, is similarly well established, with 212 PubMed-listed papers to his credit.
What To Do
While it is far from clear that there is a cause and effect relationship between cell phones (or RFEMF in general) and cancer, too little is known about the actual effects to dismiss the possibility out of hand, the way the ACS does. Caution would therefore be advised. History is filled with examples of "perfectly safe" environmental factors that later turned out to be harmful, if not disastrous. As a child, I badgered my mother to let me have my feet fluoroscoped in the local shoe store. A cautious lady, she limited my exposure to a single occasion during which I got a brief and eerie glimpse of the bones in my feet. These machines were later banned after some were found to be pumping out as much as 116 roentgens of radiation - a huge dose for a trivial purpose.
As a young man I also listened to advertisements touting the health benefits of tobacco by TV personality Arthur "Buy 'Em By the Carton" Godfrey, among many others. Even the American Medical Association (AMA) accepted tobacco advertising in its journals, with such statements as, "They won't harm anybody. They will prove enjoyable." Arthur Godfrey himself later died of emphysema, a disease most commonly caused by smoking.
And even though I am generally cautious when it comes to prescription medications, I succumbed to the blandishments of the pharmaceutical companies and took Vioxx for a backache – and even prevailed upon a naturopathic physician friend to do the same. Everyone now knows that Vioxx turned out to greatly increase the risk of heart attacks and strokes.
Click on or go the the following address for my earlier newsletter on Vioxx: http://www.cancerdecisions.com/010905.html
However, one is never too old to learn caution. Thus, while I am writing this newsletter on a laptop computer that is literally on my knee, I have placed between it and my body a thick sheet of lead from the hardware store, encased in a comfortable flannel sleeve. I have even bent the front of the shield into a wide lip, because tests with a hand-held Gaussmeter tell me that much of the electromagnetic radiation leaks from the front of the machine, although the intensity of the reading drops off dramatically within a few inches from the screen. In general, I try to reduce all unnecessary exposures to electromagnetic fields, especially while I am sleeping, by switching off the electric blanket and keeping electric appliances such as radios, clocks, etc., away from my bed.
I do own and sometimes use a cell phone, but limit my exposure to its electromagnetic fields. I generally try to use it in speakerphone mode and limit the length of conversations as much as possible. And I take supplemental antioxidants with the intention of reducing free radical damage.
In this, as in other matters, I think the Precautionary Principle applies. If the consequences of an action concerning the use of technology are unknown, but are possibly highly negative, then it is better to limit exposure rather than risk the uncertain, but possibly very negative, consequences.
In my opinion, the ACS has insulted the thinking public and done a disservice to honest scientists who are trying to study the possible link of EMF exposure and cancer. The issue is hugely important. Cell/mobile phone use has doubled since 2000, and at present there are 1.5 billion subscribers worldwide (Garfield 2004).
By attaching derogatory labels to those who are on the opposite side of the debate from themselves, the researchers at ACS will no doubt please the $112 billion cell phone industry. But this does not advance public understanding. It merely stigmatizes as irrational all those who oppose unrestricted technological change and thereby hampers a necessary scientific and public dialogue.
Ahlbom A, Day N, Feychting M et al. A pooled analysis of magnetic fields and childhood leukemia. Br J Cancer. 2000;83:692-8
Beniashvili D, Avinoach'm I, Baasov D, et al. The role of household electromagnetic fields in the development of mammary tumors in women: clinical case-record observations. Med Sci Monit. 2005;11:CR10-3.
Davis S, Kaune WT, Mirick DK, et al. Residential magnetic fields, light-at-night, and nocturnal urinary 6-sulfatoxymelatonin concentration in women. Am J Epidemiol. 2001;154:591-600.
Erren TC. A meta-analysis of epidemiological studies of electric and magnetic fields and breast cancer in women and men. Bioelectromagnetics, 2001;5:105–19.
Food and Drug Administration (FDA). What biological effects can be caused by RF energy? Last updated April 3, 2002. Retrieved July 30, 2005 from: http://www.fda.gov/cellphones/rf-energy.html#2
Gansler T, Henley SJ, Stein K, et al. Sociodemographic determinants of cancer treatment health literacy. Cancer. 2005;104:653-60.
Gansler, T. Do cell phones cause cancer? American Cancer Society website, 2005b. Retrieved from: http://www.cancer.org/docroot/PED/content/PED_11_1_Do_Cell_Phones_Cause_Cancer.asp
Garfield, Larry. Mobile phone usage doubles since 2000, but growth to slow. Infosync World News Centre, Dec. 15, 2004. Retrieved from: http://www.infosyncworld.com/news/n/5636.html
Greenland S, Sheppard AR, Kaune WT, et al. A pooled analysis of magnetic fields, wire codes, and childhood leukemia. Childhood Leukemia-EMF Study Group. Epidemiology. 2000;11:624-34
Hardell L, Mild KH, Carlberg M, et al. Cellular and cordless telephone use and the association with brain tumors in different age groups. Arch Environ Health. 2004;59(3):132-7
Hardell L, Carlberg M, Mild KH. Case-control study of the association between the use of cellular and cordless telephones and malignant brain tumors diagnosed during 2000-2003. Environ Res. 2005 Jul 12
Ilhan A, Gurel A, Arcutcu F, et al. Ginkgo biloba prevents mobile phone-induced oxidative stress in rat brain. Clin Chim Acta. 2004;340:153-62.
Kheifets LI, Matkin CC. Industrialization, electromagnetic fields and breast cancer risk. Environ Health Perspect. 1999;107:145:154.
Koyu A, Cesur G, Ozguner F, et al. Effects of 900 MHz electromagnetic field on TSH and thyroid hormones in rats. Toxicol Lett. 2005;157:257-62.
McCurdy AL, Wijnberg L, Loomis D, et al. Exposure to extremely low frequency magnetic fields among working women and homemakers. Ann Occup Hyg. 2001;45:643-50.
Moulder JE, Foster KR, Erdreich LS, et al. Mobile phones, mobile phone base stations and cancer: a review. Int J Radiat Biol. 2005;8:189-203.
Scott A, Dana KM, Stevens RY: Residential magnetic fields and risk of breast cancer. Am J Epidemiol, 2002;155:446–54.
Information on EPRI retrieved July 30, 2005 from: http://www.cspinet.org/integrity/nonprofits/electric_power_research_institute.html
Information on fluoroscopes retrieved July 31, 2005 from: http://www.straightdope.com/classics/a2_414a.html
Information on American Medical Association and tobacco retrieved July 31, 2005 from: http://www.thoracic.org/chapters/
(NIEHS website: http://www.niehs.nih.gov/emfrapid/booklet/results.htm
Thanks to the following for reading and commenting on all or parts of this article: D.S. Beniashvili, MD, of the Department of Pathology, E Wolfson Medical Center, Holon, Israel; Scott Davis, PhD, MS, Professor and Chairman of the Department of Epidemiology in the School of Public Health and Community Medicine at the University of Washington; and Professor John E. Moulder, PhD, Director of Radiation Biology, Department of Radiation Oncology, Medical College of Wisconsin.