A Summary of Stakeholder Meetings
If you had $18 million, which research would you fund?
A Summary of Stakeholder Meetings
For the California Breast Cancer Research Program's
Special Research Initiatives
March-April 2007
Introduction
"If you had $18 million, which research would you fund?” The California Breast Cancer Research Program (CBCRP) posed this question to interested members of the public at six Stakeholder Meetings in late March and early April, 2007. The meetings were part of the planning process for the CBCRP's Special Research Initiatives, an $18 million effort to investigate two intertwined questions:
- What role does the environment play in breast cancer?
- Why do some groups of women bear a greater burden of this disease?
The CBCRP's vision is to support research that not only increases scientific knowledge about these two questions, but also creates solutions that will prevent this disease and decrease the suffering caused by breast cancer. Participants in the Stakeholder Meetings were asked to brainstorm ideas that could lead to a coordinated statewide effort—taking advantage of California's geographic variation, ethnic diversity, and many research institutions—to significantly move breast cancer research forward.
The Stakeholder Meetings were held in Ukiah, Fresno, Los Angeles, and San Francisco. Two teleconferences provided further opportunities for input. Almost 200 people attended the six meetings, including breast cancer survivors and advocates, environmental activists, research scientists, staff from community-based organizations and government agencies, physicians and other healthcare professionals, and students. Participants first saw a slide presentation highlighting previous research into the role of the environment in breast cancer and the reasons why some groups of women bear a greater burden of the disease. This slide presentation can be viewed at www.CABreastCancer.org/sri/reports/.
All the ideas suggested at the Stakeholder Meetings, plus ideas submitted online via the CBCRP's website, are being collected and synthesized by the CBCRP staff and the Special Research Initiatives Steering Committee. The Steering Committee is a group of nationally prominent leaders with expertise in the impact of the environment on breast cancer and the reasons why some groups of women bear a greater burden of the disease. Meeting participants and those who submitted online are being invited to rate the ideas for impact and feasibility.
Next, the ideas go to the Special Research Initiatives Strategy Team. This is a panel of experts from across the nation who will use the ideas and other information collected by the CBCRP to develop promising strategies for the Special Research Initiatives. For more on the Strategy Team and Steering Committee, see www.CABreastCancer.org/sri/advisors.
In the
final step, the CBCRP's highest decision-making body, the California Breast
Cancer Research Council, will choose the research to be funded.
Here's a sampling of ideas brainstormed at the Stakeholder Meetings:
Create the Tools Needed to Make This Type of Research Possible
Develop better biomarkers to measure past exposure to toxic chemicals that don't stay in the body.
Either improve data in the California Cancer Registry, or hold in-depth interviews with women diagnosed with breast cancer, to get information about:
- Occupations of women diagnosed with breast cancer
- Which toxins the woman with breast cancer's mother was exposed to during pregnancy, and toxic exposures that affected her father
- History of exposure to radiation in women diagnosed with breast cancer
- Early childhood toxic exposures of women diagnosed with breast cancer
- Residential histories since birth of women diagnosed with breast cancer
Research for Social Change
Conduct research on how to achieve social change to reduce the impact of breast cancer, including:
- Investigate how to get policy makers to adopt the precautionary principle, requiring chemicals and products to be proven safe before they are used.
- Find out whether hormones in beef and chicken are causing breast cancer, and, if so, study how to enact the policy changes that will ban this use of hormones.
- Investigate how to get treatment research to women with breast cancer who can't pay for their treatment, including access to experimental treatments.
- Do research in a way that's convincingly clear to corporate and government policy makers that things that are bad for our health need to be changed.
- Pursue research strategies that will lead to reform of the healthcare system and chemical regulation policies.
Exposure to Toxins from the Environment
Develop a multi-ethnic research cohort of women to study over time. Link their residential history to toxic exposures they would have had, using California's registries of pesticides and other chemical use. Measure their body burdens of persistent chemicals and collect tissue samples. Look for differences between women who are diagnosed with breast cancer and those who are not.
Investigate:
- Combined effects of exposure to low doses of multiple chemicals
- Body burden of toxic chemicals in women diagnosed with breast cancer, in relation to the progression of their disease
- Exposures from the environment, such as moderate sunlight exposure, that may protect against breast cancer
Differences Among Ethnic Groups
Study whether differences in breast cancer among ethnic and racial groups could be due to:
- Differences in birth weight and timing of weight gain throughout life, which may affect the body burden of chemicals
- Differences in air quality experienced by various ethnic groups
- Differences in levels of social support
- Differences in women's and girls' baseline estrogen levels at various life stages
Women who are low-income or members of some ethnic minorities have less chance of surviving breast cancer, once they are diagnosed. Find out if this is due to:
- Lack of knowledge about breast cancer and medical care
- Lack of access, or lack of awareness of access, to medical care
- Language barriers
- Cultural beliefs
- Transportation
Groups with Higher or Lower Rates of Breast Cancer
Investigate:
- Immigrant populations from countries with low rates of breast cancer
- Clusters of breast cancer cases in Los Angeles County
- Environmental causes and social stressors in relation to breast cancer rates among African American, Latino, and Asian residents of San Francisco's Bayview-Hunters Point neighborhood
Building on the research showing that women with higher incomes, more education, and white collar jobs have higher rates of breast cancer, find out:
- Whether breast cancer rates are also higher among women whose parents or grandparents had higher incomes and education levels
- If aggressiveness of tumors varies with income and education levels
Rural-Urban and Other Geographic Variations in Breast Cancer
Building on the research showing that rural women have lower rates of breast cancer than urban women, find out if this is due to rural women:
- Experiencing less stress
- Being exposed to less pollution
- Being exposed to less light at night
- Drinking well water vs. city water
- Living in buildings that have fewer toxins used in building materials
- Getting more exercise (if in fact they do)
- Having lower exposures to pesticides, because urban women are exposed to indoor pest control chemicals and garden chemicals
Find out whether migrating from a rural area to an urban one, or vice versa, changes women's breast cancer risk or the course of her disease after diagnosis.
Compare differences in tumors, such as whether they depend on estrogen or not, in women in various geographic locations in California, to see if this reveals environmental patterns.
Could Variations in Breast Cancer Among Occupations Reveal Causes?
Find out:
- Whether women in occupations with high chemical exposure, such as nail salon staff and farmworkers, have more breast cancer.
- Whether nurses and teachers have high rates of breast cancer due to exposure to electrical and magnetic frequencies (EMF) by having women in these occupations wear EMF meters.
- Whether hair stylists' exposure to chemicals and EMFs is causing them to get breast cancer.
- Whether electronics workers in high-tech "clean rooms" are getting breast cancer due to exposure to solvents.
- Whether women employed as cleaners and housekeepers have higher breast cancer rates caused by exposure to cleaning products.
Farming Practices and Breast Cancer
Does working with pesticides in agriculture as a young woman, or growing up in pesticide-treated fields, lead to breast cancer later in life?
Compare changes in agricultural practices over time with changes in the rates of breast cancer in nearby communities.
A Virus?
Do infectious agents, such as viruses, cause breast cancer?
Safer Personal Care Products
Find:
- A safe sunscreen that doesn't contain ingredients that may cause cancer
- Safe cosmetics that do not contain ingredients that promote growth in laboratory breast cancer cell lines
Co-Sponsors
Many thanks to the organizations and institutions co-sponsoring the CBCRP's Special Research Initiatives Stakeholder Meetings: Breast Cancer Action, Breast Cancer Fund, California Black Women's Health Project, California Health Collaborative, Cancer Resource Center of Mendocino, Commonweal, Health Education Council, Physicians for Social Responsibility-Los Angeles, Physicians for Social Responsibility-San Francisco Bay Area Chapter, UC AAPI Policy Initiative, UC Davis Cancer Center, UCSF Comprehensive Cancer Center, UCSF National Center of Excellence in Women's Health, Zero Breast Cancer.
