Hi Everyone, Dr. Bernard here.
Proceeds from this video will be donated to Burn Pits 360, a non profit entirely dedicated
to improving post-deployment health outcomes for current and former US military personnel.
If you would like to donate with me, I have included a link to their website, in
the description below.
KT is a 38 year old woman, presenting to her primary care doctor, feeling great.
But, something’s wrong.
You see, KT was born in to a military family.
I grew up in a family that was military.
So we always lived on Marine Corps bases, and we moved following our Marine Corps Father
every 2 years.
I like to joke that it was the 11th commandment in our family that Thou Shalt Join The Marine
Corps.
When she finished high school, she joined the Reserve Officers' Training Corps program,
ROTC, for the United States Marines.
In this program, KT would get a scholarship to go to college first, and then go on active
duty for a number of years.
When she started college, it was years before the day September 11 2001.
And by the year 2005, KT found herself in the Middle East.
I spent 2005 with the 2nd Military Police Battalion over in Fallujah Iraq.
In these days, where US Armed Forces were, didn’t have infrastructure to easily dispose
of waste.
In an effort to more simply manage that waste to keep things clean and prevent contamination
and disease, soldiers would dig a pit in to the ground, throw the trash in, and then light
it all on fire, with jet fuel.
We dug a large pit.
And lit it on fire with jet fuel.
Which now that I say it out loud, sounds like a crazy thing to do.
But we absolutely did, we dumped everything in there.
Old uniforms.
Old batteries, car tires.
The burn pits were the way we disposed of anything on the Forward Operating Base.
Clearly, burning military waste with jet fuel to keep things clean while unleashing toxic
chemicals in to the air for everyone to breathe may seem contradictory, but at the time, the
claim was— there is no evidence yet that these fumes have adverse long term health
effects.
To the people nearby, they wouldn’t just be breathing in smoke, but also particulate
matter, tar, industrial chemicals, heavy metals, gasoline and jet fuel itself.
At the time, it may not have fully registered in the minds of leadership that bad things
may happen in those soldiers’ bodies later in life because of this exposure.
And while she was in Fallujah in the year 2005, KT was exposed to this burn pit.
We all noticed there was particulate matter in the air and that it was in our air conditioning
filters.
It was something we joked about.
It was something we said was gross, but we didnt think more about it than that.
KT’s primary care doctor was aware of her deployment and previous burn pit exposure.
Breathing in toxic burning garbage might not only cause immediate illness, but more and
more evidence shows now that the chemicals observed from those pits have been linked
to long term damage.
And people who otherwise had no risk factors to develop these health issues, are now developing
them.
KT’s primary care doctor referred her to get a mammogram, an X-ray of the breasts to
check for early signs of cancer because of her prior burn pit exposure.
At 38 years old, and feeling great, KT thought there was no point.
Her son was 3 years old, her family life was going well, and her post military career as
a tenure track professor was going well.
And so, she skipped her appointment for the mammogram.
I thought it was unnecessary because of my age, but also because I felt wonderful.
I didnt have any symptoms of breast cancer.
I didnt have any history of it in my family.
I just truly wasn’t concerned about the issue.
I didnt realize at the time, how high the incidence rate of breast cancer in military
people is.
I didnt know that I was at risk.
But at the reschedule just a couple weeks later, KT did get that mammogram.
And something showed up on the images.
Doctors looked deeper and a breast MRI revealed not only a large tumor, but also smaller tumors
next to it, meaning primary care was right— KT did have breast cancer.
Based on the images and physical tumor samples collected at this appointment, it looked like
KT had Stage 2B cancer, meaning it may not have been too advanced.
They caught it early and that makes sense because she was only 38 years old.
Younger people don’t typically have advanced cancer, so everything didnt seem too bad.
Except, doctors did one final test.
They sent radiolabeled sugar into her body to trace metabolic activity.
Cancers can grow fast and aggressively, meaning they would use a lot more sugar and have more
metabolism than regular body parts.
And when THIS scan came back, doctors realized that KT’s cancer wasn’t just in her right
breast.
It wasn’t just early stage disease.
It was all over her bones.
The cancer had spread to her lower back, her hips, and the bones of her thighs.
All of this meaning she had advanced, Stage 4 cancer.
If you do have Stage 2B, nothing else, scans clean, your survival could be way greater
than 93% in 5 years.
Many of them are ending up cured.
If you do have a Stage 4, it's a completely different story of course.
Still as of today, the survival of stage 4 breast cancer in 5 years is around 30% or
so.
In the bell curve, majority of my patients who I say you know, you do have Stage 4 hormone
receptor positive disease, 5 years from now, they’ll be gone.
I said, “So how long does someone with this condition have?”
I now know that she hedged her bets.
She said “I Think you might live 6-10 years.”
I now know that the statistics say 3-5 years but she was thinking I was young, strong and
could tolerate treatments pretty well, so she thought I might get a couple of additional
years.
Typically in a 38 year old, previously healthy woman, you don’t see advanced cancer.
In some cases, we know some people may have genes that could cause them to develop breast
cancer later in life, but KT didn’t have those genes.
And she wasn’t in later life.
She didn’t have a family history of cancer.
Her living environment at the time of diagnosis wasn’t any different than anyone else, she
was living in South Carolina.
She did have a past medical history of squamous and basal cell carcinoma, that is a mild skin
cancer that has nothing to do with breast cancer.
She just didn’t have the known risk factors to develop aggressive cancer like this at
this age.
But what she did have, 13 years earlier, was that she breathed in toxic fumes and particulate
matter every single day, from burning garbage incinerated by jet fuel in a burn pit.
When I was in Iraq, we had burn pits everywhere and we had ash, smoke and black clouds in
our living spaces, in our eating spaces.
It was it was really common.
And now they're finding out that in these burn pits, we were not just burning jet fuel,
but we were burning batteries and all kinds of carcinogenic chemicals.
So there's a risk that a great many service members have been exposed because we were
living on top of it.
I used to run laps around our burn pit in Fallujah.
That was my run route.
I thought nothing of it because at the time I was 25 and invincible, which is the way
you have to convoy around Iraq.
Interestingly, I was stationed with one other woman in Iraq and I ran into her about a year
ago and hadn't spoken to her in a long time.
She has the exact same kind of aggressive breast cancer that I do, the exact same kind.
And it's incredibly rare.
Anecdotally to me that that told me that the burn pits and then contaminated water were
potential exposure risks for me.
When the doctors told KT about her stage 4 breast cancer that had spread to her bones,
she tried to make a claim that her cancer was service related.
That had she not been right next to a pit of burning garbage 24 hours a day, 7 days
a week in 2005, that this probably wouldn’t have happened.
Two oncologists who specialize in breast cancer treatment agreed with this and wrote letters
supporting her claim.
A few years earlier, a registry was established for veterans to place their name on a list
to indicate that they were exposed to burn pits while they were deployed.
But for KT, more evidence was needed on her claim.
More scans over several weeks were needed.
But KT’s terminal cancer was spreading and growing and mutating all throughout her body.
She didn’t have those weeks to wait.
I got a scan.
And they wanted follow up scans as a result of something they say growing.
And they called me and said “we can see you in 6 weeks.”
In the stage 4 environment, 6 weeks is an eternity.
That’s way too long to be waiting for scans.
You can have all kinds of cancer growth going on.
At the hospital, where KT’s private insurance was covering her care, doctors immediately
start treatment.
Surgery won’t work because it had spread all over her bones.
Cutting it out of her breast won’t do anything, because it would just spread further from
her bones, if it hasn’t spread already.
Because she’s 38, KT’s premenopausal meaning every month the hormone levels in her body
fluctuate.
Breast cancer is different from other cancers, partly because breast tissue is sensitive
to those hormones.
We know cancer is an overgrowth.
That something happened to the cells, to cause them to grow uncontrollably.
Cancer growth isn’t natural.
Those cells must have mutated their genes in a way to escape nature.
To acquire some ability to just keep growing and never stop growing.
Or to lose the ability to die when it’s time.
These superpowers mean that cancer cells are similar, but just a little different from
the original regular cells, at least at first.
So if regular breast cells respond to hormones, then the superpower cancer versions of those
cells might still respond to hormones too.
Meaning they can grow even more, because of those hormones, hijacking normal function
for their own benefit and making things worse for the patient.
And in KT, her breast cancer was responsive to hormones.
If KT’s hormones fluctuate every month, and her cancer grows because of those hormones,
then one part of treatment would be to stop the hormone fluctuation.
And that would be done by forcing KT in to menopause using medicines in an effort to
starve her cancer of growth signals.
Around this time, her claim was not accepted, and so she sent in an appeal.
Additional medicines to lock her cancer cells so they couldn’t reproduce any more were
given in an attempt to prevent any more spread and growth.
And things were going well for KT.
Her cancer appeared to be stable disease.
She didn’t need to be on something like chemotherapy, so she wouldn’t lose all her
hair, she thought.
But 10 months later, a scan at checkup found that her cancer was spreading and growing
again, but even worse, the nature of her cancer had changed.
In acquiring superpowers, cancer cells start to change quickly.
The rules of nature just don’t apply to them anymore.
In locking cancer cells with medicine, it’s possible that not all of them would get locked.
Those would survive the medicine, and reproduce, passing on their medicine resistant genes.
But if KT’s cancer was also starved of hormones that were used to grow, well, those cells
that didn’t need hormones in the first place would start to grow too.
And at this first disease progression, KT’s cancer didn’t need hormones to grow anymore.
The cancer couldn’t be locked with that medicine anymore.
All of this meaning doctors switched her to chemotherapy as a way to catch as many cancer
cells as possible.
And everything goes well again for KT.
Her disease is stable again.
Chemotherapy especially targets cells that divide quickly in the body, which are not
only cancer cells, but also hair matrix cells.
And as she was on this chemotherapy, KT lost her hair.
And I asked him, I said, “Do you want mommy to coach your soccer team” he goes, “yes,
but I’d like you to wear your wig.”
And I cried after he said that.
I thought he was embarrassed that I didn’t have hair.
When really what he was saying was, “I Just want my mom to be normal.”
As the months passed, KT was doing well.
But 10 months later, her cancer had progressed again.
It had started spreading, and parts of it, had mutated again.
So when you think about how this breast cancer cells disperse, it comes from the original
destinations and then it goes to most likely to the bone, lung or liver or lymph node or
whatever the destination might be.
Many of these metastatic breast cancer that happens from the get go already have formed
a number of mutations potentially to make the cells smart enough to be able to do that.
So that's what happens a lot of times within the breast cancer cell.
We call it tumor heterogeneity.
And then when these cells actually spread, they also take a different route.
So some cells may have gotten into the bone, some cells may have jumped to the lymph node,
and then they may not have come back, although we think that they're still communicating.
Doctors start different chemotherapies for this mutated version of KT’s cancer, again.
And things were going OK again, until the cancer was found spreading to her liver.
And doctors start her on different medicines, all down these subsequent lines of therapy,
as she’s put on experimental medicine known as clinical trials.
This antibody attaches to a cancer cell and delivers a cytotoxic load of chemotherapy
into the cell.
If it works for people in breast cancer, which is a question mark right now, there’s a
chance that I could see a beating back of the current progression I have in my liver.
Right now, my liver is at risk in terms of function.
Because I have really big tumors in there.
I’m starting to have pain in my sides and actually know that I have cancer in my liver.
It was hard doing this because we had naturally assumed clinical trials are the last Hail
Mary.
You got no options left.
You’re buying as minutes as what you got.
It looks like this is just gonna be the best option.
Hopefully, one that we can tolerate for a very long time.
When something is burning, general rule of thumb is to stay away.
Because solid waste is getting turned into a gas, of which, you are breathing in part
of it.
The gas exchanges in your lungs, to your blood, and then distributes in to human tissue.
We know from the 9 11 first responders that burning building material was linked to long
term, adverse health effects.
But when it comes to burn pits, the toxins released from the waste into the air vary
widely.
And of the chemicals that have been identified, we know that many of them are known carcinogens.
So there was about 18 months of the investigation between the VA and the National Academy of
Science.
What are the chemical materials that actually could be produced by this type of burn pit?
And they discovered more than 20 different chemicals, including benzene, which is like
a big no no from the cancer view that you should not never, ever been exposed to this,
including dioxin, benzenes, and all these chemical particles were generated from the
burn pit.
And nobody even knows that how high all of this exposure actually was.
So if you say in the cancer cell model that if you have a just daily exposure of certain
particles, very, very low, if you have a slight increase of like maybe double even to quadruple
your cancer risk over time really goes up.
But basically what I learned from listening to some of the stories, is they actually had
this kind of raining shower of particles, so these people were inhaling this, on a daily
basis!
So we dont even know what’s the exposure level of the soldiers from these chemicals
from the burn pit.
So to me, it is a seriously health hazard, and even before you go in to the cancer, there
must have been very serious respiratory illness, and some of them may not be reversible.
And the question is, how do we know these chemicals cause cancer?
This brings us back to cancer cells gaining super powers.
Many of the chemicals found in this study have been demonstrated in laboratory cell
models to cause DNA strand breaks.
Have been shown to cause deletions and translocations in the genes, and impair the cell’s ability
to repair this damage.
Some of these chemicals are known to damage the chromosomes, where DNA is tightly bound.
All of this meaning the genes of the cells are broken.
In the best case, the cell dies, and the body cleans it up.
But in the worst case, the cell can’t die, because it gained that super power from mutated
and shifted genes in the body, where it starts to divide and multiply, and its descendants
keep that legacy of defying nature and escaping the body’s defenses.
It becomes a tumor, and then grows in places like KT’s right breast, before spreading
to nearby lymph nodes, then to distant sites like her bones, and then her liver.
And while many of these specific chemicals from burn pits are known carcinogens, there’s
still the particulate matter that was once in the air, but by now 15 years later, has
likely deposited in to the ground.
In Iraq, it’s the desert.
So these particles might have deposited in to sand.
But the thing about sand, is that it blows easily in to the wind.
So, what happens to the local people in these regions when it’s not just sand blowing
around in a dust storm, but possibly toxic particulate matter from burning waste 15 years
earlier?
For KT, her appeal for care, after the first rejection, was again denied.
She was able to continue her care through her private insurance, but her considerations
for her son and her husband have been her #1 priority since her diagnosis.
I am not sure how to prepare a seven year old for losing his mom.
I don’t know how to get him ready.
I worry and I actually have thought all kinds of crazy things, like maybe it would be better
for me to die when he's 10 than when he's 13.
Because at 13 maybe he gets in to rebellion.
So crazy thoughts go through your head.
Every year when he starts school, I have to tell my son's teachers, you know, his mom
has terminal cancer and he might suffer a bereavement this year.
So I really I want them to be aware and be looking for what he needs.
But in terms of how to really prepare him for it, I don't know how to.
I was absolutely willing to die for my country when I joined the Marine Corps.
I just didn't think it would be like this.
Thank you so much for watching.
Take care of yourself.
And be well.