"Talcum Powder and Fibroids"
If you randomly select a group of women
and ultrasound their uterus,
the majority of them have fibroid tumors by age 50,
and by most, I mean, more than 80% of black women,
and about nearly 70% of white women.
Half of white women already have fibroids
by their early 40s,
and the same could be said
for African-American women in their mid 30s.
After getting over the shock
of how widespread fibroids are,
the next question becomes, why the racial disparity.
Is it diet, stress, environmental exposures?
Maybe whatever it is could offer a clue
as to what causes fibroids.
For example, African-Americans tend to have
a lower intake of fruits and vegetables,
and fruits and vegetables appear protective
against fibroids, particularly citrus,
here in the Black Women’s Health Study,
though not apparently just citrus juice.
It’s interesting, if you measure the levels of beta-carotene
in fresh surgical tissue samples of uterine fibroids
and adjacent normal uterus tissue
obtained during hysterectomies,
you find significantly lower concentrations in the fibroids.
In fact, beta-carotene was not even detectable
in half the fibroid specimens.
The same thing is actually found in cancer.
Most cancerous tissues tested
had undetectable levels of beta carotene,
compared to the normal tissue
right next to the tumor.
So, maybe decreased levels of beta-carotene
somehow plays a role in causing these conditions?
Sounds like a bit of a stretch,
but you don’t know...
until you put it to the test.
But, there had never been a randomized controlled clinical trial
of fruits and vegetables for fibroids..
until, never.
They did do a randomized controlled trial
of kind-of-a-fruit-and-vegetable-
at-the-same-time—tomatoes—
but for the prevention of fibroids in Japanese quail,
and most of my patients are not Japanese, nor quail.
The action of lycopene, the red pigment in tomatoes,
“in an animal model may not accurately represent
lycopene action in humans.”
And indeed, the Harvard Nurse’s study found
no apparent link between lycopene consumption and fibroids.
So, yeah, fruits and at least green vegetables
may have a protective effect,
but we won’t know for sure until
they’re properly put to the test.
Vitamin D is another possibility
as to why African-Americans disproportionately
suffer from fibroids.
Women with darker skin are more likely
to be Vitamin D deficient;
as many as 80% of black women
may have inadequate levels of Vitamin D,
compared to only 1 in 5 white women.
Vitamin D does inhibit fibroid cell proliferation—
in a petri dish.
It may be able to shrink tumors in your pet rat,
but what about people?
A population study did find that women
with sufficient vitamin D levels
in their blood had about a third lower odds of fibroids,
consistent with the finding that women
who report lots of sun exposure
also appear to be protected,
but until there’s an interventional trial
where women are randomized to vitamin D or placebo,
we won’t know for sure if vitamin D
plays a role in fibroid prevention or treatment or not.
African-American women are also more likely
to sprinkle baby powder on their genitals,
which may not only double the odds of fibroids
but may increase the risk of ovarian cancer,
the deadliest gynecological cancer.
Internal memos show Johnson & Johnson knew
about the cancer risk, but still decided
to target African-Americans.
“Think of us”, Johnson & Johnson said,
“as a lifetime friend of the family,”
a lifetime cut short, perhaps,
by its baby powder,
or at least so said a jury,
which recently awarded a family $110 million in damages.
On top of the $200 million in verdicts from last year,
with thousands of lawsuits pending
after internal memos revealed that decades ago,
their own contracted toxicologists
were warning the company that there are multiple studies
showing a cancer link,
and anyone who denies this risk
will be perceived by the public in the same light
as those who denied a link
between smoking cigarettes and cancer:
“Denying the obvious, in the face
of all evidence to the contrary.”