Last week's blog about the link between Agent Orange and the likelihood of developing MGUS and myeloma clearly struck an emotional chord: many are concerned especially about the broader implications. Were others exposed? Are many people exposed to toxic chemicals? Is that what is really causing MGUS and myeloma? Are other chemicals producing similar toxic effects? How long ago can the exposure occur? Can early exposure pose a lingering threat? These and many more points emerged from reader responses.

A new report, a collective analysis or “meta-analysis,” published on September 14th in the journal Pediatrics extends the concerns to children. Home pesticide use increases the risk of childhood cancers, especially blood cancers such as leukemia and lymphoma. Daniel S. Wechsler, MD, PhD, a Duke University pediatric hematology-oncology specialist, comments that this is a carefully done study and raises a “smoking gun” about insecticide and herbicide exposure in childhood. The study, based upon data from 1993 to 2012, gives a contemporary look at the risks of exposure.

So why do I raise this point? The most important implication is that since these toxic chemicals are “fat-soluble” they stick around in the tissues for many years. There are children immediately susceptible, BUT there are those individuals who will develop problems later—such as MGUS and myeloma. The cumulative impact overtime is rarely considered in these types of studies and needs to be a new focus of additional research. The question is not just about later cancers, but later diseases of all sorts, such as neurological diseases, birth defects, autoimmune diseases, even allergies and many other medical issues that are emerging in our modern world.

Mark Bittman: A Farewell

And this brings me to my second follow-on note: Mark Bittman is retiring as contributing Op-Ed Writer for the New York Times, as he announced on Sunday, September 12th. After almost five years of chronicling concerns about food, Bittman will actually become involved with a new food company. This shift from writing to action is symbolic. There is only so much you can say. As he notes, he has focused on issues that largely remain unresolved—antibiotics and chemicals in food and drinks, agriculture and nutrition policies, and the environment—a  complex collection of vested interests.

For cancers such as myeloma, we are also at a turning point. We know that there are predisposing factors, dangerous exposures, trigger factors and more. It is time to have new efforts in the areas of causation, prevention, early diagnosis, and proactive interventions. Progress will take time, as Mark Bittman illustrates in the case of food! But starts must be made, projects created and funded to give our children a chance for a better future.

In the meantime, the tremendous strides toward much-improved myeloma therapies continue apace—wonderfully encouraging.

Let's embrace both approaches!

Keep your questions and comments coming to encourage actions that can make a difference.

Image of Dr. Brian G.M. DurieDr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.

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