Que nous arrive-t-il ? Une nouvelle menace, invisible, s’attaque à la santé humaine. Ce sont les perturbateurs endocriniens. Inconnus il y a 25 ans, ils mobilisent aujourd’hui des milliers de scientifiques à travers le monde qui cherchent à percer le secret de ces substances chimiques qui détraquent le système hormonal.
Bisphénol A, phtalates, pesticides, retardateurs de flamme… La liste est longue des produits d’usage courant qui renferment ces centaines de poisons, suspectés de favoriser cancers, diabète, obésité et autres maladies de la reproduction. Ils se trouvent dans l’air que nous respirons, les aliments que nous mangeons, l’eau que nous buvons, dans les habits et les cosmétiques que nous utilisons chaque jour. Un scandale autorisé par la réglementation, exploité par les industriels et toléré par les pouvoirs publics.
Pour la première fois en France, un livre fait le point sur la bombe sanitaire que constituent les perturbateurs endocriniens. Qui sont-ils ? Quand sommes-nous exposés ? Pourquoi sommes-nous si mal protégés ? Une révolution de l’espèce est en cours. Et elle se déroule dans l’ignorance et l’indifférence quasi générales.
Marine Jobert est journaliste, spécialisée dans les questions environnementales. François Veillerette, militant écologiste, est le porte-parole de l’association Générations futures. Ils ont publié ensemble Le Vrai Scandale des gaz de schiste en 2011.
Scientists are developing ways to edit the DNA of tomorrow’s children
” The fear is that germ-line engineering is a path toward a dystopia of superpeople and designer babies for those who can afford it. “
” You can do it. But there really isn’t a medical reason. People say, well, we don’t want children born with this, or born with that—but it’s a completely false argument and a slippery slope toward much more unacceptable uses. ”
” To some scientists, the explosive advance of genetics and biotech means germ-line engineering is inevitable. Ultimately, if the benefits seem to outweigh the risks, medicine would take the chance. ”
Adult women exposed to DES in utero had no evidence of large persistent changes in blood DNA methylation
2015 Study Summary
In utero exposure to Diethylstilbestrol (DES) has been associated with increased risk of adverse health outcomes such as fertility problems and vaginal as well as breast cancer. Animal studies have linked prenatal DES exposure to lasting DNA methylation changes. We investigated genome-wide DNA methylation and in utero DES exposure in a sample of non-Hispanic white women aged 40-59 years from the Sister Study, a large United States cohort study of women with a family history of breast cancer. Using questionnaire information from women and their mothers, we selected 100 women whose mothers reported taking DES while pregnant and 100 control women whose mothers had not taken DES. DNA methylation in blood was measured at 485,577 CpG sites using the Illumina HumanMethylation450 BeadChip. Associations between CpG methylation and DES exposure status were analyzed using robust linear regression with adjustment for blood cell composition and multiple comparisons. Although four CpGs had p<105, after accounting for multiple comparisons using the false discovery rate (FDR), none reached genome-wide significance. In conclusion, adult women exposed to DES in utero had no evidence of large persistent changes in blood DNA methylation.
Sources and Full Study
In utero exposure to diethylstilbestrol and blood DNA methylation in women ages 40-59 years from the sister study, NCBI, PMID: 25751399, March 2015.
Patients in the NHS are now receiving personalised care based on their DNA code. Two families have been diagnosed with rare conditions as part of a project at Newcastle Hospitals and University that used an analysis of their genomes – the complete set of people’s genes – to properly understand the health issues they are experiencing. They will now receive effective, personalised treatment, as well as helping prevent future generations who share their DNA from suffering a life of uncertainty about similar symptoms.
One hundred thousand genomes will be sequenced across the country, making the UK the world-leader in collecting and decoding human genomes to help scientists and doctors understand rare disease and design personalised treatments.
First drug fast-tracked to NHS patients under new scheme
The first drug to be approved through the Early Access to Medicine Scheme (EAMS) has been named as pembrolizumab, which is designed to treat patients with advanced melanoma. The treatment is considered a next generation drug in cancer care, stimulating the body’s immune system to fight the disease.
Green light for 2 proton beam therapy centres
The building of 2 proton beam therapy cancer treatment centres at University College London Hospitals NHS Foundation Trust and the Christie NHS Foundation Trust in Manchester will start this summer. Varian Medical Systems has been named as the equipment supplier for both, with Bouygues UK as the building contractor for UCLH and Interserve Construction Ltd at the Christie.
The government has invested £250 million in the facilities to give NHS patients a highly-targeted type of radiotherapy that can treat hard-to-reach cancers without causing damage to surrounding tissue or other side effects. The centres are expected to open for patients in 2018.
Review into medical innovation and technology gets under way
Find out more about the review chaired by Sir Hugh Taylor, Chair of Guy’s and St Thomas’s NHS Foundation Trust.
Secretary of State for Health Jeremy Hunt said:
” The breakthroughs that we are announcing today shows the UK and the NHS leading the world in genomic research, and will help ensure that people in our country will get the most advanced treatments, all underpinned by a strong economy.
The families that are receiving a first diagnosis have been given a fresh start, opening the door for new treatments for future generations with rare diseases.
We want the NHS and UK to be the best place in the world to design and discover 21st century medicines, which are boosting the economy and creating jobs across the country. That’s why our investment in the 100,000 Genome Project is so important. “
Professor Patrick Chinnery, Director of the Institute of Genetic Medicine at Newcastle University said:
” Patients of Newcastle Hospitals are the first to receive a diagnosis through whole genome sequencing by Genomics England, leading to changes in the treatment the NHS can offer their families. ”
Professor Mark Caulfield, Chief Scientist at Genomics England said:
” The 100,000 Genome Project are delighted to be returning our first diagnoses to families with rare disease from our whole genome sequencing. More will follow over the coming months. ”
Life Sciences Minister George Freeman said:
“ The explosion of biomedical innovation – whether in genomics, regenerative medicine or digital health is transforming 21st century medicine. But in recent years too many NHS patients have had to wait too long to access new treatments and slow uptake also threatens life science industry investment.
Today’s announcements show that the UK is now leading in the global race to accelerate access to medical innovations which are key to our economic health.
It’s working for our economy as well as NHS patients. The latest data shows that since we launched the UK Life Science Strategy we have attracted £3.5 billion of investment into the UK creating 11,000 jobs. ”
On proton beam therapy, Public Health Minister Jane Ellison said:
” The NHS is rising to the challenge on cancer – dealing with 700,000 more admissions this parliament compared to the last, while at the same time survival rates are rising to record levels.
We want NHS patients to have the very best care and treatment and today’s announcement brings us a crucial step closer to offering cancer patients proton beam therapy in the UK. “
The FDA looked for 31 different drugs in samples of milk from almost 2,000 dairy farms. About half of the farms — the “targeted” group — had come under suspicion for sending cows to slaughter that turned out to have drug residues in their meat. The other farms were a random sample of all milk producers.
Just over 1 percent of the samples from the “targeted” group, and 0.4 percent of the randomly collected samples, contained drug residues. An antibiotic called Florfenicol was the most common drug detected, but 5 other drugs also turned up. Perhaps most disturbing: none of the drugs that the FDA detected are approved for use in lactating dairy cows. ”
Sources and more information
MILK DRUG RESIDUE SAMPLING SURVEY, fda, March 2015.
FDA Tests Turn Up Dairy Farmers Breaking The Law On Antibiotics, npr, MARCH 08, 2015.
FDA’s Survey of Milk Finds Few Drug Residues, fda, March 5, 2015.
Questions and Answers: 2012 Milk Drug Residue Sampling Survey, fda, 03/05/2015.
Des millions de patients effectuent chaque année des examens de dépistage du cancer. Une prévention intensive qui laisse certains cancérologues sceptiques. Les cliniciens soulignent notamment les problèmes liés au surdiagnostic et au surtraitement ainsi que les risques inhérents aux techniques d’investigation employées.
Mammographie pour dépister le cancer du sein, coloscopie pour celui du côlon, dosage de l’antigène prostatique spécifique pour celui de la prostate et vaccin précoce pour celui du col de l’utérus : des campagnes d’information enjoignent régulièrement les Français comme les Allemands à se soumettre à ce type de contrôles. Mais des deux côtés du Rhin, nombre de médecins et de chercheurs doutent de l’efficacité de cette prévention et de la validité des statistiques publiées dans ce domaine. Les exemples les plus frappants qu’ils évoquent concernent le cancer du sein, le plus répandu chez les femmes (65 000 nouveaux cas en Allemagne et 50 000 en France chaque année) et celui de la prostate, son équivalent masculin. Mais les méthodes de dépistage du cancer colorectal ainsi que le traitement préventif de celui du col de l’utérus soulèvent aussi des réticences.
Likelihood that a woman with screen-detected breast cancer has had her “life saved” by that screening
2011 Study Abstract
Perhaps the most persuasive messages promoting screening mammography come from women who argue that the test “saved my life.” Because other possibilities exist, we sought to determine how often lives were actually saved by mammography screening.
We created a simple method to estimate the probability that a woman with screen-detected breast cancer has had her life saved because of screening. We used DevCan, the National Cancer Institute’s software for analyzing Surveillance Epidemiology and End Results (SEER) data, to estimate the 10-year risk of diagnosis and the 20-year risk of death–a time horizon long enough to capture the downstream benefits of screening. Using a range of estimates on the ability of screening mammography to reduce breast cancer mortality (relative risk reduction [RRR], 5%-25%), we estimated the risk of dying from breast cancer in the presence and absence of mammography in women of various ages (ages 40, 50, 60, and 70 years).
We found that for a 50-year-old woman, the estimated risk of having a screen-detected breast cancer in the next 10 years is 1910 per 100,000. Her observed 20-year risk of breast cancer death is 990 per 100,000. Assuming that mammography has already reduced this risk by 20%, the risk of death in the absence of screening would be 1240 per 100,000, which suggests that the mortality benefit accrued to 250 per 100,000. Thus, the probability that a woman with screen-detected breast cancer avoids a breast cancer death because of mammography is 13% (250/1910). This number falls to 3% if screening mammography reduces breast cancer mortality by 5%. Similar analyses of women of different ages all yield probability estimates below 25%.
Most women with screen-detected breast cancer have not had their life saved by screening. They are instead either diagnosed early (with no effect on their mortality) or overdiagnosed.
What is overdiagnosis?
What’s the problem with wanting to know if there’s a cancer or disease lurking in our bodies?
What’s the harm?
Can you give an example of testing that leads to overdiagnosis and overtreatment?
You’ve talked about health conditions defined by numbers, or benchmarks—like high blood pressure, high cholesterol, diabetes, and osteoporosis—numbers that distinguish between who’s healthy and who’s sick. Aren’t those numbers based on sound science?
Who benefits from overdiagnosis?
Why has there been so much emphasis on screening? Do you think it’s been driven by what the public wants—early warnings—or what the medical profession has imposed?
Would you advise patients who are offered testing for various conditions, based on family history or other indicators, to refuse the tests?
Fatty Acids in Fish May Shield Brain from Mercury Damage
Recent findings from research in the Seychelles provide further evidence that the benefits of fish consumption on prenatal development may offset the risks associated with mercury exposure. The study suggests that the nutrients found in fish have properties that protect the brain from the potential toxic effects of the chemical.
“We found no overall adverse association between prenatal MeHg exposure and neurodevelopmental outcomes. However, maternal PUFA status as a putative marker of the inflammatory milieu appeared to modify the associations of prenatal MeHg exposure with the PDI. Increasing DHA status was positively associated with language development yet negatively associated with the MDI. These findings may indicate existence of an optimal DHA balance with respect to arachidonic acid for different aspects of neurodevelopment.”
Sources and more information
Fatty Acids in Fish May Shield Brain from Mercury Damage, urmc, January 21, 2015.
Eating fish during pregnancy may boost baby’s development, not impair it, medicalnewstoday, 26 January 2015.
Prenatal exposure to methyl mercury from fish consumption and polyunsaturated fatty acids: associations with child development at 20 mo of age in an observational study in the Republic of Seychelles, American Society for Nutrition, ajcn.114.100503, March 2015.
Basket trials provide an innovative approach to clinical trials
In this video, Rita Porterfield, a patient with rare blood condition Erdheim-Chester disease, describes how she was successfully treated with a therapy typically used in patients with melanoma skin cancer. That’s because Rita had a mutation in the BRAF gene, also commonly mutated in patients with melanoma.
As her medical oncologist, David Hyman, explains, Rita received her treatment as part of an MSK basket trial. Basket trials provide an innovative approach to clinical trials. Unlike traditional trials, which test new treatments in patients according to their disease type (breast or lung cancer, for example), basket trials take advantage of advances in molecular oncology, offering new therapies to patients according to the genetic mutations discovered through specialized molecular testing.